Operator safety during injection vaccination of fish

Reports of adverse health effects to vaccinators after self-injection of fish vaccine motivated the present study which aimed at identifying risk factors and improving risk management. Information was collected through interviews with members of professional vaccinator teams, and with physicians who had treated injured vaccinators. In addition, a questionnaire was distributed among salmon farmers. Professional vaccinators reported from one to more than 50 stabs or self-injections during the vaccination season. Two cases of hospitalization due to anaphylactic reactions are described. Self-injections occurred exclusively on fingers and hands. The clinical picture is classified into four categories according to the type and severity of the reaction. The overall risk of self-injection leading to serious health effects was low, although the data do not allow a precise estimate. The collected information suggests that allergic hypersensitivity reactions occurred in two vaccinators, whereas increasing tolerance was reported from others. No information indicating infectious reactions was obtained, suggesting that non-steroid anti-inflammatory drugs constitutes an appropriate therapy for self-injection events. The use of a safety bow attached to the syringe and improved training and awareness of personnel apparently have reduced the incidence of self-injection since this study was conducted. Health risks for vaccinators have further been reduced by equipping vaccinators with adrenaline and the improved knowledge of local doctors regarding recommended treatment.