Administering a Rabies vaccine

Administering a Rabies vaccine

General considerations:

The combination of local treatment of the wound, passive immunization with Rabies lmmunoglobulin (RIG) and vaccination is recommended for all severe exposure (category 111) to rabies. Prompt and thorough cleansing of the wound, and administration of purified Equine or Human Rabies lmmunoglobulin (ERIG or HRIG) and cell culture rabies vaccine immediately after exposure virtually guarantee complete protection, and the risk of post-exposure treatment complications is much lower than with brain-tissue vaceines.

Intramuscular schedule:

All intramuscular injections must be given into the deltoid region or,

in small children, into the anteriolateral area of the thigh muscle.

The vaccine should never be administered in the gluteal region.

The most widely used WHO scheme calls for a single 1.0 ml dose IM, administered in the upper deltoid (anteriolateral area of thigh for children) on day 0, 3, 7, 14 and 30 with an optional further dose on day 90.

Often the day 90 dose is omitted except in those also given passive immunisation with RIG (usually categ III bite).

The gluteal region is not recommended on account of high fat content in this region which retards the absorption of the vaccine.

Age and/or weight & dose:

Neonates can be given the anti-rabies vaccine without any additional side effects vis-a-vis older children or adults. Modern tissue culture rabies vaccine should not be given in reduced dosage  irrespective of the age and/ or weight.

The dosage schedule for the modern tissue culture vaccine remains same for all age groups. Continue reading