The Definitive Guide To Blood Titers
Need to get a blood titer and have no idea what that means or what to do? For many people, getting a blood titer is a confusing process and one that can cost a lot of money and take weeks to accomplish.
Fortunately, getting a blood titer is not as complicated as it may seem. We are here to help you understand what a blood titer is, the process for getting a titer done, and how to interpret the results once the testing process is complete.
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Blood Titer – Overview
What is a blood titer?
A blood titer is a special blood test that checks if you are immune to a specific disease. The most common blood titers required are for hepatitis B titer, MMR titer and varicella (chickenpox) blood titers. Multiple other titer tests also exist to check for immunity to a variety of diseases.
| Titer | Alternate Name(s) | Specimen Type |
|---|---|---|
| Hepatitis B | Hepatitis B Surface Antibody | Blood |
| Measles | Measles IgG, Rubeola IgG | Blood |
| Mumps | Mumps IgG | Blood |
| Rubella | Rubella IgG | Blood |
| Varicella | Varicella IgG, Chickenpox IgG | Blood |
What does the word “titer” refer to?
The “titer” part of “blood titer” is a technical term that, generally speaking, represents a concentration of something. In the case of the blood titer, the “titer” refers to the amount of a specific type of antibody (a special blood protein) in a given volume of blood. The amount of antibody in the blood can, for example, then be reported on a blood titer lab report as a number in a format like milli-international units per milliliter (mIU / mL).
Why is an antibody level important?
Antibodies are highly-specialized proteins in the blood that are made by the immune system to protect the body against foreign invaders (antigens). Most of the time, a single antibody class is only effective in defending against one type of antigen. Having adequate levels of an antibody means that you are considered immune to the disease for which the blood titer was performed.
Who needs a blood titer?
If we had to guess, you currently fall into one of these situations:
- You just got accepted into a school that will train you to provide healthcare and they want you to get tested
- You work for a healthcare company (e.g. staffing, medical device, pharmaceutical) and your company and/or hospital needs proof of a blood titer for employment
- Your doctor or medical provider asked that you prove that you are immune to specific diseases for personal reasons (e.g. foreign travel or being around a new baby)
These are common situations in which one needs a titer and, believe it or not, it is generally for a good reason.
Why is a blood titer required by a school or work?
The most common reason that people need a blood titer is that they are working or studying in a healthcare environment like a hospital. Healthcare environments are full of all sorts of nasty bugs and one’s risk of getting infected with one of them is much higher than, say, getting a drink at a coffee shop.
As part of getting routine vaccinations growing up, many people have already received vaccinations that were designed to protect people against these infections and may already have antibodies in their blood. This is where the blood titer comes into play. The blood titer can check if your antibody levels are adequate – and, as a result, you are considered immune – for specific types of diseases that you might encounter in a hospital or other healthcare setting. Data on vaccination coverage in adolescents demonstrates high rates of vaccinations in the United States, suggesting that many people may already have positive blood titers for these diseases:
More awareness has been put on making sure people are immune to specific disease before studying or working in a healthcare setting. In fact, the Centers for Disease Control and Prevention (CDC) recommends that healthcare facilities put in place prevaccination testing and/or vaccination policies for healthcare providers who may be exposed to preventable infections.
Blood Titer Process
Step 1: Finding a lab order
In the United States, a blood titer, like most types of blood tests, requires a lab order (sometimes referred to as a prescription) from a licensed doctor or medical provider like a Nurse Practitioner or Physician Assistant. A lab order is a document that states who the ordering medical provider is, what tests are being performed and who will receive the results. In some cases, medical providers will write the lab order on a medication prescription. In the modern age, digital lab orders are accepted in lieu of a paper lab order.
To get a lab order, you need to visit a medical provider and get them to write the lab order for you for the correct blood titers (Accesa Labs includes the appropriate lab order as part of the price of the blood titer). After getting the lab order for a blood titer, you need to get your blood drawn so that the antibody titer level can be measured in your blood.
Step 2: Making an appointment
Some people make an appointment with their medical provider and visit the office to get a titer performed. In these cases, the lab order is usually “included” as part of the office visit and the blood will typically be drawn on-site. Once the blood is drawn, it is typically sent off to a local laboratory for processing and to generate the final report.
When a titer is performed through a medical office in this way, the lab results will be sent back to the ordering doctor or medical provider for review. In some cases, the results with be electronically routed from the lab to the office via an Electronic Medical Record (EMR) to be signed off on. For medical offices that are not connected to the lab through an EMR, the results will be sent back to the medical office by fax or mail.
Other people order their titer online because they do not have a family provider or do not want to spend extra time or money on an office visit if they do not have another reason to go. People who end up ordering online will need to go to a lab draw station, sometimes known as a Patient Service Center (PSC), to get their blood drawn and processed for the blood titer. Most laboratories run a network of PSCs to accommodate people who need to get their blood drawn. No lab has a PSC location in every city although many have PSCs in convenient areas nationwide. Major national laboratories (we are affiliated with Quest Diagnostics) have 1,000+ PSCs nationwide and are generally represented in every major metropolitan area.
In most cases, you can make an appointment for a blood draw at a PSC ahead of time and save time on the day of your blood titer. For example, choose a lab near your home or office then walk into the lab at your designated appointment time. While some blood tests require fasting before a blood draw, no fasting is required before a blood titer. Other than making sure that you are well-hydrated so it is easy to draw your blood, no special preparation is needed.
Step 3: Visiting the lab
On the day of your test, you need show up at the PSC 15 minutes before your appointment (if you scheduled one) with your lab order and sign in. If you are lucky, you will find a comfortable chair available in the waiting room. The PSC will generally want to see a printed copy of the lab order although they will accept a fax copy as well. We have found that faxed lab orders are quite convenient for anyone who orders their blood titer on a mobile device.
If you are trying to use your health insurance to pay for your blood titer (not available through Accesa Labs), make sure you bring your insurance card and your ID. You will need to show the PSC staff this information insurance card and identification. If you are using a prepaid lab order from a place like us, you simply need to show them your paper lab order or make sure it is faxed to the PSC location.
Once the PSC is ready to draw your blood, a staff member will call you in and sit you in a chair. Someone will draw your blood with a needle (mostly painless) into special lab vials. These vials will be processed in various ways to measure your titer levels. Assuming you are feeling good enough to leave (after all, getting blood drawn is not for the faint of heart), you will be sent on your way. Fortunately, the whole process typically takes under 15 minutes once your name is called.
Using health insurance
Some people consider trying to pay for their blood titers using health insurance. In the old days, health insurance used to pay for almost everything and it was no problem getting it covered.
Over time, as the cost of healthcare has risen, it has become increasingly difficult to get health insurance to pay for blood titers. Presently, there is more paperwork involved to even get the insurance company to consider paying for your test. Even with the right paperwork, it has to be filled out a certain way to justify the “medical necessity” of a blood titer to the health insurance company. Without it, the health insurance company will typically deny the claim for reimbursement.
Unfortunately, many people go to the lab and provide their insurance information without being 100% sure that their health insurance company will cover the testing. This can lead to a big sticker shock down the road. The lab will draw your blood and process it and then send a bill to your health insurance company. If the insurance company denies the claim, they will tell the lab and you will typically be put into the lab’s billing system as an unpaid blood draw. The lab will then bill you at list price for the testing which, in some cases, can be 5-10 times the price you would have paid if you prepaid for your blood titers.
If you have any form of deductible on your health insurance, you are almost always better off paying for the blood titer ahead of time so that you do not get hit with a bigger bill down the road. Some people are even able to recoup money they paid for the lab testing by submitting a standard receipt to the insurance company after the fact.
Blood Titer Results (Common Questions)
How long does it take to get test results?
Barring special circumstances like weather, common blood titer results should be ready in about 4 business days. Some complicated titers require specialty processing and can take longer. Once the titer lab report has been prepared by the lab, they will send it to the ordering doctor or medical provider to review the final results. Once they have been reviewed, the results will then be released to the patient. Some medical providers like to hang onto test reports until the next office visit so that they can discuss the test results in person.
What do blood titer results look like?
Blood titer results can be reported as “qualitative” or “quantitative” results. Qualitative results typically say something like “immune” or “not immune” on them. This type of result gives you a binary assessment of your immunity status against generally accepted standards.
In contrast, quantitative results give you an actual numerical blood titer result. These numbers represent the antibody concentration of the specific blood titer measured. Fortunately, numerical results also come with a reference range produced by the lab which is a guide that helps you understand your results. This reference range helps determine whether you are considered immune to the disease or not. For an example of a blood titer report, choose one of the “Sample Report” options on our titer test page.
To learn more about how to interpret your blood titer results, check out this video:
https://www.youtube.com/watch?v=Uil5_tCy5DU
What if the blood titer result is negative?
A negative blood titer suggests that no immunity exists to the specific disease. In most cases, a person with a negative titer will have to get revaccinated or else sign a waiver saying that they understand the risks associated with working in a healthcare environment as it relates to that disease. The best thing to do at that point is talk to whoever is asking for the titer report and see what next steps they recommend.
What if the blood titer result is positive?
Lucky for you. A positive blood titer means that you are considered immune to the disease being tested. If you are getting the blood titer for work or school, all you need to do is submit the lab report to whoever is in charge of compliance.
Where can I get a blood titer?
If you have a regular doctor or medical provider, you might want to get in touch to see if they can perform the test and how much it costs. Accesa Labs offers most types of blood titers and you can simply order them online and get tested at a local lab at a guaranteed price.
Conclusion
We hope that you found this review on blood titers helpful. We plan to add to it as questions come up from our customers. Feel free to contact us if you have feedback!