Question about MMR vaccination

[def1]

So the school I have been accepted to requested titers for measles, mumps and rubella. My mumps titer came back negative. On the school documentation it says that for Mumps proof of immunity determined by serological titer OR documentation of 2 doses of MMR are required. Well I have documentation of the 2 doses of MMR from when I was 1 and 5 years old. I called to ask if those 2 doses were good or not and they told me that I needed an additional 2 doses of MMR to be able to register for classes.

Does that seem correct to you guys? I would think at most I would need a booster shot, but not an additional 2 doses. Its going to end up costing me 110 dollars for both. Have any of you been in this situation before. I guess I really don't have a choice but I'm not really looking forward to getting 2 shots and spending that much money.

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[willen101383]

The school told you what their requirements are. Get ready for 4 years of being a ***** and ordered around. I dont know how many background checks/drugscreens/vaccs, Ive gotten thus far for different rotation sites. Its part of being a med student.

 

[Mt Kilimanjaro]

Ask the school.

 

[DAPI]

Do schools care if the titers are a few years old or do they have to be like in the last year or something?

 

[Mt Kilimanjaro]

Do schools care if the titers are a few years old or do they have to be like in the last year or something?

Ask the school(s).

 

[DAPI]

Ask the school.

Ask the school(s).

Yeah, we get it, we should ask the school to be sure, but there are probably people out there that can at least give us a heads up about their experienc

 

[thesauce]

The school told you what their requirements are. Get ready for 4 years of being a ***** and ordered around. I dont know how many background checks/drugscreens/vaccs, Ive gotten thus far for different rotation sites. Its part of being a med student.

Absolutely agree. OP: this is a battle you cannot win. You will need to get the boosters if you cannot prove immunity through titers. You will have to jump through similar hoops for each hospital you rotate at, including any away rotations you choose to do. Make sure you have a central place where all your vaccination records are kept so you can arrange them to be sent as the need arises.

 

[Mt Kilimanjaro]

Yeah, we get it, we should ask the school to be sure, but there are probably people out there that can at least give us a heads up about their experienc

You could have called the school and got a definitive answer in the time it took to write that response.

Their experience at another school is not relevant to yours.

 

[DAPI]

You could have called the school and got a definitive answer in the time it took to write that response.

Their experience at another school is not relevant to yours.

False, its past 5pm on the East Coast and the receptionist is unlikely to know the answer to this question anyways requiring a transfer, a message machine, and a returned phone call in a few days...

 

[mimelim]

absolutely agree. Op: This is a battle you cannot win. You will need to get the boosters if you cannot prove immunity through titers. You will have to jump through similar hoops for each hospital you rotate at, including any away rotations you choose to do. Make sure you have a central place where all your vaccination records are kept so you can arrange them to be sent as the need arises.

+1

 

[def1]

Absolutely agree. OP: this is a battle you cannot win. You will need to get the boosters if you cannot prove immunity through titers. You will have to jump through similar hoops for each hospital you rotate at, including any away rotations you choose to do. Make sure you have a central place where all your vaccination records are kept so you can arrange them to be sent as the need arises.

Yeah this seems to be the unfortunate truth.

 

[PTPoeny]

Wait for the fun of applying for away rotations...

Trust me, different schools have different requirements. Some will accept documentation of childhood vaccination, others want titer testing and others want quantitative titers. I'm also old enough that I had chickenpox and one place that was okay with documentation of vaccinations was not okay with documentation of disease. Between originally matriculating to medical school, applying 3 places for aways and now verifying my vaccination status for residency I jumped through 5 slightly different hoops. I think the only way that asking on here will help OP is if someone from their own school replies.

And school requirements do not have to match up with CDC recs or any form of reason or logic. They can ask for whatever they want.

 

[Arbor Vitae]

Absolutely agree. OP: this is a battle you cannot win. You will need to get the boosters if you cannot prove immunity through titers. You will have to jump through similar hoops for each hospital you rotate at, including any away rotations you choose to do. Make sure you have a central place where all your vaccination records are kept so you can arrange them to be sent as the need arises.

just out of curiosity, what do you have to go through when it comes time to be licensed? Do they review your entire medical record or something?

 

[anguisette]

My measles titer came back negative. I got a single MMR shot and now my titer shows that I'm reactive for measles. Maybe you can do one shot and redo the titer?

 

[Arbor Vitae]

My measles titer came back negative. I got a single MMR shot and now my titer shows that I'm reactive for measles. Maybe you can do one shot and redo the titer?

I think that's called a booster. That's all OP should need to do. My HepB surface Ab was nonreactive so I have to do the whole series again.

 

[thesauce]

just out of curiosity, what do you have to go through when it comes time to be licensed? Do they review your entire medical record or something?

As far as I'm aware, they don't require any medical record information for licensure. State medical boards verify your education, criminal background, etc. It's up to the individual hospitals what they want in terms of vaccinations. After all, some docs don't even practice medicine.

 

[dsoz]

According to http://www.ohsu.edu/xd/education/st...ss-center/upload/New-Student-Requirements.pdf the only ones that are time sensitive are Tetanus (last 10 years) and Tuberculosis (2 negative results in the last 12 months). I have the feeling that most schools will be really similar.

Before I was accepted at OHSU, I was looking into the vaccine requirements for Nova and COMP-NW. The COMP requirements were about the same as OHSU, and the Nova ones wanted the TB test done right before classes started so it was good all year long. If you go more than 12 months, you need to get it done again (and, I think, stop your clinical activities while you wait for the results).

dsoz

 

[music2doc]

So the school I have been accepted to requested titers for measles, mumps and rubella. My mumps titer came back negative. On the school documentation it says that for Mumps proof of immunity determined by serological titer OR documentation of 2 doses of MMR are required. Well I have documentation of the 2 doses of MMR from when I was 1 and 5 years old. I called to ask if those 2 doses were good or not and they told me that I needed an additional 2 doses of MMR to be able to register for classes.

Does that seem correct to you guys? I would think at most I would need a booster shot, but not an additional 2 doses. Its going to end up costing me 110 dollars for both. Have any of you been in this situation before. I guess I really don't have a choice but I'm not really looking forward to getting 2 shots and spending that much money.

You need to get the MMR series as they have told you. Why would you even ask this question? Don't be stupid, just do it.... If they are making you pay, see about getting a summer job at the hospital and the hospital will likely foot the bill as this is generally standard protocol when they discover the immunization apparently didn't hold.

 

[Arbor Vitae]

You don't want to be getting sued for infecting somebody later on down the road.

 

[magicm]

They likely want two does since the mmr vaccine (like many) requires multiple doses for long lasting immunity and its possible that the first time around (as a kid) you fell into that tiny category of people who didn't develop antibodies from the vaccine. This basically covers their ass and yours

 

[def1]

I ended it up getting it settled.

The Dean informed me that the two shots I already have were sufficient. So I guess it never hurts to ask.

 

[Arbor Vitae]

I ended it up getting it settled.

The Dean informed me that the two shots I already have were sufficient. So I guess it never hurts to ask.

seems risky, what school is this so I know not to go to their hospital?

 

[anguisette]

I ended it up getting it settled.

The Dean informed me that the two shots I already have were sufficient. So I guess it never hurts to ask.

And then you'll go get new shots when you have health insurance... right?

 

[dietitiantodoc]

And then you'll go get new shots when you have health insurance... right?

just because it doesn't show up in the titer doesn't mean he/she doesn't have immunity. I have worked in tons of hospitals and documentation of many vaccinations is sufficient even if the titer comes back negative. The sample of blood they take is so small comparatively and antibodies aren't present in huge concentrations in the blood.

 

[anguisette]

just because it doesn't show up in the titer doesn't mean he/she doesn't have immunity. I have worked in tons of hospitals and documentation of many vaccinations is sufficient even if the titer comes back negative. The sample of blood they take is so small comparatively and antibodies aren't present in huge concentrations in the blood.

But is there another way to show immunity?

I don't claim to know anything about the lower limit of quantitation of these titers or what concentration level needs to be in your blood, but if there's a chance that the vaccination didn't take, why not just get another shot and new titers for peace of mind?

 

[def1]

seems risky, what school is this so I know not to go to their hospital?

They told me that based on CDC guidelines.

Also I found this

How would I follow up with a new healthcare worker (HCW) who has 2 documented doses of measles-mumps-rubella (MMR) vaccine but whose serologic testing doesn't show immunity to one of these diseases? (Taken from August 2010 Needle Tips)
Two documented doses of MMR vaccine is considered proof of immunity according to ACIP. However, what ACIP recommends is not
always what schools and institutions accept. Here are some basics about MMR vaccination and healthcare personnel.
1. ACIP considers receipt of 2 documented doses of MMR vaccine, given on or after the first birthday and separated by at least 28 days, to be proof of immunity to measles, mumps, and rubella. No serologic testing is required or recommended to confirm immunity in this instance.
2. If a HCW does not have any documented doses of MMR, he or she can (1) be tested for immunity or (2) just be given 2 doses of MMR at least 4 weeks apart. If the testing option is used, and the test indicates that the HCW is not immune to one or more of the vaccine components, the HCW should receive 2 doses of MMR at least 4 weeks apart. Note that a test finding of an "indeterminate" or "equivocal" level of immunity indicates that a HCW who lacks 2 documented doses of MMR vaccine be considered nonimmune. Also note, that ACIP does not recommend serologic testing after vaccination.
3. ACIP does not routinely recommend more than 2 doses of MMR vaccine. A negative serology after 2 documented doses probably represents a false negative (i.e., antibody titer is too low to detect with commercial tests). If a healthcare setting relies on post-vaccination testing to determine immunity, a negative serology can erroneously indicate that a HCW needs additional doses. Remember, ACIP does not recommend routine serologic testing after MMR vaccination.
For more information, see ACIP's recommendations on the use of MMR at www.cdc.gov/mmwr/PDF/rr/rr4708.pdf.

http://www.immunize.org/askexperts/experts_mmr.asp

 

[def1]

And then you'll go get new shots when you have health insurance... right?

I have health insurance, but it wasn't covered because its not recommended by CDC. Thats the whole reason I started asking questions.

 

[Arbor Vitae]

They told me that based on CDC guidelines.

Also I found this


http://www.immunize.org/askexperts/experts_mmr.asp

i see, i was mainly just joking

 

[Gauss44]

So the school I have been accepted to requested titers for measles, mumps and rubella. My mumps titer came back negative. On the school documentation it says that for Mumps proof of immunity determined by serological titer OR documentation of 2 doses of MMR are required. Well I have documentation of the 2 doses of MMR from when I was 1 and 5 years old. I called to ask if those 2 doses were good or not and they told me that I needed an additional 2 doses of MMR to be able to register for classes.

Does that seem correct to you guys? I would think at most I would need a booster shot, but not an additional 2 doses. Its going to end up costing me 110 dollars for both. Have any of you been in this situation before. I guess I really don't have a choice but I'm not really looking forward to getting 2 shots and spending that much money.

If you are not immune, you should get the boosters. I think I saw on the news that there have been some mumps cases around Massachusetts lately. Better not to chance it.

You can always get a second opinion if you think they did the titer wrong.