What happens if I keep testing negative for hep b titers? Getting annoyed with these damn vaccines.

[Ancient_Eldritch]

I'm an entering med student in fall 2016 and am seriously getting annoyed with all these vaccinations and titers. I'm in a very rural community so I have to drive two hrs either way to do any of this, so that makes matters more complicated, but is it just me or is this vaccine/testing handled in pretty much the worst and most annoying way possible?


I mean, for example, I'm doing the 1-week tb requirement, which means I have already done the 48 hr 2 step TB test once, and now I just completed the first step of the second 48 hr 2 step TB test, and have to come in again in 48 hrs so I can satisfy the 1-week requirement. It's pretty ****ing ridiculous that I have to do this every year. Why don't they just give us TB vaccinations, so we don't have to keep doing this over and over again? It just seems so unnecessarily complicated, especially since I'm driving 2 hrs and getting billed for something that should be possible to read by sending the doc a picture.

As for the main issue: I have had the hepatitis B vaccination 3 times when I was a kid and I just had blood my drawn and it turned out I tested negative for the titer. Because of this I have to do the entire hep-b vaccination series again and another titer. This whole process is going to take about 4 months, so what happens if I get a negative titer again?

This is getting so annoying and ridiculous. I really hope it's a lot easier to do this stuff in medical school bc this is getting to be a serious pain in the butt.

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[mvenus929]

The BCG vaccine is the only vaccine we have against tB, and we don't give it because it sucks. So there is no good TB vaccine, which is why the healthcare field is so particular about TB testing.

Also, you can't read a TB test by looking at it. You have to be able to feel it. I think it's ridiculous that you can't find someone closer to you to read it, but sending a picture is not the answer.

 

[Ancient_Eldritch]

The BCG vaccine is the only vaccine we have against tB, and we don't give it because it sucks. So there is no good TB vaccine, which is why the healthcare field is so particular about TB testing.

Also, you can't read a TB test by looking at it. You have to be able to feel it. I think it's ridiculous that you can't find someone closer to you to read it, but sending a picture is not the answer.

That makes sense =/. I figured doing the BCG would be at least a little bit better bc we wouldn't have to do that test every year from what I understand though the test to verify you have it is pretty expensive. Do most places require the 1 week TB test? Meaning you have to do the test twice.

As for hep-b, at least for me it doesn't seem any better than the TB vacc. I got 3 time vacc when I was a kid, and I still didn't have the antibodies in the titer.

 

[Psai]

Some people don't seroconvert for hep b. You just need to have documentation that you have had the full series

 

[Ancient_Eldritch]

Some people don't seroconvert for hep b. You just need to have documentation that you have had the full series

Unfortunately, the med school said I needed to do the full series again, so that's what I'm doing now .

 

[sloop]

If the PPD testing is a pain in the ass for you, splurge for the interferon gamma release assay. You'll have to go to a lab (which may or may not be further than your doc), but you don't need the repeat visit.

The BCG vaccine mainly just provides some protection against tuberculous meningitis. It's not really effective at preventing pulmonary disease and the U.S. is not an endemic region so the NNT would be ridiculous. It can also cause some problems with reading PPD results. As such, it's not routinely used here.

 

[Smurfette]

1. It is not unusual for your hepB titers to be too low. Happened to me as well but I converted after 5 immunizations. If you don't convert after getting the whole series repeated, then you'll probably get a waiver.

2. Did you ask the school if some of this could wait until you actually start next year since it's a hardship for you? You'll need a new Tb test next year anyhow and it would probably be free through your school to get everything done; most schools and hospitals try to PPD test all their employees at the same time every year. A sizable number of people in my class were sent to health services during the first week or two to get everything that was not already done taken care of (myself included) and it was not a big deal.

3. Keep copies of any titers, PPD results, etc that you have. When changing jobs in the future, you may need to provide your records so keeping them on file will make things easier going forward.

4. Reading your own PPD is a huge no-no. And as someone else said, it needs to be FELT, not just looked at for redness. There's really no one closer than 2 hours away that can read a PPD? As for the 2-step/1 week one, some places require that to be done, but not all....I had that done for my residency program when I first started so now I just need the usual 48 hr one done yearly at the places I've worked at since. AFAIK, most places will not make you repeat the 2-step version if you show proof you had it done once in the past with negative results.

5. Listing your status as "med student" when you are not (yet) is misleading. There is an option for "med student (accepted)" if you object to being called a "pre med".

 

[sloop]

5. Listing your status as "med student" when you are not (yet) is misleading. There is an option for "med student (accepted)" if you object to being called a "pre med".

To be fair, if I was this concerned about not misleading people about what I do, I would introduce myself as "the dude who puts notes in charts and updates sign-out."

 

[Smurfette]

To be fair, if I was this concerned about not misleading people about what I do, I would introduce myself as "the dude who puts notes in charts and updates sign-out."

Hey, it's SDN...people get very uptight about users listing the right status, especially if doling out advice to others (even if that's not the case in this thread)!

 

[Ancient_Eldritch]

Hey, so I have another question. Is it REALLY necessary for me to do another full series of hep b vaccines after I failed the titer? I got another hep b vaccine, but I'm thinking that if I'm resistant then I'd get the same results regardless of whether not I get the whole series or just one. That'd save me a ton of time. Is that correct? Also, if I'm not resistant to the hep b vacc, wouldn't a titer a month after one vaccination be enough to conclude that?

 

[xanybar]

Maybe get the disease?
Too bad those county doctors or country doctors are probably third world doctors, if they don't know that some people don't respond to immunizations...

 

[Goro]

I believe that something like 20% of people are non-responders to the vaccine trio the first time around. You should be fine with the second round. Go chat up your Immunology or Micro profs to get the exact numbers.

I'm an entering med student in fall 2016 and am seriously getting annoyed with all these vaccinations and titers. I'm in a very rural community so I have to drive two hrs either way to do any of this, so that makes matters more complicated, but is it just me or is this vaccine/testing handled in pretty much the worst and most annoying way possible?


I mean, for example, I'm doing the 1-week tb requirement, which means I have already done the 48 hr 2 step TB test once, and now I just completed the first step of the second 48 hr 2 step TB test, and have to come in again in 48 hrs so I can satisfy the 1-week requirement. It's pretty ****ing ridiculous that I have to do this every year. Why don't they just give us TB vaccinations, so we don't have to keep doing this over and over again? It just seems so unnecessarily complicated, especially since I'm driving 2 hrs and getting billed for something that should be possible to read by sending the doc a picture.

As for the main issue: I have had the hepatitis B vaccination 3 times when I was a kid and I just had blood my drawn and it turned out I tested negative for the titer. Because of this I have to do the entire hep-b vaccination series again and another titer. This whole process is going to take about 4 months, so what happens if I get a negative titer again?

This is getting so annoying and ridiculous. I really hope it's a lot easier to do this stuff in medical school bc this is getting to be a serious pain in the butt.

Unfortunately, the med school said I needed to do the full series again, so that's what I'm doing now .