Problem: Mildred is in your office today (in May) for a routine checkup. She is a 17-year-old student at a local early college program. Her vaccination record includes five doses of DTaP, two doses of tetanus and diphtheria toxoids, adult type (Td), one dose of quadrivalent meningococcal conjugate vaccine (MCV4), four doses of inactivated poliomyelitis virus vaccine (IPV), one dose of MMR, three doses of human papillomavirus vaccine, three doses of hepatitis B vaccine, and influenza vaccine last season. She had varicella (chickenpox) as a child. She is not taking any medications, including oral contraceptives. Her only allergy is to duck feathers; following exposure to duck feathers, she develops urticaria. She is single, sexually active, and not planning to become pregnant. Her last menstrual period was 3 weeks ago. She shares an apartment with her sister who has a congenital immune disorder.
1. Does Mildred need any vaccinations? If so, which vaccines?
2. Are any vaccinations contraindicated in this case?