Re: [Gnumed-devel] one more vaccinations detail

[Hilmar Berger]

Hi,
> - HepAB base immunization requires 3 shots in adults
> - someone was given 2 out of 3 in due course
> 
> Are those two injections still valid when the patient comes
> back for the 3rd shot after:
> 
> - 1 year (yes)
> - 3 years (probably)
> - 5 years (?)
> - 10 years (probably not)
> - 25 years (well ?)
> 
> What about if that patient only had 1 out of the 3 shots in
> the first place ?
> 
> This is what we don't cover yet. The docs I found all say that
> "all shots are valid". It seems obvious, though, that after a
> sufficiently long period of time incomplete base immunizations
> are likely to be void - or aren't they ?
just my 0.1 cents:
Given the differences and uncertainties in the course of immunity after
vaccination in individuals I guess that there will be no way to be sure that
the patient is still immune after unlimited time.
If you scan the medical literature you will probably find some information
on which percentage of patients had sufficiently high AB-levels after short
time (say the normal time between boosters or up to 1 year). I guess that
after that time and in absence of specific research you either have to
measure the AB-level in this specific patient or just let the patient decide
if he is willing to spend money for another shot. 
In children the question probably is if you complete the last vaccination,
start a new immunization or wait until the next recommended date. 
I guess that you will never get enough hard facts to have this decided by
some logic. You will probably have to take into account the risk of the
children to be infected, the attitude of the parents toward vaccination, the
current health status etc.

Hilmar

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