Recommended Dosage for Rabivax (Rabies Vaccine)
For post-exposure prophylaxis in previously unvaccinated individuals, Rabivax should be administered as a 4-dose regimen of 1.0 mL intramuscular injections on days 0,3,7, and 14. 1
Post-Exposure Prophylaxis Dosing Schedule
Previously Unvaccinated Individuals:
- Standard regimen: 1.0 mL intramuscular injection on days 0,3,7, and 14 2, 1
- Immunocompromised patients: 5-dose regimen of 1.0 mL intramuscular injections on days 0,3,7,14, and 28 2, 1
- Administration site: Deltoid muscle for adults and older children; anterolateral thigh for younger children 1, 3
- Important: Never administer in the gluteal area as this may result in lower neutralizing antibody titers 1
Previously Vaccinated Individuals:
- 1.0 mL intramuscular injection on days 0 and 3 only (2 doses total) 1
- No Rabies Immunoglobulin (RIG) is needed for previously vaccinated persons 2, 1
Pre-Exposure Prophylaxis Dosing
For individuals at risk of rabies exposure (veterinarians, laboratory workers, travelers to endemic areas):
- 1.0 mL intramuscular injection on days 0,7, and 21 or 28 (3 doses total) 3
- Studies with Rabivax-S specifically have shown 100% seroconversion with this 3-dose schedule 4
Administration with Rabies Immunoglobulin (RIG)
For post-exposure prophylaxis in previously unvaccinated individuals with Category III exposures:
- RIG dose: 20 IU/kg body weight on day 0 1
- Infiltrate the full dose around and into wounds if anatomically feasible 1
- Any remaining volume should be administered intramuscularly at a site distant from vaccine administration 2, 1
- Never administer RIG in the same syringe or at the same anatomic site as the vaccine 1, 3
Efficacy and Safety
- Rabivax has demonstrated immunogenicity comparable to other licensed rabies vaccines in clinical studies 5, 6
- Both intramuscular and intradermal routes have shown good immunogenicity with Rabivax 5, 4
- Post-marketing surveillance has shown an excellent safety profile with mostly mild adverse events that resolve without sequelae 6
Special Considerations
- Routine serologic testing is not necessary for healthy individuals completing the recommended post-exposure prophylaxis regimen 2
- For immunocompromised patients, serologic testing is recommended after vaccination to confirm adequate antibody response 2, 1
- Proper wound cleansing with soap and water for 15 minutes is an essential component of post-exposure management 1, 3
Common Pitfalls to Avoid
- Administering vaccine in the gluteal area (reduces efficacy)
- Giving RIG to previously vaccinated individuals (unnecessary and may suppress immune response)
- Delaying initiation of post-exposure prophylaxis (should begin as soon as possible after exposure)
- Incomplete vaccination series (all doses must be administered according to schedule)
- Improper wound infiltration with RIG (all wounds should be infiltrated if anatomically feasible)