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 NICE NG218.
• 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 NICE CKS,NICE NG218.
• Use electronic medical record prompts and reminders to opportunistically identify patients who are eligible, due, or overdue for vaccinations NICE NG218.
• 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 NICE CKS.
• 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 NICE CKS.
• Document the immunisation status clearly in the patient’s record using appropriate SNOMED CT codes and update records promptly after any vaccination NICE NG218.

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.