I was giving a patient a vaccine today, and I have a cut in my arm that was bleeding. 

The syringe that we use is a safety syringe that you push in and the needle goes inside. When I went to push the needle in after I was done some liquid, I’m assuming was the some contents of the vaccine splashed up on my arm.  I’m not sure it went into the bleeding cut. 

Is there any risk of HIV or any blood borne illnesses from this? The lady was in her late 50s.

I hope  this is clear, let me know if I need to clarify anything.  Thank you doctor 

This sounds like an entirely zero risk event in relation to HIV and all other blood-borne infections -- even if the patient is infected (and she probably isn't). Of course you were there and I wasn't -- but from your description, I can't imagine that any patient blood was in the vaccien that contacted your arm. But even if you dipped your hand into a bucket of HIV infected blood, there would be little or no transmission risk -- even with a small cut like you describe. (Anyway, was it really actively bleeding? If so, you should not have been giving the vaccine or otherwise in direct contact with patients, until the bleeding had stopped and the wound was covered. If it was a healing cut, or even a recent one that had stopped actively bleeding, there would be little or no risk.)

A general comment:  Various public health and other experts have done a poor job of explaining blood related risks to the public. It's easy to have the impression that even the slightest blood contact is risky. It simply isn't true. During the entire 4 decades of the known world wide HIV/AIDS epidemic, there has been no reported case of anyone acquiring HIV from the trivial sort of contact you're worried about. The only documented blood-borne transmissions are in health care personnel who are injured with a visibly blood-contaminated sharp instrument while caring for a known-infected patients; and maybe a rare case with massive blood exposure of the kind that might occur in giving emergency care to an auto accident victim.

If any doubt remains, discuss with your supervisor; or if the office has an infection control nurse, with him or her. But in the meantime, I see no need for concern and would not recommend you be tested for HIV or viral hepatitis.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

Is it okay if I ask a few more questions?

This event happened after I injected the patient, so the liquid had been in the syringe that was injected into the patient? Does that change your opinion?

I don’t know if I would describe the cut as actively bleeding. It was bleeding a little bit definitely, but it wasn’t pouring blood or anything. 

Thank you. And I do agree with you, some sources make it seem like it’s almost a guaranteed risk!

I'm still not concerned about the cut -- both because its exposure would be low risk, and for the reason above -- I see no possiility of exposure. And as already discussed, I see no reason to suppose the patient has HIV or hepatitis B or C. Do you have reason to believe she is at high risk? (e.g. injection drug user, formerly incarcerated, and so on)?

Don't overthink this. You're not going to be the first person in the world infected in this manner.