From the Guidelines
Dr. Poor should receive post-exposure prophylaxis for rabies immediately if bitten by a potentially rabid animal, following a 4-dose vaccination regimen, as recommended by the Advisory Committee on Immunization Practices (ACIP) 1. The regimen consists of rabies immune globulin (RIG) and the rabies vaccine series. RIG should be administered once at 20 IU/kg body weight, with as much as possible infiltrated around the wound and the remainder given intramuscularly.
- The rabies vaccine should be given as a series of four doses on days 0,3,7, and 14, administered in the deltoid muscle (not the gluteal area, as this reduces effectiveness) 1.
- If Dr. Poor has been previously vaccinated against rabies, only two doses of vaccine are needed (on days 0 and 3) and RIG is not required. Treatment should begin as soon as possible after exposure, as rabies is nearly always fatal once symptoms develop.
- The vaccine works by stimulating the immune system to produce antibodies against the rabies virus before it can reach the central nervous system 1. Wound cleansing with soap and water is also essential as a first aid measure.
- Dr. Poor should not delay seeking treatment even if the exposure occurred in a low-risk area or from a seemingly healthy animal, as prompt medical intervention is crucial in preventing human rabies 1.
From the Research
Dr. Poor and Rabies Vaccine
There is no direct information available about Dr. Poor in relation to the rabies vaccine. However, the provided studies discuss various aspects of rabies vaccines, including their preparation, administration, and efficacy.
Types of Rabies Vaccines
- Human diploid cell strain (HDCS) vaccine is a type of rabies vaccine prepared in human cell cultures, which replaced earlier vaccines made from animal tissues due to its higher immunogenicity and lower reactogenicity 2.
- Purified Vero cell vaccine (PVRV) and purified chick embryo cell vaccine (PCECV) are other types of rabies vaccines used in post-exposure prophylaxis, with varying safety and immunogenicity profiles compared to HDCS vaccine 3.
Administration and Efficacy
- The HDCS vaccine is typically administered in three 1-ml doses on days 0,7, and 21 for pre-exposure prophylaxis, and in five doses on days 0,3,7,14, and 28 for post-exposure prophylaxis, often in combination with human rabies immune globulin (HRIG) 2, 4, 5, 6.
- Studies have shown that the combination of HDCS vaccine and HRIG does not significantly inhibit the active immune response, with high titers of neutralizing antibodies developed in most volunteers 4, 5, 6.
- A systematic review and meta-analysis found that HDCS vaccine demonstrated superiority in terms of safety compared to PVRV and PCECV, but no significant difference was observed in terms of immunogenicity 3.