Nurses: what do you do?

[snuffles]

I'm starting nursing school in this coming fall. I cannot decide what to do about the Hep. B vaccine. I can sign a waiver. I'm breastfeeding my 21 mo. (who has never had any vax)

[CanidFL]

I think it’s a risk/benefit analysis you will have to do for your family.

I know that working with patients in a hospital setting is higher risk then sitting at a desk in corporate America.

I have been thinking a lot about this too since I am going back to midwifery school soon. I think I will get a booster (I got the 3 shot series when I was 14) although I won’t be breastfeeding at the time. I really need to do more research though since HepB hasn’t been on my radar much.

[Redheaded_Momma]

I had the HepB series in nursing school. I didn't know any better at the time However your chance of exposure is much greater than the normal population. I don't think I would do it while BF but would consider getting the series once DC is weaned.

[kate3]

I would give serious consideration to getting the Hep B series prior to any contact with patients.

I have been a nurse for almost 20 years. The one thing that you need to be aware of is that situations can be unpredictable, escalate, and become dangerous quickly. Even "perfect" universal precautions will not protect against a bite or needlestick.

I would also check about whether or not you will be allowed to do clinicals without the Hep B series. Although the school allows a waiver, the hospital may not and could refuse you.

[ErinsJuneBug]

I had to do it - as well as get a PPD every year. I tried to get out of it, but basically the contract the school has with the hospital requires each student to have these vaccines. Im also breastfeeding (she is almost 3) so there will be atleast be 1 more PPD i have to get before i graduate.

I really struggled with this - but at the end of the day i feel that finishing nursing school is in the benifit of our family. I hate that my daughter might get some toxins via breastmilk, but i try and weigh the risk with the fact that SHE hasnt had vaccines, and its better for her to breastfeed then not.

Once i am actually a nurse i think it'll be easier to refuse vaccines when employeed (especially if i am in a union). Also depending on where i work i would consider getting more vaccines in the future. (ie - last semester i was on a liver transplant floor and was glad i had gotten the Hep B vaccine/ and right now i am on a floor that has a lot of TB patients so i will have no problem getting another PPD in a few months).

[mamakay]

I lean to the non-vax side, but I'd get the HepB series if I were a nurse.

[WaitingForKiddos]

I got the series when I was teaching and exposed to kids at high risk for Hep B. Teaching and nursing are jobs where you'll be exposed to poop and blood.

[columbusmomma]

Originally Posted by mamakay

I lean to the non-vax side, but I'd get the HepB series if I were a nurse.

Me too, and I did!

[snuffles]

I appreciate the input. So, it *is* okay for me to get the vaccine although my ds has not had the vaccine? And, is Hep. B one of those diseases that I can get the vax for, be exposed to, and yet still pass it on to other people? Am I mistaken, or have I heard of this happening with other diseases (like whooping cough)?

Just to play devil's advocate, what about other viruses--like HIV and Hep C? There is no vaccine for HIV and Hep C is not one of the vaxes required. What is the protocol if you're stuck and the patient is infected with one of these viruses? Why can't I follow the same protocol if I'm stuck, or bitten by a patient with Hep B? And, is Hep B is more common?

[applejuice]

I was a daycare provider and I changed diapers. This exposed me to poop and pee, and any vaccine that the baby got within a month. I have never got a vaccine.

[prairiechild]

I would investigate whether there is mercury in the vaccine. If there is, you would pass it on to your baby. See if there is a mercury free brand available. If not, I would at least wait until you are done breastfeeding.

You will definitely be pushed to get the flu vacc later on. I no longer take that one. The standard brand has mercury and really doesn't protect very well.

[prairiechild]

This says the engerix b does not have a preservative.
http://us.gsk.com/products/assets/us_engerixb.pdf

I am thinking that is correct as I can only recall hep b vacc in single dose vials. I don't think they use mercury in single dose vials.

[mamakay]

Originally Posted by snuffles

I appreciate the input. So, it *is* okay for me to get the vaccine although my ds has not had the vaccine? And, is Hep. B one of those diseases that I can get the vax for, be exposed to, and yet still pass it on to other people? Am I mistaken, or have I heard of this happening with other diseases (like whooping cough)?

Just to play devil's advocate, what about other viruses--like HIV and Hep C? There is no vaccine for HIV and Hep C is not one of the vaxes required. What is the protocol if you're stuck and the patient is infected with one of these viruses? Why can't I follow the same protocol if I'm stuck, or bitten by a patient with Hep B? And, is Hep B is more common?

If the HepB shot "works", it should prevent transmission, I think.

I looked into it a while back, and HepB is a little more common and contagious for HCWs than HepC and HIV.
Here's the CDC's recommendations on post-exposure prophylaxis:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm

The reason I'd do the shot as opposed to Ig upon exposure is that I personally think the vaccine is safer than the Ig. They can only screen the donors for known viruses, and they're always discovering new viruses that do horrible things.

[Amila]

I had 2 of the shots in the series back in college before I knew anything. Then I started working as a deputy coroner. I never got the third shot because they told me I would have to restart the whole series...but it was probably the only situation in which i would have agreed if I had no protection at all (I felt 2 shots was probably fine).

Then again my job consisted of dealing with body fluids on a DAILY basis. and I am a paranoid health OCD freak, lol.

I would never vax my children, but I would consider getting the Hep B shot if I were in your shoes.

[gothmommy]

I got 2 of the 3 shots when I was in my BSN program. I was also pregnant with DS#1 and reacted to the injections. We got our shots by going to the school pharmacy (where there was a standing order for us to get our 3 vials, one each at the appropriate intervals, by showing our ID and validation label--which was a way to show proof of tuition payment for the school of nursing) and either go to the health center or have a fellow student, etc. give the shot. My MIL gave my 2 injections (she is a Respiratory ICU nurse). So for the 3rd shot, I just picked it up and never had it injected. Blood tests taken a few months later showed that I had indeed seroconverted. As of 2005, I was still seroconverted, but my titer was down to almost not being immune. My MSN program offered a titer and a booster, but I declined and all I had to provide was a copy of the same form on file with my kids' school stating that pursuant to state code yadda-yadda-yadda, I decline the vaccine for religious reasons.

[amnesiac]

There are a few threads here you might like to check out:
http://www.mothering.com/discussions...play.php?f=241

I did complete the series. If I hadn't previously then I would now largely because part of my job involves drawing blood on hep B patients.

[KMK_Mama]

I will also be starting nursing school in the near future and I will be getting the Hep B series.

[WildKingdom]

For the OP- Just FYI, there is no Hep C vaccine. Only A and B.

[ErinsJuneBug]

Hep C is normally transmitted via subcutaneous drug use anyway. As for Hep A - it is transmitted via the oral fecal route, and while it CAN be deadly many people have no symptoms at all and present with food poisoning type symptoms. I personally don’t feel as 'at risk' for Hep A. I practice very conservatively, turning my head to avoid splashes of fecal matter and wash my hands before and after each patient. If there was a legit HIV vaccine that I believe could protect me you better believe I would be getting it.

I wish you the best of luck - keep researching. If you feel very strongly against getting them then be sure to talk with your school well before clinical placement, they will need to find a hospital that will accept you.

[T&D2005]

I got the hep b vaccine when in nursing school too. I didn't know better then but I'm not sure what I would do now. However, I know I wouldn't do it while I was breastfeeding. If you choose to get it, and are done bfing baby, then you can get it during school. Your clinicals aren't until the end of your first semester or even your 2nd semester in some schools so you can push it off a few months anyway. I have worked with Hep b individuals and it's a risk you are exposed to as well as everything else out there with no vaccine. I would do more research on it and weigh the pros and cons of your specific situation. If you do decide on it, I would make sure you know of ways to "cleanse" your body of toxins after each injection- but that's just my opinion.