Indications
Rabies vaccine is indicated for prophylactic immunization against rabies and treatment of patients following suspected rabies contact.
In case of severe (WHO category 3) wounds, rabies immunoglobulin should be administered as soon as possible with the first dose of rabies vaccine. The anti-rabies immunoglobulin should be used as local wound soakage injections as much as possible, with the rest part for muscle injection. The rabies vaccine should be administered in different injection site.
Vaccination of immunized subjects: If vaccine administered in less than 5 years of exposure (cell culture rabies vaccine): 2 injections one on each of DO, D3. If vaccine administered in more than 5 years of exposure or incomplete vaccination: 5 injections on DO, D3, D7, D14 and D28 with administration of immunoglobulin if required. Post-exposure vaccination must be administered on the basis of severity under medical supervision.
WHO guidelines on post-exposure treatment depending on wound severity-
Touching or feeding of animal, licks on intact skin:
- Recommended treatment:Â None, if reliable case history is available.
Nibbling of uncovered skin, minor scratches, superficial bites (except on head, neck, shoulder girdle.arms or hands) or abrasions without bleeding, licks on broken skin:
Administration
- Prompt and gentle thorough washing with soap or detergent and flushing the wound with running tap water for at least 15 minutes.
- After washing, disinfectants like either ethanol (700 ml/l) or tincture or aqueous solution of iodine or povidone iodine must be applied.
- Don’t bandage or suture the wound.
Co-administration: Corticosteroid and immunosuppressive treatment may interfere with antibody production and cause vaccination failure. In these cases, a titration of neutralizing antibodies should be performed.
Interaction
Contraindications
Side Effects
Pregnancy & Lactation
Pregnancy. The potential risk of administration of rabies vaccine during pregnancy is unknown. Due to the severity of the disease, pregnancy is not considered to be a contraindication to post-exposure prophylaxis.
Lactation: It is not known whether the vaccine is excreted in human breast milk. Due to the severity of the disease, breast-feeding is not considered a contraindication.
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