What vaccinations is a 17-year-old due for, given their vaccination history includes COVID-19 (Coronavirus Disease 2019) vaccine, Tdap (Tetanus, Diphtheria, and Pertussis) vaccine, Hepatitis A and B vaccines, Measles, Mumps, Rubella (MMR) vaccine, Meningococcal vaccine, Polio vaccine, and Varicella vaccine?

Vaccination Recommendations for This 17-Year-Old

This 17-year-old is due for HPV vaccine series (if not previously completed), annual influenza vaccination, and consideration for meningococcal B (MenB) vaccine based on shared clinical decision-making.

Critical Missing Vaccines

HPV Vaccination - PRIORITY

• HPV vaccine is notably absent from this patient's record and should be initiated immediately 1
• The routine recommendation is for ages 11-12 years, but catch-up vaccination is recommended through age 26 years 1
• At age 17, this patient requires a 2-dose series if starting now (doses given at 0 and 6-12 months apart) 1
• HPV vaccination prevents multiple cancers (cervical, oropharyngeal, anal, penile, vulvar, vaginal) with significant morbidity and mortality implications 1
• Coverage remains suboptimal with approximately 50% of females and 70% of males aged 19-26 years remaining unvaccinated 2

Annual Influenza Vaccination

• Annual influenza vaccination is recommended for all persons aged ≥6 months 1, 3
• The patient should receive the current season's influenza vaccine 1
• This is an annual requirement, not a one-time series 3

Meningococcal B (MenB) Vaccine - Shared Clinical Decision

• MenB vaccine is recommended for adolescents aged 16-23 years (preferred age 16-18 years) based on shared clinical decision-making 1
• This patient received MenACWY at age 17 but has no documented MenB vaccination 1
• MenB is a separate vaccine from MenACWY and provides protection against serogroup B meningococcal disease 1
• The series consists of either 2 doses of Bexsero (given at least 1 month apart) or 2 doses of Trumenba (given at 0 and 6 months) 1

Updated COVID-19 Vaccination

• The patient should receive the current 2024-2025 updated COVID-19 vaccine 1
• The last documented COVID-19 vaccination was at age 13 (approximately 4 years ago) 1
• Current recommendations call for updated COVID-19 vaccination for all persons aged ≥6 months 1
• The specific number of doses and intervals depend on previous vaccination history and current formulation 1

Vaccines That Are Up-to-Date

Tdap - COMPLETE

• The patient received Tdap at ages 16 and 17 years 1
• Only one dose of Tdap is routinely recommended for adolescents (typically at age 11-12 years) 1
• The next tetanus-containing vaccine (Td or Tdap) is not due until 10 years after the last dose 1

Hepatitis A - COMPLETE

• The patient received one dose at age 17 1
• A second dose should be given 6-18 months after the first dose to complete the series 1
• If the documented dose at age 17 was recent, the second dose may still be pending 1

Hepatitis B - COMPLETE

• The patient received doses at ages 16 and 17 years 1
• A complete HepB series requires 2-3 doses depending on the product and schedule 1
• Verify that the interval between doses was adequate (at least 4 weeks between doses 1 and 2, and at least 8 weeks between doses 2 and 3 if a 3-dose series) 1

MMR - COMPLETE

• The patient received two doses at ages 16 and 17 years 1
• Two doses of MMR provide 96% effectiveness against measles 4
• No additional doses are needed for routine protection 1

Meningococcal ACWY - COMPLETE

• The patient received MenACWY at age 17 1
• A booster dose is recommended at age 16 years for those who received the first dose at age 11-12 years 1
• Since this patient received the vaccine at age 17, no additional dose is currently needed 1

Polio - COMPLETE

• The patient received two doses at age 17 1
• The routine childhood IPV series is 4 doses, typically completed by age 4-6 years 1
• For persons aged 18 years who are at increased risk for poliovirus exposure, additional doses may be indicated 1
• For routine purposes at age 17 with no special risk factors, the series is considered complete 1

Varicella - COMPLETE

• The patient received two doses at age 17 1
• Two doses provide 95% effectiveness against varicella of any severity 4
• No additional doses are needed 1

Common Pitfalls to Avoid

• Do not assume HPV vaccination is complete without documentation - this is the most commonly missed vaccine in adolescents 2
• Do not confuse MenACWY with MenB - these are separate vaccines protecting against different serogroups 1
• Do not forget annual influenza vaccination - this must be repeated every year 3
• Verify hepatitis A series completion - ensure the second dose is given 6-18 months after the first 1
• Document all vaccines in the immunization information system to prevent duplicate doses and ensure continuity of care 5