Antirabies%2525252520vaccine

# Antirabies Vaccine ## Overview Rabies vaccine is an inactivated virus vaccine used for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Two common formulations are Human Diploid Cell Vaccine (HDCV) and Purified Chick Embryo Cell Vaccine (PCECV). ## Primary Indications * **Pre-exposure prophylaxis:** High-risk groups (e.g., veterinarians, laboratory workers, animal control). * **Post-exposure prophylaxis:** Following exposure to a high-risk animal (bites, scratches, or mucous membrane contact). ## Adult Dosing * **Pre-exposure prophylaxis (PrEP):** 1 mL IM (deltoid) on days 0 and 7. * **Post-exposure prophylaxis (PEP):** * **If previously vaccinated:** 1 mL IM on days 0 and 3. No Rabies Immune Globulin (RIG) required. * **If not previously vaccinated:** 1 mL IM on days 0, 3, 7, and 14. RIG (20 IU/kg) should be infiltrated around the wound site on day 0. ## Pediatric Dosing * **Dosing:** Identical to adults (1 mL IM). * **Site:** Children < 1 year should receive the injection in the anterolateral thigh. Children ≥ 1 year may receive the injection in the deltoid. * **Note:** RIG dose (20 IU/kg) is calculated based on pediatric body weight. ## Dose Adjustments * **Immunocompromised patients:** PEP requires a 5th dose on day 28 in addition to the standard 4-dose regimen. Serologic testing 1–2 weeks post-vaccination is recommended. * **Local protocol:** Dosing timing and RIG infiltration volume/technique may vary based on local public health guidelines (e.g., CDC/WHO protocols). Always verify against local jurisdictional requirements before administration. ## Contraindications * **PrEP:** Do not administer if there is a history of severe allergic reaction (anaphylaxis) to a previous dose or vaccine component. * **PEP:** There are **no contraindications** for PEP, as rabies is 100% fatal once symptoms appear. If an allergic reaction occurs, manage supportively and continue treatment under close medical supervision. ## Adverse Effects * **Local:** Injection site pain, erythema, swelling, or pruritus (very common). * **Systemic:** Mild fever, malaise, headache, dizziness, and muscle aches. * **Rare:** Serum sickness-like reactions (usually 5–14 days post-vaccination). ## Key Drug Interactions * **Immunosuppressants:** Corticosteroids, hydroxychloroquine, and other immunosuppressive agents may diminish the immune response to the vaccine; avoid these if possible during PEP. ## Monitoring * Monitor site for signs of local reaction. * In immunocompromised patients, monitoring titers is necessary to ensure seroconversion. ## Clinical Pearls * **Wound Care:** Thorough washing of the wound with soap and water is the single most effective intervention for preventing rabies after an exposure. * **RIG Administration:** If the full recommended dose of RIG cannot be infiltrated into the wound, the remainder should be injected IM at a separate site from the vaccine. * **Storage:** Keep refrigerated (2°C to 8°C); do not freeze. *** *Disclaimer: This information is for educational purposes only. Rabies protocols are strictly governed by state or national public health authorities. Always verify current prescribing information, local public health requirements, and CDC/WHO guidelines before initiating post-exposure prophylaxis.*