The Adult Vaccine Assessment Tool

Questions:

1. Are you
   Male Female
 I could become pregnant  I am pregnant now  I am not planning to become pregnant  I could not become pregnant
2. What year were you born? (some vaccines are age-related) 190019011902190319041905190619071908190919101911191219131914191519161917191819191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001
3. Will you be traveling outside the U.S. in the near future?
   Yes No
4. Do you have a weakened immune system due to illness or medications?
   Yes No
5. Do you have HIV infection? Yes
   What is your CD4 count?  Under 200  200 or higher
   No
6. Are you a first-year college student who lives in a college dormitory or a new military recruit?
   Yes No
7. Do you work with patients in a doctor’s office, hospital, nursing home, or other health care setting?
   Yes No

  Some medical conditions and other situations can put you at higher risk for certain infections.

8. Do you have any of these medical conditions?  Check all that apply to you.
    Heart disease (for example, congestive heart failure)  Diabetes mellitus type 1 or 2 (also called "sugar diabetes")  Chronic lung disease (for example, asthma and chronic obstructive pulmonary disease [COPD])  Kidney failure, end-stage renal disease, or on dialysis  Chronic liver disease (for example, cirrhosis or alcoholic liver disease) or hepatitis C infection  Spleen has been damaged or removed (for example, due to surgery or sickle cell disease)  Cancer or cancer treatment  Bone marrow transplant
9. Review the items listed below and check those that apply to you:
    Alcoholism  Smoke cigarettes  Man who has sex with men  Homeless  Factors that can increase your risk for hepatitis A or hepatitis B (such as travel to some countries, exposure to blood or bodily fluids, or exposure to contaminated food or drink)
10. Have you had the chickenpox disease or received the chickenpox vaccine?
    Yes No Not Sure

That's it! Just click "My Results" to find out which vaccines you may need.