Rabies Vaccine

Post-exposure vaccination consists of a series of vaccinations given to people who have been possibly exposed through bites or scratches from potentially infected animals, especially dogs.

Pre-exposure vaccination  consists of a series of vaccinations for people at high risk of exposure to rabies. Vaccination of travellers is usually not recommended unless there is a known risk of exposure, for example: those who are veterinarians, long-term travellers and expatriates living in areas with a high risk of exposure; adventure travellers who might come into direct contact with infected mammals; wildlife professionals, or researchers. These travellers should receive the required three injections 28 days prior to travel.

Two vaccines that are both derived for growing the virus in cells are recommended: a human diploid cell vaccine [HDCV] or a purified chick embryo cell vaccine [PCECV].

Rabies is found on?every continent of the world. Only 10 countries, however, are rabies-free due to vaccination of both domestic (e.g., dogs, cats) and wild animals (e.g., bats, raccoon) that harbour the virus. Some of these countries include islands of the Caribbean, Fiji, Finland, Ireland, Japan, New Zealand, Norway, Singapore, Sweden, United Kingdom and Uruguay.

Mild side effects include headache, nausea, abdominal pain, muscle aches, dizziness, and soreness, and redness, swelling or itching where the injection was given.  More serious reactions include hives, pain in the joints and fever.  

After possible exposure to rabies:

Recent studies indicate that 4 doses of a cell-derived vaccine(a human diploid cell vaccine [HDCV] or a purified chick embryo cell vaccine [PCECV]in combination with rabies immune globulin (RIG) will generate adequate immuneresponses and that a 5th dose of vaccine does not enhance the immuneresponse.

If unvaccinated priorto exposure to rabies:

A combination of RIG and vaccine is recommended for bothbite and non-bite exposures. The reduced vaccination schedule with HDCV orPCECV vaccine should be administered intramuscularly, as follows:

• First dose: as soon as possible after exposure(day 0);
• Second dose: day #3;
• Third dose: day #7; and
• Fourth dose: day #14.

In addition, RIG should be injected into and around thewound site. Careful and vigorous cleaning of the wound is an importantcomponent of rabies prevention.

If previously vaccinatedprior to exposure to rabies:

A 2 dose regimen is recommended, as follows:

• First dose: day 0; and
• Second dose: day #3.

Use of RIG is not necessary and should not be used. Careful andvigorous cleaning of the wound is an important component of rabies prevention.

Before exposure to rabies:

For pre-exposurevaccination, a 3 doses regimen in recommended, as follows:

• First dose: day 0;
• Second dose: day # 7; and
• Third dose: day # 21 or 28.

Special considerations:

For persons with compromised immune systems (e.g., HIV,organ transplant recipient, etc.) a 5-dose vaccination regimen with 1 dose ofRIG is recommended after exposure to rabies.

Source: http://www.cdc.gov/rabies/resources/acip_recommendations.html