If day 0 of rabies post‑exposure prophylaxis is on [DATE], on which dates should the subsequent PVRV doses be administered?

Rabies PEP Follow‑up Dates (PVRV IM)

• bold: not needed? Instruction: Bold the sentence that makes recommendation. We'll do.

Bold Recommendation Give subsequent PVRV doses on days 3,7, and 14 after day 0; if immunosuppressed, also give a fifth dose on day 28; if previously vaccinated, give only day 3. 1

• How to calculate dates:

  • If day 0 was [DATE], schedule:
    • Day 3: [DATE + 3 days]
    • Day 7: [DATE + 7 days]
    • Day 14: [DATE + 14 days]
    • Add Day 28 (only if immunosuppressed): [DATE + 28 days] 1

• Special cases:

  • Previously vaccinated (completed prior PrEP/PEP or documented adequate titer): doses only on day 0 and day 3; no HRIG. 1
  • Not previously vaccinated: give HRIG on day 0 (or up to day 7 if missed), plus vaccine on days 0,3,7,14. Avoid gluteal site. 1

• Rationale for morbidity/mortality/QoL:

  • The ACIP 4‑dose schedule prevents rabies with no added benefit from a 5th dose in immunocompetent patients; day 28 is reserved for immunosuppressed to ensure protective titers. 1