title: Use of specific immunoglobulins and vaccines for the management of accidental needlestick injury in the child: a practical review in the anti-vaccination movement era.
abstract: BACKGROUND
  Accidental needle injury is a common but still discussed problem.
  
  
  OBJECTIVE
  We discuss possible options to optimize the management of injured children in light of the available literature findings.
  
  
  RESULTS
  The risk of viral infection is low. However, blood investigations are mandatory, as well as appropriate counselling. Anti-HBV immunoglobulins are recommended in all unvaccinated subjects exposed to a HBsAg-positive source; however, there is no agreement regarding their administration in unvaccinated children. Use of anti-tetanus immunoglobulins in unvaccinated child with minor and clean wound is well defined; however, wound type classification in the event of needlestick injury may be difficult and subjective. There is no agreement on the routine use of antiretroviral prophylaxis.
  
  
  CONCLUSIONS
  From a practical point of view, several unsolved issues have emerged regarding the management of the children with needlestick injury, which appear particularly relevant in the anti-vaccination movement era. International guidelines should be encouraged at this regard.
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Sollai
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Jessica
authors.initials: J
authors.lastname: Iacopelli
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Giovannini
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Prato
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Galli
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: de Martino
authors.affiliation: a Department of Health Science , University of Florence, Anna Meyer Children's University Hospital , Florence , Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
mesh_terms: D000070377:Anti-Vaccination Movement; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use*; D008297:Male; D016602:Needlestick Injuries / Q000150:complications / Q000628:therapy*; D014612:Vaccines / Q000627:therapeutic use*; D014777:Virus Diseases / Q000517:prevention & control*
chemical_list: D007136:Immunoglobulins; D014612:Vaccines
keywords: HBV; HCV; HIV; Immunization; Needlestick injuries; Prophylaxis; Tetanus