Screening Protocols & Immunizations
Taking Charge of Your Health
Another way to ensure that you are doing your best to safeguard your health is to ask your doctor about screening tests and immunizations. Based on your health and personal risks, your doctor can develop a schedule that is best for you.
Common screening tests include: Pap tests, mammograms, cholesterol checks, eye and glaucoma exams, dental check ups, Hepatitis C test, colon cancer screening, skin cancer screening, bone density checks, abdominal aortic aneurysm screening, HIV test and prostate cancer screening. Be sure to talk with your doctor about screening as new tests and changing recommendations do occur. As women, we were conditioned to schedule our first mammogram at 40, our first colonoscopy at 50 and routine pap smears annually beginning around age 20. In December of 2013 the U. S. Preventive Services Task Force increased the age of the initial mammogram to 50, while noting the importance of “individual risk assessment and shared decision making regarding screening for women 40-49 years of age.” In other words, talking to your physician is part of the recommendation.
For many tests whether or not you have a ten-year life expectancy is an important screening pre-qualification.
For men, the screening dilemma for prostate cancer can be confusing. PSA testing is at the center of extensive discussion about screening requirements. After years of being on the required list for male testing beginning at age 50, the PSA test is no longer recommended by the U. S. Preventive Services Task Force at any age unless certain requirements exist, in part because prostate cancer screening only has a small impact on the prostate cancer death rate. In the U. S. men have a 3% chance of dying from prostate cancer and a 16% chance of being diagnosed. This has led to the oft quoted fact that you are much more like likely to die with prostate cancer than from it. Often the subsequent testing necessitated by a false positive PSA test results in incontinence or impotence: both huge detriments to male health. It is a case where the side effects of treatment are often worse than the disease. In some studies, a full 50% of men who opt for surgery will become impotent and may become incontinent; radiation may also cause these same side effects as well as troublesome bowel problems. This is especially true in cases of slow growing cancers and presents a dilemma not only for treatment, but a hardship for those affected.
An MIT article written by Drs. H Gilbert Wekls and Peter Albertson regarding PSA testing and why the U. S. Preventive Services Task Force recommends against PSA testing reports, “Lots of people are hurt, few are helped.” Nine out of ten men who learn they have prostate cancer opt for either surgery or radiation therapy; however, the staggering numbers of side effects these men endure should give pause and validates weighing treatment options carefully with the advice of a physician. According to researchers at Massachusetts General Hospital, the “conundrum of disease screening – how to maximize its benefits in helping head off potentially deadly illnesses while minimizing the harm it can cause…[causing] physicians and patients are [now] weighing research against clinical judgment to find the right balance.”
Relative to the impetus for aggressive screening, Dr. Rita Redberg at UCSF warns, “We’ve invented all sorts of pseudo-diseases…people with mild abnormalities are being treated and may be harmed from side effects of drugs they don’t need to take.” As medical guru Atul Gawande writes, “Over testing has created a new, unanticipated problem: over-diagnosis. This isn’t mis-diagnosis, the erroneous diagnosis of a disease. This is the correct diagnosis of a disease that is never going to bother you in your lifetime.” According to Dr. Wilt of the University of Minnesota, “The answer to over-diagnosis and excessive treatment isn’t to halt screening, but to be more selective about who is screened and how often they are tested…To screen or not to screen involves carefully weighing the harm associated with a test, against the potential benefit of finding a problem.” This, of course, seems perfectly reasonable; unless you are one of the small percentage for whom early detection might be helpful. Nuances like this keep researchers busy trying to maximize early identification, but not wanting to cause harm in the process.
Skin cancer is the most common cancer in the United States. It's also one of the most preventable. The primary cause is exposure to UV rays from the sun or tanning beds. People of all skin colors can develop skin cancer. It's one of the easiest cancers to detect and most types are highly curable. Most people benefit from routine skin cancer exams to catch problems early.
Vaccines & Immunizations
According to the Centers for Disease Control and Prevention, vaccination is one of the most effective strategies to prevent and control infectious disease. Vaccines have an excellent safety record, are safer than therapeutic medicines and some even decrease the use of antibiotics which in turn lowers the chance of antibiotic resistance. New vaccines and immunizations are constantly in development. Cutting edge research is also ongoing to reduce the number of vaccine inoculations though the use of laser technology. Hence the number and type of immunizations are subject to change over time.
The primary reasons to be vaccinated include:
Vaccine-preventable diseases exist worldwide and with today's mobility and travel can spread quickly
About 50,000 people die in the U. S. every year from vaccine-preventable diseases
Diseases affect people of all ages, but infants and the elderly are at even higher risk for serious infections
Adults with chronic conditions - heart disease, diabetes or lung disease - and those with weakened immune systems are more likely to develop complications from preventable diseases
Vaccinations are among the most safe and effective medical products
Vaccines can provide a lifetime of protection
History of Vaccination
“In the 18th century in Europe, approximately 400,000 people died annually of smallpox, and one third of the survivors went blind. The case-fatality rate varied from 20% to 60% and left most survivors with disfiguring scars. The fatality rate in infants was even higher, approaching 80% in London and 98% in Berlin during the late 1800s.” (Source: www.ncbi.nlm.nih.gov)
“In 1796, Edward Jenner, an English country doctor from Gloucestershire, administered the world’s first vaccination as a preventive treatment for smallpox. While still a medical student, Jenner noticed that milkmaids who had contracted a disease called cowpox did not catch smallpox. Unlike smallpox, which caused severe skin eruptions and dangerous fevers in humans, cowpox led to few ill symptoms in these women. On May 14, 1796, Jenner took fluid from a cowpox blister and scratched it into the skin of James Phipps, an eight-year-old boy. A single blister rose up on the spot, but James soon recovered. On July 1, Jenner inoculated the boy again, this time with smallpox matter, and no disease developed." (Source: www. history.com)
“Jenner's work represented the first scientific attempt to control an infectious disease by the deliberate use of vaccination. Strictly speaking, he did not discover vaccination but was the first person to confer scientific status on the procedure and to pursue its scientific investigation. During the past years, there has been a growing recognition of Benjamin Jesty (1737–1816) as the first to vaccinate against smallpox. When smallpox was present in Jesty's locality in 1774, he was determined to protect the life of his family. Jesty used material from udders of cattle that he knew had cowpox and transferred the material with a small lancet to the arms of his wife and two boys. The trio of vaccines remained free of smallpox, although they were exposed on numerous occasions in later life. However, the recognition of these facts should not diminish our view of Jenner's accomplishments. It was his relentless promotion and devoted research of vaccination that changed the way medicine was practiced." (Source: /www.ncbi.nlm.nih.gov)
“ Louis Pasteur’s 1885 rabies vaccine was the next to make an impact on human disease, followed by antitoxins and vaccines against diphtheria, tetanus, anthrax, cholera, plague, typhoid, and tuberculosis." (Source: www.historyofvaccines.org)
By the end of the 1920s, vaccines for diphtheria, tetanus, whooping cough and TB were available. Another major breakthrough came in 1955 when the polio vaccine was introduced and by 1979, the virus had been virtually eliminated across the country. Throughout the mid to late 1900s, vaccination spread across the globe dramatically reducing the number of deaths from disease and establishing the concept of preventative public health measures.
Despite the overwhelming research on vaccine safety some parents worry that giving too many vaccines too soon may overwhelm a baby’s immune system, but through normal play babies are exposed every day to many more antigens than they will receive in vaccines. Although the number of vaccines recommended is higher now, the number of antigens is lower.
Another parental concern that arises is around a connection between vaccines and autism. Extensive scientific studies for the past 15- 20 years have found no relationship between vaccines and autism and the one study that initiated the concern was found to be generally discredited.
Recommended for children 0-10 years
Hepatitis A (HepA)
Hepatitis B (HepB)
Diphtheria, Tetanus, and Acellular Pertussis (DTaP)
Inactivated poliovirus (IPV)
Inactivated influenza (IIV) or live-attenuated influenza (LAIV)
Measles, mumps, and rubella (MMR)
vaccines recommended for
ages 19 to 59
Tetanus, diphtheria, pertussis (Td/Tdap)
Measles, mumps, rubella (MMR)
Varicella ( VAR)
Herpes zoster vaccine (HZV)
Human papillomavirus (HPV) Female / Male
Pneumococcal 13-valent conjugate (PCV13)
Pneumococcal polysaccharide (PPSV23)
Hepatitis A ( HepA)
Hepatitis B ( HepB)
Serogroups A, C, W, and Y meningococcal conjugate vaccine (MenACWY) or Serogroups A, C, W, and Y meningococcal polysaccharide vaccine (MPSV4)
Serogroup B meningococcal vaccine (MenB)
Haemophilus influenzae type b (Hib)
recommended for adolescents
Tetanus, diphtheria, and acellular pertussis (Tdap)
An annual IIV or LAIV vaccine
These vaccines are primarily recommended for 11- to 12-year-olds (except for the annual influenza vaccination), but can be administered throughout adolescence if not received previously
60 and older
Annual Flu - Influenza
Td - Tetanus every 10 years
Tdap - Tetanus, Diphtheria & Pertussis 1 dose
Shingles (Zoster) - 1 dose
Pneumococcal - PCV13 and PPSV23
Varicella - 2 doses 28 days apart (if you never had chickenpox)
Meningococcal - 1 dose if indicated
Hepatitis A, B & Hib - Hep A 2 doses, Hep B 3 doses, Hib 1 or 3 doses
Due to health condition considerations a consult with MD is important for those in this age group