A gardener presents with a puncture wound from a nail. What vaccine is recommended given the patient's last tetanus shot was 7 years ago?

The recommended vaccine in this scenario is Tdap. Tdap stands for Tetanus, Diphtheria, and Pertussis vaccine. Since the patient has sustained a puncture wound and their last tetanus shot was 7 years ago, it's important to assess their immunity and provide protection against tetanus, especially given the nature of their injury.

In adults, Tdap is typically used for booster vaccinations since it includes protection against pertussis, in addition to tetanus and diphtheria. The Centers for Disease Control and Prevention (CDC) recommends that adults receive a Tdap booster every 10 years, but in cases of potentially contaminated wounds, a booster may be administered earlier (if it has been 5 years since the last tetanus booster) to ensure adequate protection against tetanus.

Other options, such as DTaP and DT, are more appropriate for children or specific populations. DTaP is specifically for children under 7 years old and includes the same components as Tdap, while DT is used in specific situations when pertussis vaccination is not indicated, typically in children who cannot tolerate pertussis components.

Given the nature of the patient’s injury and the timing of their last tetanus vaccination, Tdap