Child Screenings

Well-baby exam: birth, 1, 2, 4, 6, 9, 12, 15, 18 and 24 months. Infants discharged less than 48 hours after delivery need a visit 2 to 4 days after birth. In addition, a visit with a pediatrician before the baby is born is recommended for first-time parents, those with high-risk pregnancies and those who want to learn about feeding, circumcision and well-baby care. During the well-baby exam you may receive advice about your child’s safety, health, nutrition and development. These exams may also include immunizations and the following screenings:

• Hearing as a newborn and as your child’s health care provider advises
• Weight, length and head circumference
• Hemoglobin or hematocrit: once between 9 and 12 months
• For children at risk of lead exposure, blood test at 1 and 2 years of age. Additional state or local childhood lead screening guideline regulations may apply.

Well-child exam: at age 30 months and then once a year for children ages 3 to 10. You may receive advice about your child’s safety, injury prevention, health, nutrition and development. Well-child exams may include immunizations and the following screenings:

• Blood pressure
• Vision
• Hearing
• Height, weight and Body Mass Index (BMI)* percentile-for-age

Well-child exam: once a year. Well-child exams may include immunizations, discussions on health and wellness issues (nutrition, physical activity, healthy weight, injury prevention, avoidance of tobacco, alcohol and drugs, sexual behavior, dental health, mental health and second hand smoke) and the following screenings:

• Blood pressure
• Vision and hearing: at ages 12, 15 and 18 or as your child’s health care provider advises
• Height, weight and BMI
• Chlamydia screening for sexually active females under 25

Adult Screenings

Well-person exam: At this exam you may receive immunizations, counseling on health and wellness issues (nutrition including discussion of folic acid supplementation for women of child bearing age, family planning, physical activity, injury prevention, misuse of drugs and alcohol, tobacco cessation, sexual behavior, dental health, mental health) and the following screenings:

• Blood pressure
• Height, weight and BMI

• Breast cancer: Self breast exam every month; clinical breast exam by your health care provider every 2 to 3 years
• Cervical cancer: Annually beginning within 3 years of sexual activity or age 21 (whichever comes first). Every 2 to 3 years for women ages 30 and older with 3 normal Pap tests in a row.
• Chlamydia: sexually active women under 25

• Cholesterol: To begin no later than age 35

Well-person exam: At this exam you may receive immunizations, counseling on health and wellness issues (nutrition, exercise, injury prevention, misuse of drugs and alcohol, tobacco cessation, sexual behavior, dental health, mental health) and the following screenings:

• Blood pressure
• Height, weight and BMI
• Colorectal cancer: Beginning at age 50, screening options include 1 of these 5 testing schedules:
  • - Flexible sigmoidoscopy every 5 years
  • - Fecal occult blood (FOBT) each year, plus flexible sigmoidoscopy every 5 years
  • - Double-contrast barium enema every 5 years
  • - Colonoscopy every 10 years

• Breast cancer: Self breast exam every month; clinical breast exam by your health care provider and mammogram every year
• Cervical cancer: Every 2 to 3 years for women with 3 normal Pap tests in a row
• Cholesterol: To begin no later than age 45

• Cholesterol: To begin no later than age 35
• Prostate cancer: 50 and older discuss risk and benefits of prostate cancer screening with your health care provider

Well-person exam: At this exam you may receive immunizations, counseling on health and wellness issues (nutrition, physical activity, injury prevention, alcohol misuse, tobacco cessation, secondhand smoke, sexual behavior, mental health) and the following screenings:

• Blood pressure
• Height, weight and BMI
• Cholesterol: Continued screening per health care provider
• Colorectal cancer: Beginning at age 50, screening options include 1 of these 5 testing schedules:
  • - Flexible sigmoidoscopy every 5 years
  • - Fecal occult blood (FOBT) each year, plus flexible sigmoidoscopy every 5 years
  • - Double-contrast barium enema every 5 years
  • - Colonoscopy every 10 years
• Hearing: as your health care provider recommends
• Vision (by Snellan chart): as your health care provider recommends

Pregnant women should visit their health care provider or OB/GYN in their first trimester for an initial visit and to establish a prenatal care schedule. During this visit your health care provider will check your health and the health of your baby.

Based on your medical history, your health care provider may recommend the following tests, screenings and immunizations:

Tests, education and screenings recommended for all pregnant women at their first prenatal visit:

• Hematocrit/Hemoglobin
• Syphillis
• HIV
• Rubella immunity to identify women needing rubella vaccine after giving birth
• Rh(D) blood type and antibody testing. If Rh(D) negative, repeat testing at 26 to 28 weeks.
• Hepatitis B
• Urinalysis as your health care provider advises
• Education regarding diet and activity during pregnancy
• Education and counseling regarding tobacco and other substance avoidance

• Special blood tests
• Ultrasound tests including special testing (used with blood tests during the first trimester for chromosomal abnormality risk) and routine two dimensional tests for fetal assessment
• Amniocentesis
• Chorionic Villus Sampling

In addition, two vaccines, MMR and Varicella should NOT be given during pregnancy.

Recommended
Inactivated influenza vaccine is allowable at any time during pregnancy, and is recommended for those who are pregnant during flu season (October to March).

Recommended Immunization Schedule

Vaccine

Birth

1-2 mo.

2 mo.

4 mo.

6 mo.

6-18 mo.

12-15 mo.

15-18 mo.

24 mo.

4-6 yrs.

11-12 yrs.

19-49 yrs.

50-64 yrs.

65+ yrs.

Hepatitis B

1

Rotavirus

Diphtheria-Tetanus-Pertussis (DTaP)

Tetanus-diphtheria-Pertussis (Td/Tdap)

2

3

3

3

Haemophilus influenza type b (Hib)

Pneumococcal (PCV)

Inactivated polio virus (IPV)

Influenza (flu) Annually

Recommended annually from 6 to 59 months of age

4

4

Measles, Mumps, Rubella (MMR)

Varicella (chicken pox)

Hepatitis A

5

Human Papillomavirus (HPV)

6

Meningococcal (MCV4)

Pneumococcal (PPV)

7

Zoster

8

() Indicates when immunications are recommended (1) Only if combination vaccine used after the birth dose (2) Tdap (3) Td booster every 10 years (4) Annually (5) 2 dose series (6) 3 dose series (7) one lifetime dose (8) One single dose for age =60

Meningococcal vaccine (MCV4) - If not previously vaccinated at 11-12 years of age, routine vaccination is recommended for 13-18 years of age and college freshmen living in dormitories.

Tdap (adolescent) - If not previously vaccinated, those 13-18 years of age, discuss catch-up vaccination with your doctor.

Td (adults) - If not previously vaccinated with Tdap, substitute one single dose of Tdap for Td.

HPV - If not previously vaccinated, those 13-26 years of age, discuss catch-up vaccination with your doctor.

Measles, Mumps, Rubella (MMR) and Varicella - Those ages 19 and older who lack evidence of immunity (e.g., lack of documentation of vaccination or have no evidence of prior infection) should be vaccinated.

Influenza, new or updated vaccines - Refer to www.cdc.gov for updated vaccine recommendations released after January 2008.

For additional information on immunizations, please visit the Centers for Disease Control and Prevention (CDC) Web site at www.cdc.gov.

Reference: Guide to Clinical Preventive Services, 2007. Recommendations of the U.S. Preventive Services Task Force, (www.preventiveservices.ahrq.gov), American Academy of Family Physicians (www.aafp.org), American Academy of Pediatrics (www.aap.org)

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