Rabies Vaccine

Single-dose 1ml and 0,5ml vial, both equivalent to 1 vaccination dose (IM)

Executive Summary

(May 22, 2023)

Rabies is a zoonotic disease positioned as one of the most lethal viral infections; mortality approaches 100%. It is also preventable in nearly 100% of expositions when vaccination (+/- rabies immunoglobulin) has been properly administered. 

 

Adult and pediatric vaccination regimen for post-exposure prophylaxis (PEP)(4, 8, 9)

 

*Some regions and their local guidelines still  recommend a universal 5-dose regimen for PEP as previously was recommended by the US-CDC (3), and currently some manufacturers (10).  


**Complete 4 doses of PEP scheme or 3 doses of PrEP (pre-exposure prophylaxis).

About rabies

Vaccination and Immunoglobulin

Vaccination of rabies was pioneered in 1885 (1) and is now is globally recommended for pre-exposure and post-exposure prophylaxis (PrEP and PEP respectively)(4, 7, 8), for it is extremely successful in  preventing the disease, being one of the most effective vaccines ever invented (8). It has an achievable cost-effectiveness when appropriately indicated (3, 8). 

 

Rabies Immunoglobulin (RIG)

Different management strategies have been proposed for RIG.

 

Note: every bite injury must be properly managed based upon local standard wound care, tetanus and rabies protocols. 

Adult and Pediatric dose

Rabies Vaccination for Post-Exposure Prophylaxis (PEP)(4, 8, 9)

 

*Some regions and their local guidelines still  recommend a universal 5-dose regimen for PEP as previously was recommended by the US-CDC (MMWR 2008). 

**Complete 4 doses of PEP scheme or 3 doses of PrEP (pre-exposure prophylaxis).

For adults and older children, the vaccine should be injected into the deltoid muscle (2, 6, 7). In infants and small children, the anterolateral aspect of the thigh may be preferable, depending on age and body mass.

Renal, hepatic, or other adjustments

No renal or hepatic adjustments needed.

Pregnancy and Lactation

References

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EMDrugs Team