Rabies Vaccine

What Is Rabies?

Rabies is an infection caused by a virus. This virus is almost always fatal unless it is treated before symptoms appear. It affects the central nervous system.

People usually get rabies through a bite or scratch from an infected animal. Wild animals in the US that commonly carry the virus include bats, raccoons, skunks, foxes, and coyotes. Dogs, cats, and other domestic animals can also carry the disease. The rabies virus is found in the saliva, brain, or nervous tissue of infected animals. In the US, rabies in humans is rare. It is more common in other countries.

Rabies symptoms include:

Flu-like symptoms, such as headache, fever, and fatigue
Pain, tingling, or itching at the site of the bite wound or other site of viral entry
An increase in saliva
Siezures
Painful spasms and contractions of the throat when swallowing
Erratic, excited, or bizarre behavior
Paralysis

Symptoms may not appear for weeks or months after a bite.

If an animal has bitten you, wash the wound with soap and water right away. Call your doctor or go to the emergency room.

What Is the Rabies Vaccine?

The vaccine is made from killed rabies virus. It is given by injection.

Who Should Get Vaccinated and When?

There are two reasons someone shoud get the rabies vaccines:

Preventive vaccination
Vaccination after exposure

Preventive Vaccination

This is for people at high risk of exposure to rabies, such as:

Veterinarians and animal handlers
Rabies laboratory workers
People who explore caves
Travelers who may come in contact with rabid animals

The preventive vaccine is given in three doses. The second dose is given seven days after the first dose. The third dose is given 21 or 28 days after the first dose. People who may be exposed to the virus a lot should be tested for immunity on a periodic basis. Booster doses may be needed.

Vaccination After Exposure

This vaccination is given to anyone who has been bitten by an animal or was exposed to rabies. This treatment includes 4 doses of rabies vaccine. One dose is given right away. Three more doses are given on the third, seventh, and fourteenth days. A shot of rabies-specific immune globulin (RIG) should be given along with the first dose. Two doses are given for people who have been vaccinated before. One dose is given right away and another is given on the third day. RIG is not needed for people who have already had the vaccine.

What Are the Risks Associated With the Rabies Vaccine?

Like any vaccine, the rabies vaccine can cause serious problems, such as severe allergic reactions. The risk of serious harm or death is extremely small.

The most commonly reported problems include:

Soreness, redness, swelling, or itching around the injection site
Headache
Nausea
Abdominal pain
Muscle aches
Dizziness
Hives
Pain in the joints
Fever

Rarely, an illness similar to Guillain-Barre syndrome and other nervous system disorders have been reported with the vaccine.

Who Should Not Get Vaccinated?

Talk with your doctor before being vaccinated if you:

Had a life-threatening allergic reaction to a previous dose of rabies vaccine or one of its parts
Have a weakened immune system from a disease, drug use, or cancer
Are ill—Wait until you recover to get the preventive vaccine. If you have been exposed to rabies, you should get the vaccine right away.

What Other Ways Can Rabies Be Prevented Besides Vaccination?

Here are some ways to prevent rabies:

Vaccinate house pets.
Avoid contact with wild animals.
Do not touch any wild animal, even if it appears to be dead.
Seal basement, porch, and attic openings. This will prevent an animal from getting into your home.
Report animals that act strangely or look sick to animal control authorities.

Rabies symptoms in animals may include:

Strange behavior (often overly aggressive or vicious)
Disorientation (eg, nocturnal animals such as a bat or fox appearing in the daylight)

What Happens in the Event of an Outbreak?

In the event of an outbreak, authorities will identify and control the source of the outbreak. They will increase how often they monitor wild and domestic animals. Steps will be taken to increase animal rabies vaccination rates. Safety education will be provided to the public.

WHERE CAN I GET MORE INFORMATION?

Global Alliance for Rabies Control
http://www.rabiescontrol.net/

Vaccine and Immunizations
Centers for Disease Control and Prevention
http://www.cdc.gov/vaccines/

World Health Organization
http://www.who.int/en/

REFERENCES:

Malerczyk C, Detora L, Gniel D. Imported human rabies cases in Europe, the United States, and Japan, 1990 to 2010. J Travel Med . 2011;18(6):402-407.

McGettigan JP. Experimental rabies vaccines for humans. Expert Rev Vaccines . 2010;9(10):1177-1186.

Rabies. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated February 9, 2012. Accessed November 28, 2012.

Rabies. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/rabies/ . Updated September 19, 2012. Accessed November 28, 2012.

Rabies vaccine: what you need to know. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-rabies.pdf . Updated October 6, 2009. Accessed November 28, 2012.

3/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies. MMWR Morb Mortal Wkly Rep. 2010;59(2):1.

Last reviewed November 2012 by Brian Randall, MD
Last Updated: 11/26/2012

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