COVID Vaccine Might Cause Positive TB Test

 

As we move quickly through the new vaccine and await the results of vaccinations, more issues are being found.  One concern is the COVID vaccine could trigger a positive TB test result.  As of this writing, I have been advised that at least one facility administered the vaccine and, within a few days, completed their annual TB skin test only to have almost everyone test positive.  

A quick search on the Internet revealed that the CDC is aware of the issue.  There are already several articles addressing the problem as well (example: Article).

A nurse for the facility where the TB test was completed and showed positive after the vaccine recommends updating the TB test first.  Most facilities such as ICF programs obtain an annual TB test.  If your facility is scheduling a COVID Vaccine, it might be advisable to update all TB tests for the year first.  To get specific recommendations or instructions, discuss this with the facility nurse or medical advisor.  

Vaccine Information for ICF/IID Providers

When it comes to vaccines, most ICF programs give the required vaccines as outlined by the federal and state health agencies.  Consents are usually obtained in the form of simple "routine medications" or "required vaccine" consents.  The COVID-19 Vaccine is a little different in that it is not a "required" vaccine and in fact is optional. This raises concern for the ICF program in my opinion.  

Although the state and CMS have not issued any formal guidelines for administering the vaccine to people living in ICF programs - i.e. what consents you may need - there is a "Best Practice" model you may want to consider.  

For programs I work directly with, we are taking this approach in Texas.  First, we obtained the side effects.  This can be found on the FDA website as a "Fact Sheet" midway down the page (FDA Website).  I took the following actions: 

1.  Obtained the Fact sheet

2.  Developed a consent for the vaccine

3.  Attached fact sheet and consent form:

     a.  Guardian review and signature

     b.  SDM review and signature

     c.  IDTeam review and signature

     d.  or Individual review and signature if competent

4. Consent was then reviewed by the IDTeam 

5. Consent, IDTeam review then reviewed by the Specially Constituted Committee or Human Rights Committee. 

While I may be going overboard, I feel like it is better to cover it so there are no questions. 

You will need to keep in mind that the vaccine comes in two doses.  According to current sources, the vaccine does not end the need for social distancing, mask, and other precautions.  The state has also not issued any information (Texas) as to when or if mask and precautions can be stopped after the administration of the full vaccine. 

Information on Vaccine: 

FDA website with vaccine information

FDA Fact Sheet for Caregivers