.png&w=384&q=75)
Rabies vaccine is indicated for prophylactic immunization against rabies and treatment of patients following suspected rabies contact.
Pre-exposure Immunization:
Post-exposure Immunization:
Rabies vaccine is an inactivated virus vaccine that is used for active immunisation against rabies. It can be used for pre- and post-exposure immunisation. For post-exposure immunisation, it is often used in conjunction with rabies immunoglobulins as it takes about 7-10 days for the specific antibodies to develop.
To reconstitute the vaccine, transfer content of supplied diluent into the vial containing freeze-dried preparation. Do not shake. After reconstitution the solution should be homogeneous, clear and free from any particles. Vaccine must be injected immediately after reconstitution and the syringe should be destroyed after use.
Method of administration for intramuscular use: The 1ml dose of Rabies vaccine should be given intramuscularly in the deltoid in adults and in the anterolateral aspect of the thigh muscle in children under 1 year. It should not be injected into the gluteal region. Do not inject intravenously.
Method of administration for intradermal use: The 0.1 ml dose of Rabies vaccine (per site) should be administered intradenmally in the upper arm, over the deltoid.
Pre-exposure immunization: 1 ml for children and adults.
Primary-vaccination: According to the WHO recommendations 1 injection by the intramuscular route on days DO, D7, D21 or D28, followed by a booster dose one year later.
Boosters: Thereafter, one injection every 5 years or when the titre is found to be less than 0.5 lU/ml
Post-exposure immunization:
Local treatment of the wound
Vaccination of non-immunized subjects
Intramuscular schedules: One Intramuscular (IM) dose comprised of 1 ml.
Standard intramuscular (1-1-1-1-1) regimen:
Or
Abbreviated multisite (2-1-1) regimen:
Intradermal schedules: One intradermal (ID) dose is comprised of 0.1 ml.
Thai Red Cross (2-2-2-0-1-1) schedule:
Or
WHO Modified Thai Red Cross (2-2-2-0-2) schedule:
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: 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:
Recommended treatment: Administer vaccine immediately on Day 0, D3, D7, D14 and D28.Stop treatment if animal remains healthy throughout the observation period of 10 days or if animal is killed humanely and found to be negative by appropriate laboratory techniques.
Single or multiple transdermal bites or scratches specially on head, neck, shoulder girdle,arms or hands. Contamination of mucus membrane with saliva (i.e. licks on broken skin):
Recommended treatment: Administer rabies immunoglobulin immediately with the first dose of rabies vaccine. Administer rabies vaccine on Day 0, D3, D7, D14 and D28 or D90 (optional). Stop treatment if animal remains healthy throughout the observation period of 10 days or if animal is killed humanely and found to be negative by appropriate laboratory techniques
Concurrent use with immunosuppressants may reduce the efficacy of vaccines.
Rabies vaccine is contraindicated in the following cases:
Pre-exposure-
Minor local reactions like pain, erythema, oedema, pruritus and induration at the injection site and lasting to 24-48 hours. Moderate fever, shivering, fainting, asthenia, dizziness, respiratory manifestations (dyspnoea, wheezing), fever, abdominal pain, vomiting and allergic skin reactions (urticaria, rash, itching).
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.
Keep out of the reach and sight of children. Store at +2 °C to +8 °C. Transportation should also be at +2 °C to +8 °C. Protect from light. Do not freeze
Rabies Vaccine [Human] (2.5IU/ml)