Help keep your children healthy with the immunizations and screenings they need for a healthy life.1
|Screening Tests||0-1 year (Infancy)||1-4 years (Early Childhood)||5-10 years (Middle Childhood)||11-17 years (Adolescence)|
|Routine Checkups (including cholesterol screening, height, weight, developmental milestones, and BMI)2||Ages 1-2 weeks; and 1, 2, 4, 6, 9, and 12 months. Assess breastfeeding infants between 3-5 days of age||Ages 15, 18, and 24 months; and 3 and 4 years||Annually||Annually|
|Anemia||Once between ages 9-12 months||As needed at discretion of clinician||Starting at age 12, screen all nonpregnant adolescents for anemia every 5-10 years during well visit. Annually screen for anemia if at high risk|
|Blood Test for Lead||Initial screening between ages 9-12 months||Annually at ages 2 and 3 years, and again at 4 years if in areas of high risk||If never screened, prior to entry to kindergarten|
|Urinalysis||Once at age 5 at discretion of clinician|
|Blood Pressure||Annually, beginning at age 3|
|Hearing||Assess prior to discharge, or by 1 month||Pure-tone audiometry at ages 4, 5, 6, 8, 10, 12, 15, and 17|
|Vision||Assess prior to discharge, and by 6 months||Visual acuity test at ages 3, 4, 5, 6, 8, 10, 12, 15, and 17 Screen for strabismus (lazy eye) between ages 3 and 5 years|
|Pap (Females)||If sexually active|
|Tests for Sexually Transmitted Diseases||If sexually active|
|Testicular Exam (Males)||Clinical exam and self-exam instruction annually beginning at age 15|
|Hepatitis A||2 doses routinely recommended at 12-24 months, and high-risk children over 24 months|
|Hepatitis B||3 doses routinely recommended at birth and ages 1-4 months and 6-18 months|
|Diphtheria, Tetanus, Pertussis (DTaP) Tetanus, Diphtheria, and Acellular Pertussis (Tdap) [Note: replaces Tetanus Diphtheria (Td)]||5 doses of DTaP routinely recommended at ages 2, 4, and 6 months;
15-18 months; and 4-6 years
|1 dose of Tdap between ages 11- 12 instead of Td vaccine; also between ages 13-18 years who missed Td booster at 11-12 years|
|Polio||4 doses routinely recommended at ages 2 and 4 months, 6-18 months, and 4-6 years|
|Haemophilus (Hib)||4 doses routinely recommended at ages 2, 4, and 6 months; and 12-15 months|
|Measles, Mumps, Rubella (MMR)||1 dose routinely recommended between 12-15 months||1 dose between 4-6 years|
|Varicella (Chicken Pox)||1 dose routinely recommended between 12-15 months; 4 and 6 year booster|
|Pneumococcal Vaccine for Infants||3 doses routinely recommended at ages 2, 4, and 6 months||1 dose between 12-15 months|
|Meningococcal Vaccine||Certain high-risk group only. As needed at discretion of clinician||1 dose between ages 11-12 years; 1 dose at high school or college entry if not previously vaccinated|
|HPV||3 doses between ages 11-12 years female|
|Flu Vaccine||Annually for all children ages 6 months-5 years and all high-risk children 5 years or older|
|Rotavirus||3 doses at 2, 4, and 6 months|
1. Please check subscriber certificate/benefit description for a complete listing of covered tests and procedures. Your plan may not cover every screening test listed.
2. BMI is recommended for children between ages 2-17 years.
These guidelines are generally for healthy children with no current symptoms or prior history of a medical condition. Parents of children with medical conditions or a family history of certain diseases should talk to their doctor about the right recommendations for their children.
The following tests or vaccines are not routinely recommended, but may be appropriate, depending on age and/or risk factors: Hepatitis C; Tuberculosis; HIV; Pneumococcal vaccine for older children (PCv); Meningococcal vaccine for children less than 11 years old.
These guidelines were developed by Massachusetts Health Quality Partners (MHQP), a broad-based coalition of health care providers, plans, and purchasers working together to promote improvement in the quality of health care services in Massachusetts. Blue Cross Blue Shield of Massachusetts is an MHQP member.