4.3 Preventive Care and Screening
Key Takeaways
- Immunization schedules are published by the CDC and updated annually; medical assistants must know the routine childhood and adult vaccination schedules
- Cancer screening recommendations include mammography (breast), colonoscopy (colorectal), Pap smear (cervical), and PSA/DRE (prostate) based on age and risk factors
- Age-appropriate screenings include blood pressure, cholesterol, blood glucose, BMI, depression screening, and STI testing based on risk factors
- The medical assistant's role in preventive care includes maintaining immunization records, reminding patients of due screenings, and providing patient education materials
- Vaccines must be stored at proper temperatures (refrigerator 36-46°F; freezer -58 to 5°F) and documented with vaccine name, manufacturer, lot number, expiration date, site, route, and administrator
Preventive Care and Screening
Preventive care focuses on disease prevention and early detection rather than treatment of existing conditions. Medical assistants play a vital role in ensuring patients receive recommended screenings and vaccinations.
Immunization Schedule Highlights
Routine Childhood Vaccinations:
| Vaccine | Protects Against | Schedule |
|---|---|---|
| HepB | Hepatitis B | Birth, 1-2 months, 6-18 months |
| DTaP | Diphtheria, tetanus, pertussis | 2, 4, 6 months; 15-18 months; 4-6 years |
| IPV | Polio | 2, 4 months; 6-18 months; 4-6 years |
| Hib | Haemophilus influenzae type b | 2, 4, 6 months; 12-15 months |
| PCV13 | Pneumococcal disease | 2, 4, 6 months; 12-15 months |
| MMR | Measles, mumps, rubella | 12-15 months; 4-6 years |
| Varicella | Chickenpox | 12-15 months; 4-6 years |
| HPV | Human papillomavirus | 11-12 years (2-3 dose series) |
| Tdap | Tetanus, diphtheria, pertussis (booster) | 11-12 years |
| MenACWY | Meningococcal disease | 11-12 years; booster at 16 |
Routine Adult Vaccinations:
| Vaccine | Recommendation |
|---|---|
| Influenza | Annually for all adults |
| Td/Tdap | Tdap once, then Td booster every 10 years |
| Shingles (RZV) | Age 50+ (2-dose series) |
| Pneumococcal (PCV20/PPSV23) | Age 65+ or high-risk adults |
| COVID-19 | Per current CDC recommendations |
| HPV | Up to age 26 (catch-up to age 45 for some) |
Vaccine Storage Requirements:
- Refrigerator vaccines (most): 36-46°F (2-8°C)
- Freezer vaccines (varicella, MMR, some COVID): -58 to 5°F (-50 to -15°C)
- Monitor temperatures twice daily and record in a temperature log
- Use calibrated thermometers in all storage units
- Never store vaccines in the door of the refrigerator (temperature fluctuates)
- If temperature excursion occurs, do NOT use vaccines until consulting the manufacturer
Cancer Screening Recommendations
| Cancer | Screening Test | Starting Age | Frequency |
|---|---|---|---|
| Breast | Mammography | 40-50 (varies by guideline) | Every 1-2 years |
| Cervical | Pap smear ± HPV test | Age 21 | Every 3 years (Pap alone) or 5 years (Pap + HPV) |
| Colorectal | Colonoscopy, FIT, stool DNA | Age 45 | Colonoscopy every 10 years; FIT annually |
| Prostate | PSA ± DRE | Age 50 (earlier for high-risk) | Shared decision-making with provider |
| Lung | Low-dose CT scan | Age 50-80 with 20+ pack-year smoking history | Annual |
Vaccine Administration Documentation
Every vaccine administration must be documented with:
- Patient name and date of birth
- Vaccine name and manufacturer
- Lot number and expiration date
- VIS (Vaccine Information Statement) date and date given to patient
- Dose and route of administration
- Injection site (right deltoid, left thigh, etc.)
- Name, title, and signature of the person administering the vaccine
- Date and time of administration
The Vaccine Information Statement (VIS) is a CDC-produced document that must be given to the patient (or parent/guardian) before each vaccination. It explains the benefits and risks of the vaccine.
At what temperature should most refrigerator-stored vaccines be maintained?
Which document must be provided to patients (or parents) before every vaccination?
Which of the following is the recommended starting age for colorectal cancer screening (colonoscopy)?
Which of the following must be documented when administering a vaccine? (Select all that apply)
Select all that apply