Original Effective Date:
08/01/1994
Current Effective Date:
01/01/2015
The following recommendations in the Recommended Frequency column are based on the Report of the U.S. Preventive Services Task Force, Second Edition, Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the Hawaii State Department of Health. The column QUEST Integration Benefits highlights the EPSDT requirements for eligible children. See the complete requirements under EPSDT in the benefit policies section of the manual. The Department of Health's Vaccines for Children program guidelines for Hep B and varicella immunizations may also be followed.
| Screening | Age | Recommended Frequency | QUEST Integration Benefits |
|---|---|---|---|
| Well-baby examination (Growth/developmental assessment) |
First year Second year 3-5 years 6-18 years |
Seven exams in first year* 15, 18 and 24 months Annually Every 2-3 years with clinical judgment** |
Six exams in first year 15, 18 and 24 months Annually Every 2 years with clinical judgment |
| Blood pressure | 3 years | With each office visit | With each office visit |
| Eye examination | 3-4 years |
Newborn-3 years – visual screening. See Early Periodic Screening, Diagnosis and Treatment (EPSDT) Screening Guidelines Vision testing beginning at age 3-4 years at each EPSDT exam. |
|
| Hearing screens | All ages | With each office visit except when audiogram is done | |
| Behavioral assessment | All ages | With each office visit | |
| Dental exam | Ongoing | Regular visits to dental provider; floss/brush daily | Beginning at age 1 unless there are problems before then. Regular visits to dental provider, floss/brush daily. |
| TB test | At 12 months, and before school entry | Repeat as appropriate for populations at risk | At 12 months, before school entry |
*The first exam is done in the hospital shortly after birth.
**The Hawaii State Department of Health recommends periodic exams for children in grades 1, 4, 7 and 10.
| Immunizations | Age | Recommended Frequency | QUEST Integration Benefits |
|---|---|---|---|
| DTaP (acellular pertussis component) | 2, 4, 6, 15-18 months; 4-6 years | ||
| Td booster | 11-12 years or 14-16 years | ||
| Polio (IPV) | 2, 4, 6-18 months; 4-6 years | ||
| MMR (measles- mumps-rubella) | 12-15 months; 4-6 years | Children who previously have not received the second dose of MMR should receive it by 11-12 years | |
| Hib (H.influenzae, type b) | 2, 4, 6, 12-15 months | ||
| Hep B | Birth-2 months, 1-4 months, 6-18 months | Children who have not received three doses of Hepatitis B vaccine should initiate and complete the series by age 11-12 years. Unvaccinated adolescents should receive Hepatitis B during any visit. | |
| Varicella | 12-18 months | 11-12 years if not before | |
| Rubella | 12 years or older | Females, prior to childbearing age | |
| Prevnar | 2, 4, 6 months, 12-15 months | Also recommended for certain children at 24-59 months | |
| Hep A | For high-risk groups only | ||
| Flu shots | Recommended annually for children older than 6 months of age with certain risk factors. | Following VFC recommendations | |
| Pneumococcal polysaccharide (23 Valent) | Use for children 5 years and older | For high-risk groups only | |
| Menomune | For college dormitory residents |
| Health Education | Age | Recommended Frequency | QUEST Integration Benefits |
|---|---|---|---|
| Child safety car seat | 5 years or younger | ||
| Lap shoulder car belt | 5 years or younger | ||
|
Safety/injury prevention (bike/sun) |
Ongoing | ||
| High-risk sexual behavior | 12 years and older | Associated risks | |
| Unintended pregnancy | 12 years and older | Associated risks | |
| Tobacco, alcohol, drugs | Ongoing | Associated risks | |
| Diet, exercise | Ongoing | Associated benefits | |
| Dental health | Ongoing | ||
| Dental sealants | Older than 5 | ||
| Caring for newborn; Baby Bottle Tooth Decay | Younger than 2 |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |