Adolescent Health Maintenance, Screening, and Immunization
Preventive visit
Every adolescent should have an annual preventive visit with confidential time. Use a structured psychosocial interview such as HEEADSSS (home, education/employment, eating, activities, drugs, sexuality, suicide/depression, safety) and explain confidentiality and its limits at the start. Screening should be developmentally appropriate: depression from age 12, anxiety from age 8, substance use, sexually transmitted infection and HIV for sexually active youth, blood pressure, obesity, vision and hearing, dental care, and lipids once in late adolescence.
Immunizations
Routine adolescent vaccines include Tdap at 11–12, MenACWY at 11–12 with a booster at 16, HPV at 11–12 (can start at 9; catch-up through 26), annual influenza, and COVID-19 per the current schedule. MenB is shared clinical decision-making at 16–18. Verify catch-up schedules and contraindications.
Traps
A sports physical is not a substitute for a preventive visit. Do not skip confidential time because a parent is present. HPV is often missed because it is bundled with other vaccines. MenB is not routine for all adolescents. Screening instruments identify risk; they do not diagnose. An abnormal screen requires assessment, not automatic labeling.
Rule of thumb
At every visit, ask privately about mood, safety, substances, sexuality, and contraception. If a 16-year-old has received only one HPV dose, continue the series rather than restarting. Document confidentiality discussions and screening results.