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calv
05-11-2009, 05:40 PM
anyone have titers done on their child? DC had titers done for the MMR vax. Sounds like she's fully immune w/out getting a second shot. Yet at the same time the nurse wasn't sure on what the numbers meant.

TIA!

bobeNC
05-11-2009, 06:14 PM
Just curious, why were titers done and how long since the first vaccine was given? How old is your DC? I believe schools require two MMRs prior to starting. Typically one is given between 12-15 months and the second between 4-6 years and titers are not done.

JBaxter
05-11-2009, 06:28 PM
maryland requires 2 measles 1 mumps and 1 rubella. Something like 96% of children get "full immunization status" after 1 vaccination.

o_mom
05-11-2009, 06:35 PM
Just curious, why were titers done and how long since the first vaccine was given? How old is your DC? I believe schools require two MMRs prior to starting. Typically one is given between 12-15 months and the second between 4-6 years and titers are not done.

An alternative to getting two doses to to have titers checked after the first dose. The second dose is not a "booster", but meant to catch the approx 3% of people who do not respond to the first dose. A positive MMR titer after one dose is considered proof of immunity by the CDC. School requirements will many times allow for this and if not, there are exemptions available in many states.

To the OP: The test results should come back as immune or not immune, along with a numerical result. As long as the test shows "immune", the numerical result isn't really important.

calv
05-11-2009, 07:03 PM
maryland requires 2 measles 1 mumps and 1 rubella. Something like 96% of children get "full immunization status" after 1 vaccination.

yes, this exactly. Many children are already immune to the first MMR shot so no need to have a 2nd MMR. Schools accept the titer/immune result hence the 2nd shot isn't needed.

calv
05-11-2009, 07:04 PM
An alternative to getting two doses to to have titers checked after the first dose. The second dose is not a "booster", but meant to catch the approx 3% of people who do not respond to the first dose. A positive MMR titer after one dose is considered proof of immunity by the CDC. School requirements will many times allow for this and if not, there are exemptions available in many states.

To the OP: The test results should come back as immune or not immune, along with a numerical result. As long as the test shows "immune", the numerical result isn't really important.

thanks. The nurse was telling me DC is immune yet she had no clue what the numbers meant. Go figure. She said DC is due for the 2nd MMR shot, I just rolled my eyes over the phone and I'll wait for the Pedi to call me back to confirm :)

kayte
05-11-2009, 07:06 PM
Schools accept the titer/immune result hence the 2nd shot isn't needed.

It does matter where you are. We are planning on having it done too, but here in Texas we will have to site religious/conscience objections to get out of the second (full strength) dosing. But some states will just accept the test results.

billysmommy
05-11-2009, 07:30 PM
maryland requires 2 measles 1 mumps and 1 rubella. Something like 96% of children get "full immunization status" after 1 vaccination.

Massachusetts has the same requirement

DrSally
05-11-2009, 10:19 PM
anyone have titers done on their child? DC had titers done for the MMR vax. Sounds like she's fully immune w/out getting a second shot. Yet at the same time the nurse wasn't sure on what the numbers meant.

TIA!

When the time comes for DS to get his MMR "booster", I plan on asking for titers to see if we can avoid the 2nd shot. If the nurse didn't know how to interpret the numbers, I would ask her to ask the ped, they should know.

JBaxter
05-11-2009, 10:36 PM
Its not a booster its a 2nd MMR.

DrSally
05-11-2009, 10:37 PM
Its not a booster its a 2nd MMR.

That's why I put "booster" in quotes. Most people refer to it still as a booster eventhough it is just a 2nd MMR vax. I was being a bit facteious

KrisM
05-11-2009, 11:20 PM
How bad was getting the titers checked? I'd like to do that for DS, but am unsure if he'll cooperate.

o_mom
05-12-2009, 06:56 AM
How bad was getting the titers checked? I'd like to do that for DS, but am unsure if he'll cooperate.

It's a regular blood draw from the arm. It has not been an issue for mine, but YMMV obviously. I held them on my lap and the tech used a butterfly needle (smaller, easier for kids). Lots of distraction and talk of stickers and McDonald's for after (a rare treat here). Much easier than a finger stick for us. We have had several blood draws on each child for lead levels so we've had practice and just piggybacked onto a blood draw that was happening anyway.

JMS
05-12-2009, 08:09 AM
nak..

i just asked my ped about titers (DD has had 1 MMR less than a yr ago) & she told me that her titers would come back showing immunity. She told me that the reason for the 2nd MMR is more b/c the immunity would eventually wear off w/ only 1 dose. Any thoughts on this theory?

o_mom
05-12-2009, 08:13 AM
nak..

i just asked my ped about titers (DD has had 1 MMR less than a yr ago) & she told me that her titers would come back showing immunity. She told me that the reason for the 2nd MMR is more b/c the immunity would eventually wear off w/ only 1 dose. Any thoughts on this theory?

Your ped needs to refresh her memory. ;)

http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/mmr/faqs-mmr-hcp.htm#users

"Why is a second dose of MMR necessary?
About 2%-5% of persons do not develop measles immunity after the first dose of vaccine. This occurs for a variety of reasons. The second dose is to provide another chance to develop measles immunity for persons who did not respond to the first dose."
...
"The second dose is not a "booster"; it is intended to produce immunity in the small number of persons who fail to respond to the first dose."

calv
05-12-2009, 09:11 AM
so if DD is 'immune' to the MM&R will she eventually need another vax?

how about other titers? What have you had checked on your DC besides titers for MMR?

TIA!

o_mom
05-12-2009, 09:23 AM
so if DD is 'immune' to the MM&R will she eventually need another vax?

how about other titers? What have you had checked on your DC besides titers for MMR?

TIA!

From a health perspective, she should not need another one. The CDC ACIP is very clear that response to the first one provides lifelong immunity. However, the requirements of schools, employers, etc., do not always follow CDC guidelines and there are times that they won't accept the titers in place of a documented second dose. For schools (including college) a religious waiver can be used to meet the requirement, but employers do not always accept this. If she should choose a career in healthcare later, it is possible her employer could insist on another dose.

tnrnchick74
05-12-2009, 12:08 PM
I had my MMR titer checked as part of my prenatal/early OB testing done to see if I was immune to rubella. Funny thing was that I had jsut recently started a job (RN) where the MMR titer is common practice...and THAT test came back an non-immune to rubella and they called me back in for a MMR booster...the OB's lab test showed I WAS immune to rubella, so he sent his lab tests to the hospital occupational health.

Tanya
05-12-2009, 12:57 PM
I had titers done for MMR for my first daughter instead of getting the 2nd shot and she was immune. I will warn you that MY insurance did NOT cover titers and it was something like $600 which I think is soooo wrong. They'd totally pay for an unnecessary shot though. Anyway, hubby's employer gives us so much money in a health reimbursement account and luckily we were doing well medically that year (unlike this year when I've already used it all and then some for infertility), so the HRA covered it.

Titer testing is just testing the antibodies, so they just take some blood. My older daughter is a screamer, so it took a couple people to hold her down, but that's true for shots as well.
My younger daughter had blood taken for lead testing and she sat on my lap and didn't flinch or make a sound. She cried when she got vaccinations though.
In my opinion, shots are more painful than having blood taken and I go through both regularly.

I plan on having titers done before giving a second chickenpox shot as well. If she'd ever been around anyone with chickenpox, I would have done the titer before the first shot, but EVERYONE vaccinates for everything around here. I only knew of someone with chickenpox when my daughter was a newborn and I wasn't willing to expose her at that point.

Oh, and my pediatrician just filled out my daughter's school vaccination chart for both MMR's (one was titer date) without any questions and the school never questioned any of it either. We're in Indiana. I never had to do any exemptions, but I also didn't question it beforehand or make a big deal of it.

DrSally
05-12-2009, 12:58 PM
Interesting, Turnchick. I had mine tested before I went on a trip overseas in gradschool. It came back immune. Then, many years later, I had it tested again as part of my prenatal checkup. It came back borderline for Rubella. The OB said told the hospital not to give me another MMR post-delivery. I didn't discuss his reasoning with him, but I assume it's b/c after a certain point, more MMR's aren't goint to improve your immunity. I think I had already had at least 3 in my lifetime--the first 2 in childhood and then another before going overseas after college, possible even one before I was adopted.

DrSally
05-12-2009, 01:00 PM
Tanya, good point on the insurance. I'll make sure to check that when the time comes for us. I've only heard of doing titers for the MMR (to avoid the 2nd shot if not needed), not the varicella vax. Can you tell me more about that one?

o_mom
05-12-2009, 02:54 PM
Tanya, good point on the insurance. I'll make sure to check that when the time comes for us. I've only heard of doing titers for the MMR (to avoid the 2nd shot if not needed), not the varicella vax. Can you tell me more about that one?

I'm not sure how the varicella one works - both DS1 and DS2 have had CP, even though DS1 was vaccinated for it. Since the CP vax is known to wear off, I'm not sure if the titer would really cover them for life like the MMR titer does. I haven't had to deal with it yet as DS3 isn't of school age and DS1 & 2 don't have to have it. ETA: Our insurance covered it without issue, but it is certainly wise to check ahead of time.

lablover
05-12-2009, 03:55 PM
My DD had titers tested for varicella because she was diagnosed with a probable case of CP when she was around 12 mo old. I was hoping she had immunity and I could avoid the shot. I began to second guess the CP diagnosis when she developed a similar rash the next year. She was tested last winter and she does not have immunity. My DD did very well with the blood draw, we also tested her lead and iron levels at the same time. She has to get blood draws for her food allergies too. I think the expertise of the person drawing the blood factors into it also. Like PP said, I don't think you can use a varicella titer as a substitute for the booster. Our state only requires one varicella vaccination for school though.

o_mom
05-12-2009, 04:16 PM
My DD had titers tested for varicella because she was diagnosed with a probable case of CP when she was around 12 mo old. I was hoping she had immunity and I could avoid the shot. I began to second guess the CP diagnosis when she developed a similar rash the next year. She was tested last winter and she does not have immunity. My DD did very well with the blood draw, we also tested her lead and iron levels at the same time. She has to get blood draws for her food allergies too. I think the expertise of the person drawing the blood factors into it also. Like PP said, I don't think you can use a varicella titer as a substitute for the booster. Our state only requires one varicella vaccination for school though.

Yes, the more I think about it, the more sense this makes. If your DC tested immune to varicella before having the vaccine, that would mean that he/she had CP and therefore does not need the varicella vaccine. Testing positive after one dose of the vaccine, however, would not be enough to show long-term immunity.

DrSally
05-12-2009, 04:36 PM
My DD had titers tested for varicella because she was diagnosed with a probable case of CP when she was around 12 mo old. I was hoping she had immunity and I could avoid the shot. I began to second guess the CP diagnosis when she developed a similar rash the next year. She was tested last winter and she does not have immunity. My DD did very well with the blood draw, we also tested her lead and iron levels at the same time. She has to get blood draws for her food allergies too. I think the expertise of the person drawing the blood factors into it also. Like PP said, I don't think you can use a varicella titer as a substitute for the booster. Our state only requires one varicella vaccination for school though.

Ah, that makes sense if you think they've been exposed to CP to check ahead of getting the vax. DS has had blood draws for allergies too. The first was a horrible nightmare, but that's b/c he was younger and there were 2 inexperienced techs trying to get the draw and basically restraining him while blocking my view of him/him of me. DH had him on his lap. The 2nd time, it was just DS on my lap, I whispered in his ear the whole time and he didn't even cry. The tech was much better and she said DS was listening to me/focusing on my voice the whole time. I agree that the skill of the tech makes a big difference on blood draws.

DrSally
05-12-2009, 04:39 PM
Your ped needs to refresh her memory. ;)


:yeahthat:

Tanya
05-14-2009, 04:45 PM
It's been awhile since I discussed this with our pediatrician, but I'm pretty sure he said that the 2nd dose of Varicella is also NOT a "booster", but just giving the same vaccine again to cover those that didn't get immunity the first time. That's why we decided to titer test.

And in case anyone is interested, for my daughter's MMR Titer,
the billed amount was $867.85
network discount was $43.41
paid by plan was $361.92
and applied to deductible was $462.52 (what we owed)

I had no idea it would be that expensive and never even gave it a thought since the vaccines have always been 100% covered. So for future Titers (yes, I will still do them), I will have to make sure we will have money in our HRA to cover them...so it can't be a year we're doing fertility treatments or I'm giving birth or someone has to have surgery or whatever. Ha ha ha.




Hope this helps....

How effective is this vaccine?
The first dose of MMR vaccine produces immunity to measles in 95-98% of children vaccinated. The reason for the second dose is to protect those persons who did not become immune after one dose. After two doses of measles vaccine, 99% of persons become immune to the disease.



How effective is this vaccine?
Seventy-nine percent of children between age 12 months and 12 years develop immunity to the disease after one dose of vaccine. For older children and adults, an average of 78% develop immunity after one dose and 99% develop immunity after the recommended two doses.

Although some vaccinated children (about 2%) will still get chickenpox, they generally will have a much milder form of the disease, with fewer blisters (typically fewer than 50), lower fever, and a more rapid recovery.