Rabies Vaccination

Rabies vaccines used for human are inactivated vaccines. These vaccines are used for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

Pre-exposure prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) involves receiving the rabies vaccination before potential exposure to the virus.  PrEP is recommended for individuals at high risk of rabies exposure, including laboratory workers handling live rabies virus and related viruses, as well as professionals who may have direct contact with infected animals, such as animal disease control staff and wildlife rangers. PrEP may also be recommended prior to recreational activities or travel to certain regions and for people residing in remote, highly rabies-endemic areas where access to rabies treatments is limited.

The dosing regimen for rabies PrEP consists of either a two-dose or three-dose series, depending on the risk category. The two-dose regimen involves vaccination on days 0 and 7, while the three-dose regimen includes vaccination on days 0, 7, and one booster on day 21 or after.

The two-dose regimen is suitable for those with lower exposure risk, whereas three doses may provide higher immunity response. In certain circumstances (e.g., frequent occupational exposure), periodic antibodies testing and additional booster doses may be necessary.

Therefore, travellers to areas where rabies is a risk should consult a doctor to determine the most suitable rabies vaccination regimen based on the travel itinerary, potential exposure risks, and individual preferences.

Important notes: Pre-exposure prophylaxis does not eliminate the need for post-exposure prophylaxis (PEP) after exposure. Anyone exposed to a suspected rabid animal (e.g., being bitten or scratched) must seek immediate medical care for PEP. PrEP simplifies PEP by eliminating the need for rabies immunoglobulins (RIG) and reducing the number of vaccine doses required after exposure.

Pre-exposure vaccination is recommended for prolonged trip to endemic areas, particularly for visits to remote rural regions without medical facilities, or people who will travel even for a short period in rabies infected areas if their activities may involve some special risk (hiking, cycling, trekking and animal handling). It should be noted that pre-exposure immunisation does not eliminate the need for post-exposure immunisation. Travellers should therefore seek local medical opinion if bitten by animals abroad even when they had already received a course of pre-exposure immunisation.

Adverse reactions

The rabies vaccine can cause mild side effects like pain, redness, swelling, or itching at the injection site, as well as systemic reactions such as fever, headache, tiredness, or muscle aches. Serious systemic, anaphylactic, or neurologic reactions are rare.

Contraindications

A history of anaphylaxis to a previous dose or a vaccine constituent contraindicates further PrEP administration with that vaccine or any vaccine containing that constituents.