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Question 31#

A 62-year-old man presents to his new primary care physician for a first visit. The patient has not seen a doctor for more than 10 years. He has mild intermittent bronchial asthma. The patient is sexually active with a single long-term partner. He does not recall receiving any vaccines since childhood. Which of the following vaccines should be offered?

A) Pneumococcal, influenza, zoster, and tetanus-diphtheria-acellular pertussis (Tdap)
B) Pneumococcal, influenza, zoster, and tetanus-diphtheria (Td)
C) Pneumococcal, influenza, and human papilloma virus
D) Pneumococcal, influenza, and tetanus-diphtheria-acellular pertussis (Tdap)
E) Pneumococcal, influenza, and meningococcal

Correct Answer is A


Assessment for adult vaccination should be based on age, comorbidities, immunization history, and other risk factors like travel plans and sexual behaviors. Adults should get tetanus and diphtheria vaccine (Td) every 10 years. Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine should replace one of the Td vaccines if not given before or during adult life. Zoster vaccine is indicated for individuals over 60 years of age. The influenza vaccine is recommended for all persons aged 6 months and older, including all adults. Pneumococcal vaccine is indicated in patients with chronic illnesses such as heart failure, bronchial asthma, chronic obstructive pulmonary disease, chronic kidney disease, and diabetes mellitus. Otherwise, the pneumococcal vaccine is administered once at the age of 65. Human papillomavirus (HPV) vaccine is indicated in females who are 11 to 28 years of age. The meningococcal vaccination is recommended for adults with anatomic or functional asplenia or persistent complement component deficiencies, as well adults with human immunodeficiency (HIV) virus infection. Meningococcal vaccine is also indicated for patients traveling to meningitis endemic areas.