How should I assess the immunisation status of an adult patient presenting for a routine check-up?

Assessing the immunisation status of an adult patient during a routine check-up involves the following steps:

• Check the patient's vaccination records, including the NHS summary care record and any patient-held records, to identify which vaccines have been received and which are outstanding. If the patient-held record is not available, encourage the patient to provide it or update records at a subsequent appointment ².
• If the vaccination history is unclear or unavailable, assume the patient is not immunised and plan a full course of catch-up immunisations according to UKHSA guidance on vaccination of individuals with uncertain or incomplete immunisation status ¹,².
• Use electronic medical record prompts and reminders to opportunistically identify patients who are eligible, due, or overdue for vaccinations ².
• Consider the patient’s age, risk factors, and any relevant vaccination programmes (e.g., MenACWY for ages 10–25, HPV vaccine schedules, Td/IPV boosters) when assessing immunisation needs ¹.
• Ask about vaccinations received abroad if the patient was born outside the UK, and use the UK and international immunisation schedules comparison tool to clarify their status ¹.
• Document the immunisation status clearly in the patient’s record using appropriate SNOMED CT codes and update records promptly after any vaccination ².

In summary, the assessment relies on thorough review of available records, use of electronic prompts, clear documentation, and following catch-up vaccination protocols when history is uncertain or incomplete.