Recommended Vaccines and Laboratory Tests for a 35-Year-Old Male
A 35-year-old male with no significant medical history should receive annual influenza vaccine, Tdap (if not previously given in adulthood), hepatitis B series, and HPV vaccine (3-dose series), along with baseline laboratory testing including HbA1c or fasting glucose, lipid panel, comprehensive metabolic panel, CBC, and risk-based screening for sexually transmitted infections. 1, 2
Core Vaccinations
Annual and Routine Vaccines
- Influenza vaccine: Administer annually using standard-dose quadrivalent inactivated vaccine 3, 1
- Tdap: Give one dose if not previously received in adulthood, then Td booster every 10 years 3, 1
Age-Appropriate Vaccines
- HPV vaccine (Gardasil 9): Administer 3-dose series at 0,1-2, and 6 months for men through age 26; may consider for ages 27-45 if likely to have new sexual partners 3, 1
- Hepatitis B: Universal vaccination recommended for all adults aged 19-59 years; use HEPLISAV-B (2-dose series at 0 and 1 month) or traditional 3-dose series (0,1, and 6 months) 3, 1
Risk-Based Vaccines
- Hepatitis A: Indicated if patient has risk factors including men who have sex with men, injection drug use, chronic liver disease, or travel to endemic areas; 2-dose series at 0 and 6-12 months 3, 1
- Meningococcal ACWY: Only if specific risk factors present (college students, military recruits, asplenia, complement deficiency, microbiologists) 3
Essential Laboratory Tests
Metabolic Screening
- Diabetes screening: HbA1c, fasting plasma glucose, or 2-hour OGTT; repeat every 3 years if normal 2
- Lipid panel: Fasting lipid profile including total cholesterol, LDL, HDL, and triglycerides to assess cardiovascular risk 2
Baseline Assessment
- Comprehensive metabolic panel: Electrolytes, creatinine with eGFR, liver function tests (ALT, AST, total bilirubin, alkaline phosphatase) 2
- Complete blood count (CBC): Provides baseline hematologic assessment 2
- Thyroid-stimulating hormone (TSH): Consider as part of baseline evaluation 2
- Urinalysis: Screen for proteinuria, hematuria, or other renal abnormalities 2
Risk-Based Laboratory Tests
- Hepatitis B serology: HBsAg, HBsAb, anti-HBc if risk factors present (healthcare worker, multiple sexual partners, injection drug use) or before starting hepatitis B vaccination series 3, 2
- Hepatitis C antibody: If risk factors including injection drug use, multiple sexual partners, or occupational exposure 2
- STI screening: Syphilis (RPR or VDRL), gonorrhea, and chlamydia testing if multiple sexual partners or new partners; annual testing for those at ongoing risk 2
- HIV testing: Should be offered at least once to all adults; more frequent testing if risk factors present 2
Important Clinical Considerations
Vaccination Timing
- Vaccines should be administered regardless of timing of other healthcare visits; do not delay vaccination until "complete" preventive visit 1, 4
- Multiple vaccines can be given during the same visit at different anatomic sites 3
Common Pitfalls to Avoid
- Do not order non-fasting lipid panels when fasting values are required for accurate cardiovascular risk assessment 2
- Do not use point-of-care HbA1c devices for diagnosis without quality assurance; only laboratory-based NGSP-certified methods should be used 2
- Do not fail to assess family history, as this significantly impacts screening recommendations for diabetes, cardiovascular disease, and cancer 2
- Do not assume immunity to hepatitis B without documentation; many adults lack adequate vaccination records 3, 1