For a 13-year-old with a partial-thickness burn, which immunizations should be administered today?

For a 13-year-old with a partial-thickness burn, which immunizations should be administered today?

• A. Td, IPV, and Var (if there is no history of disease)
• B. None (because a tetanus-containing vaccine was administered within the last 10 years)
• C. Td, Hep B, and MMR
• D. Td, MMR, Hep B, and Var (if there is no history of disease)

Answer: (D)

Tetanus protection is essential with any open wound, including partial-thickness burns, and this visit is a prime opportunity to bring a teen up to date on vaccines if immunity is uncertain. Burns are considered tetanus-prone wounds, so a tetanus-containing vaccine should be given today if the patient’s last booster was not recent or if their immunization history is unknown or incomplete. At the same visit, it’s appropriate to offer catch-up vaccines for other routine adolescent immunizations if there is no history of disease or proven immunity. That means giving MMR, Hepatitis B, and Varicella vaccines if the patient is not known to be immune. This combination—tetanus booster plus no-evidence-of-immunity vaccines for measles/mumps/rubella, hepatitis B, and varicella—best protects the teen during a wound-focused visit. The other options miss one or more of these important protections: some assume no tetanus need based on a 10-year rule that doesn’t apply to a tetanus-prone burn, while others omit one or more catch-up vaccines.

Tetanus protection is essential with any open wound, including partial-thickness burns, and this visit is a prime opportunity to bring a teen up to date on vaccines if immunity is uncertain. Burns are considered tetanus-prone wounds, so a tetanus-containing vaccine should be given today if the patient’s last booster was not recent or if their immunization history is unknown or incomplete.

At the same visit, it’s appropriate to offer catch-up vaccines for other routine adolescent immunizations if there is no history of disease or proven immunity. That means giving MMR, Hepatitis B, and Varicella vaccines if the patient is not known to be immune. This combination—tetanus booster plus no-evidence-of-immunity vaccines for measles/mumps/rubella, hepatitis B, and varicella—best protects the teen during a wound-focused visit.

The other options miss one or more of these important protections: some assume no tetanus need based on a 10-year rule that doesn’t apply to a tetanus-prone burn, while others omit one or more catch-up vaccines.