what are the pros and cons of being immunized for the first time as an adult?
August 3, 2005 5:49 AM   Subscribe

If an 18-year-old currently residing in the U.S. has never had any vaccinations or immunizations, what are the pros and cons of starting the process of becoming immunized now?

She has forged paperwork from her home country that says that she has had the essentials (MMR, tetanus, no Hep B). She is attending college this fall in the U.S. I can certainly see the need for her to get them, but are there risks that I am not aware of when starting this as an adult? Does standard college medical insurance cover this sort of thing?
posted by k8t to Health & Fitness (15 answers total)
The risks of the vaccinations strike me as less than the risks of catching something. Colleges are a lot of young people living very closely together and a lot of them not taking real good care of themselves.

If nothing else, get polio. It's still around, and I know more about polio than I wish I did, you don't want it. The immunization has been around for 50 years and they have a lot of data about the risks of that.
posted by unrepentanthippie at 6:09 AM on August 3, 2005

i'm pretty sure you can get immunization shots and papers from your city's public health clinic for free.
posted by yeahyeahyeahwhoo at 6:21 AM on August 3, 2005

Hepatitis B can be a big problem at colleges, so it would be smart to get vaccinated.
posted by zsazsa at 6:53 AM on August 3, 2005

Best answer: If she plans on staying in the US, she'll probably need to be vaccinated anyhow even with fraudulent papers. At some point, she's likely to have to go through a USCIS / ICE physical where, IIRC but am not certain, they take blood and do titers for antibodies. In other words, they will probably know that she was fibbing about being immunized.

Immunizations are cheap or free at city/county health departments. People there will have current and correct information about risks of immunization to adults, and current and correct information about the risks the various immunizable diseases pose when caught by adults.

She should do it in any case, unless there's something actually contraindicated for her, because willingly and knowingly risking being Typhoid Mary at her college is a skeezy thing to do.
posted by ROU_Xenophobe at 7:04 AM on August 3, 2005

Response by poster: Thanks for the info everyone! On her college website it seems that getting Hep B, MMR, Tetanus, and Menigitis will be around $200. Not bad for being on campus. We'll check out the public health department too - if it isn't a pain for her to get to via bus. Thanks again! ROU, thanks for the head's up on the USCIS physical as well.
posted by k8t at 7:21 AM on August 3, 2005

ROU, k8t:

The USCIS physical exam (Form I-693) does not require antibody titers. It only requires that a USCIS-designated civil surgeon sign off on the medical form, which includes an HIV blood test, tuberculosis skin test, and proof of the required vaccinations. Any doctor's note that the civil surgeon is willing to believe will be sufficient to get a signature on the I-693. However, all the supporting documentation is submitted along with the form itself, and if the immigrant should come under special scrutiny from USCIS, those doctor's notes may be investigated.

The required visit to the civil surgeon will probably run you $100-$200 in cash anyway, and you'll be able to get a referral to a cheap community clinic where you can get the required vaccinations for a similar price.
posted by rxrfrx at 7:50 AM on August 3, 2005

Why does she have forged paperwork? Were the vaccinations just not available, was she unwilling to get them, or does she have some sort of medical reason for not being vaccinated?

She shouldn't have any significant medical repercussions, although she should, of course, talk to a doctor about it.
posted by bshort at 8:34 AM on August 3, 2005

rxrfrx: thanks. I thought my bride had had titers done as part of the immigration physical because she knew that some of them were edging low at about that time, but that must have been from her last check related to nursing. Woe unto me for spreading untruth.

Still, if you have fibbed to INS, it's never a bad idea to make that fib into truth.
posted by ROU_Xenophobe at 8:44 AM on August 3, 2005

She may want to take a look at this page of contraindications.
posted by bshort at 8:45 AM on August 3, 2005

Response by poster: "Why does she have forged paperwork? Were the vaccinations just not available, was she unwilling to get them, or does she have some sort of medical reason for not being vaccinated?"

In her home country, they just aren't available. But on the original program that she came into the country on, it was required. Most of the kids on that program get forged copies.
posted by k8t at 9:43 AM on August 3, 2005

k8t: thank you for satisfying my curiosity.
posted by bshort at 10:37 AM on August 3, 2005

This hypothetical student may have gotten away with forged documents on this go round, particularly as State most likely knew and looked the other way, but if she continues to use those documents again and again (say for filing for asylum) she risks getting caught and that would not be good. Supposing such a naughty student really existed outside of a hypothetical.

I'd say the disease risk from actually getting the shots is less than the disease risk associated with life in a country where the shots are unavailable.
posted by Pollomacho at 2:09 PM on August 3, 2005

On the subject of cons of being immunized - there is a small chance she could be allergic to the vaccine. After my first MMR, I developed an allergy to it and after my 2nd, I was violently ill (vomiting and such) for a week and my shoulder swelled to the size of a baseball (keeping in mind I was probably 4 or so at the time). Still, that's a very slight chance and it's probably better to be immunized.
posted by IndigoRain at 3:18 PM on August 3, 2005

I got the mandated jabs before I came to the US, because it was free to get them done at my NHS surgery, and not free to get them done in the US. They were somewhat nervous about doing it -- the practice nurse had never given the two vaccinations to an adult before, and I was a little nauseous for a couple of days afterwards, but there were no lasting effects.

I've not yet had the I-693 medical, but I do have the batch numbers on headed paper for the relevant shots, which will probably pass muster. As with all immigration business, it's best to follow the rules above and beyond the letter, unless there's a very specific medical reason to do otherwise.
posted by holgate at 4:18 PM on August 3, 2005

Response by poster: The program that she (and thousands of other kids) go on has a standard health form that is merely signed off on by a doctor. It is in the native language and in English. No Hep B is listed.

I think that it is pretty common knowledge that they do it.

At the time she was a minor though, so I can't imagine that they'd hold it against her.

We've decided that she'll get them at school. When I told her she was really surprised. I told her that it was illegal for her to attend school without them (a slight fib, true), and she couldn't believe it. She said that she thought America was "freer" than that... interesting story.
posted by k8t at 6:33 PM on August 3, 2005

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