[Question #3030] Is testing required?

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93 months ago
Hello doctors.
Here's my story: I am born and bred in New Jersey, and this is only my second visit to Mumbai(India). I had to visit the local hospital here for flu shot booster since I had missed mine back in NJ for this year. I always try to be assured my observing if all that is used to inject is always fresh and not re-used. Specially after the incidence in NJ in 2015 where the nurse re-used needles and syringes to vaccinate multiple people. So, the nurse here prepared the vaccine at some distance, so i could not make sure if she used everything fresh. However, before she injected me, i asked her if everything was un-used, and she said yes. But I noticed that she used a different needle to aspirate the vaccine from the vial and maybe changed to another one to inject me. My concern here is, i'm not sure if she used the fresh needle to aspirate the vaccine into the syringe. also what instrument she used to crack open the vial, was lying on the dressing trolley. I'm scared of the instrument being contaminated. Also, the injection was deep Intra-muscular. She was not wearing gloves and stopped the bleeding after the injection at her site with her bare hands. All of this, has FREAKED me out. And I'm scared of HIV And HCV contraction from the events. I'm completely immunised for Hep. B.  Am I at risk for the blood-borne pathogens??? Also I got all my tests done before coming to Mumbai and all negative. But this event has made me feel I put myself at risk by going to the local hospital in Mumbai. Do i need to get tested????
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Edward W. Hook M.D.
93 months ago
Welcome to our Forum.  Your nurse followed recommended procedures by changing needles because the first needle would have been dulled when it was used to perforate the vaccine vial to get the vaccine that was administered to you (you would not want them to use a dull needle, would you :)).  Further, you asked for re-assurance and recieved it when receiving vaccine in a established health care facility.  I would not be concerned and would not consider this a reeason to test for HIVm hepatitis C or any othe rblood borne pathogen.  I hope this reassurance is helpful.  I would not feel the need for testing in the same situation.  EWH
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93 months ago
Thanks for your swift reply. :)) My concern is I did not see her opening it from the pack, she was almost 20 feet away. 
She did say it was fresh. But i dont know how good of a hospital it is, as I'm totally unaware of the locality. Is it safe to assume that they follow the protocols of using new needles and syringes?? Also she touched her fingers at the site of injection while it was still oozing out blood without wearing gloves. So I'm freaking out completely fro contracting a blood-borne infection.
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Edward W. Hook M.D.
93 months ago
No change in my assessment.  You asked her.  Why would she not tell the truth?

As far as gloves, it might surprise you that in North America health care providers wear gloves to protect themselves, not the other way around.  Even if she had contaminated blood on her fingers when she held the gauze to your puncture site, this would not put you at risk for HIV or hepatitis. These infectious are not transmitted in this way, through surface contamination.  The virus must be injected DEEP into tissue.  EWH
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