Middlesex County North

MEDICAL SERVICES These tables provide schedules of preventive care guidelines that are recommended for healthy adults and children by leading health authorities. Talk with your doctor about these guidelines to determine what is appropriate for you and your family members. 0-12 SCREENING TESTS* Newborn Screening (PKU, sickle cell, hemoglobinopathies, hypothyroidism) Once - Newborns Head circumference Periodically up to age 2 Height and weight At each well visit for infants, then at least annually IMMUNIZATIONS** Hepatitis A 2 doses - 1 dose 12-23 months; 1 dose at least 6 months later Hepatitis B 3-4 doses - 1 dose at birth; 1 dose 1-2 months later; 1 dose 4 months+ and 1 dose between 24 weeks-18 months Diphtheria-tetanus-pertussis (DTaP) 5 doses - 1 dose at 2, 4, and 6 months; 1 dose 15-18 months; 1 dose 4-6 years Polio (IPV) 4 doses - 1 dose at 2 and 4 months; 1 dose 16-18 months; 1 dose 4-6 years H. Influenzae type b (Hib) 3-4 doses - 1 dose at 2, 4 and 6 months+; 1 dose between 12-15 months Pneumococcal conjugate 4 doses - 1 dose at 2, 4, and 6 months; 1 dose between 12-15 months Measles-mumps-rubella (MMR) 2 doses - 1 dose between 12-15 months; 1 dose between 4-6 years Chicken pox (varicella) 1 dose between 12-18 months; or any child after the first year without history of chicken pox or previous immunization Influenza Annually - between 6-23 months Booster tetanus-diphtheria and pertussis (TdaP) 1 dose - 11-12 years Meningococcal 1 dose - 11-12 years 13-18 SCREENING TESTS* Blood pressure Periodically - 18 years and older Height and weight/ Body mass index (BMI) Periodically - 18 years and older Depression Routinely - 18 years and older Alcohol misuse screening; behavioral health counseling Routinely - 18 years and older Chlamydia If sexually active Pap test Every 1-2 years beginning at age 21, earlier if sexually active Rubella titer or vaccination history For women of childbearing age IMMUNIZATIONS** Booster tetanus-diphtheria and pertussis (TdaP) 1 dose if not given between 11-12 years and/or if already received the Td booster Meningococcal 1 dose at the start of high school or college if not given between 11-12 years old 19-39 SCREENING TESTS* Blood pressure Periodically Height and weight/body mass index (BMI) Periodically Cholesterol Every 5 years - Men 35 and older Pap test Every 1-2 years - if 30 and older, either a Pap smear every 2-3 years after 3 consecutive normal results or HPV DNA test plus a Pap smear every 3 years if results of both tests are negative. Chlamydia Annually - 25 and younger and sexually active Rubella titer or vaccination history Women of childbearing age Depression Routinely Alcohol misuse screening; behavioral health counseling Routinely IMMUNIZATIONS** Tetanus-diphtheria (Td) Every 10 Years 40-64 IMMUNIZATIONS** Tetanus-diphtheria (Td) Every 10 years Influenza Annually - 50 and older Herpes zoster (shingles) 1 dose - 60 and older SCREENING TESTS* Blood pressure Periodically Height and weight/ Body mass index (BMI) Periodically Cholesterol Every 5 years - Men 35 & older Women 45 and older Rubella titer or vaccination history Women of childbearing age Pap test Every 2-3 years after 3 consecutive normal results or HPV DNA test plus a Pap smear every 3 years if results of both tests are negative. Mammogram Every 1-2 years Prostate Annually - at 50, both the prostate-specific antigen (PSA) blood test2 and digital rectal examination (DRE) should be offered. Colorectal Beginning at age 50, yearly stool blood test (FOBT), or flexible sigmoidoscopy every 5 years, or yearly stool blood test plus flexible sigmoidoscopy every 5 years, or double contrast barium enema every 5 years, or colonoscopy every 10 years. Depression Routinely Alcohol misuse screening; behavioral health counseling Routinely 65 & over IMMUNIZATIONS** Tetanus-diphtheria (Td) Every 10 years Influenza Annually - 50 and older Pneumococcal 1 dose - 65 and older SCREENING TESTS* Blood pressure Periodically Height and weight/ Body mass index (BMI) Periodically Cholesterol Every 5 years - Men 35 & older Women 45 and older Pap test Every 2-3 years after 3 consecutive normal results or HPV DNA test plus a Pap smear every 3 years if results of both tests are negative. Women 70 and older may stop screening. Mammogram Every 1-2 years Osteoporosis (Bone density test) Routinely - Women 65 years and older Prostate Annually - both the prostate-specific antigen (PSA) blood test2 and digital rectal examination (DRE) should be offered. Colorectal Beginning at age 50, yearly stool blood test (FOBT), or flexible sigmoidoscopy every 5 years, or yearly stool blood test plus flexible sigmoidoscopy every 5 years, or double contrast barium enema every 5 years, or colonoscopy every 10 years. Depression Routinely Alcohol misuse screening; behavioral health counseling Routinely * Based on the recommendations of the U.S. Preventive Services Task Force (USPSTF). ** Immunization schedules often change. The most current recommendations for immunizations may be found on the Centers for Disease Control Web site at www.cdc.gov.