From the Guidelines
Rabies vaccination is strongly recommended for individuals at high risk of exposure to the rabies virus, including veterinarians, animal handlers, laboratory workers, and travelers to areas where rabies is common, as stated in the guidelines by the Advisory Committee on Immunization Practices 1. These high-risk groups should receive pre-exposure vaccination to prevent rabies, which is almost always fatal if symptoms develop.
- The pre-exposure vaccination regimen typically consists of three doses of vaccine given on days 0,7, and 21 or 28, as outlined in the recommendations 1.
- Post-exposure prophylaxis, which includes the rabies vaccine series and rabies immune globulin, is also crucial for individuals bitten or scratched by animals suspected of having rabies. Key points to consider for rabies vaccination include:
- Pre-exposure vaccination should be offered to persons in high-risk groups, such as veterinarians and their staff, animal handlers, rabies researchers, and certain laboratory workers 1.
- Travelers to areas where rabies is common, especially if they will be far from medical care, should also be vaccinated 1.
- The vaccine works by stimulating the immune system to produce antibodies against the rabies virus, providing protection against this nearly always fatal disease 1. Given the high mortality rate of rabies once symptoms develop, preventive vaccination is crucial for those at risk, and the recommended vaccination regimens should be followed as outlined in the guidelines 1.
From the FDA Drug Label
INDICATIONS AND USAGE Rabies Immune Globulin (Human) Heat Treated, Imogam Rabies – HT, in conjunction with the standard series of Rabies Vaccine vaccinations, is indicated for individuals suspected of exposure to rabies, particularly severe exposure, with one exception: persons who have been previously immunized with Rabies Vaccine
The essential components of rabies post-exposure prophylaxis are wound treatment and, for previously unvaccinated persons, the administration of both human rabies immune globulin (RIG) and vaccine.
Recommendations for passive and active immunization after exposure to an animal suspected of having rabies have been outlined by the WHO and by the United States Public Health Service Advisory Committee on Immunization Practices (ACIP)
The following individuals should get the rabies vaccine:
- Previously unvaccinated persons who have been exposed to rabies, particularly severe exposure
- Individuals who have been bitten by an animal suspected of having rabies
- Individuals who have been exposed to an animal suspected of having rabies through a non-bite exposure, such as a scratch or abrasion
- Individuals who have had contact with bats, unless it can be certain that no bite, scratch, or mucous membrane contact occurred
- Individuals who have been exposed to wild terrestrial carnivores, such as raccoons, skunks, and foxes, unless the animal is available for diagnosis and public health authorities are facilitating expeditious laboratory testing, or if the brain tissue from the animal has already tested negative
However, persons who have been previously immunized with Rabies Vaccine should only receive the vaccine, without Rabies Immune Globulin (RIG) 2, 2.
From the Research
Individuals at Risk
The following individuals should consider getting the rabies vaccine:
- Animal care workers, including veterinarians, veterinary technicians, animal control workers, and wildlife rehabilitators, as they are at a higher risk of exposure to rabies 3
- Individuals who work with animals that may be infected with rabies, such as those in laboratories or animal shelters
- People who spend time outdoors in areas where rabies is common, such as hikers or campers
- Individuals who handle or come into contact with wild animals that may be infected with rabies
Pre-Exposure Prophylaxis
Pre-exposure prophylaxis (PrEP) is recommended for individuals who are at high risk of exposure to rabies, such as:
- Veterinarians and veterinary staff 3
- Laboratory workers who handle rabies virus or infected animals
- Animal control workers and wildlife rehabilitators 3
- Travelers to areas where rabies is common
Post-Exposure Prophylaxis
Post-exposure prophylaxis (PEP) is recommended for individuals who have been bitten or exposed to rabies, including:
- Individuals who have been bitten by an animal that may be infected with rabies 4, 5
- People who have come into contact with an animal that may be infected with rabies, such as through a scratch or lick
- Individuals who have been exposed to rabies through a laboratory accident or other means
Special Considerations
Special considerations should be taken into account when administering the rabies vaccine, including: