Immunization lecture

A 62-year-old man with recently diagnosed chronic obstructive pulmonary disease presents to your office in November for a routine examination. He has not had any immunizations in more than 10 years. Which of the following immunizations would be most appropriate for this individual.

• Tetanus-diphtheria only

• Tdap, pneumococcal, and influenza

• Pneumococcal and influenza

• Tdap, pneumococcal, influenza, and meningococcal

Answer explanation

In an adult with a chronic lung disease, vaccination with pneumococcal vaccine and annual vaccination with influenza vaccine are recommended. A Tdap booster would be recommended to all adults who have never had a Tdap vaccine as an adult. Therefore, answer choices A (Td only) and C (pneumococcal and influenza) are not correct. Answer D includes meningococcal vaccination, which is only recommended for high-risk groups (college dormitory residents, military recruits, and patients with certain complement deficiencies, with functional or anatomic asplenia, or who travel to countries where the disease is endemic).