Antirabies%2525252525252525252525252520vaccine

# Antirabies Vaccine ## Overview This vaccine provides passive immunity against rabies virus. It is available as a purified chick embryo cell (PCEC) vaccine or a human diploid cell (HDCV) vaccine. ## Primary Indications * **Post-exposure prophylaxis (PEP):** Following a potential rabies exposure (e.g., animal bite or scratch). * **Pre-exposure prophylaxis (PrEP):** For individuals at high risk of rabies exposure. ## Adult Dosing **Post-Exposure Prophylaxis (PEP - Unvaccinated or Incompletely Vaccinated Individuals):** * **Rabies Immune Globulin (RIG):** 20 international units (IU)/kg given intramuscularly (IM) on day 0. Administer in the wound area if possible; any remaining dose given IM at an alternate site. * **Rabies Vaccine:** * **Days 0, 3, 7, and 14 (4 doses):** 1 mL IM. * For individuals who are immunocompromised, an additional dose on day 28 may be considered. **Post-Exposure Prophylaxis (PEP - Previously Vaccinated Individuals):** * **Rabies Immune Globulin (RIG):** Not indicated. * **Rabies Vaccine:** * **Days 0 and 3 (2 doses):** 1 mL IM. **Pre-Exposure Prophylaxis (PrEP):** * **Primary Series:** 1 mL IM on days 0, 7, and 14 (3 doses). * **Booster Doses:** For individuals with ongoing risk, antibody titers should be checked every 2 years. If titers are low, administer a booster dose of 1 mL IM. ## Pediatric Dosing Pediatric dosing is the same as adult dosing based on weight for RIG and standard doses for vaccine, with intramuscular injections given in the anterolateral thigh or deltoid muscle depending on the volume. ## Dose Adjustments No dose adjustments are necessary for renal or hepatic impairment. ## Contraindications * Severe allergic reaction to a previous dose of rabies vaccine or any component of the vaccine. * Severe allergy to egg or egg products (though this is less of a concern with newer vaccines like PCECV). ## Adverse Effects Common adverse effects include local reactions at the injection site (pain, redness, swelling), headache, nausea, abdominal pain, muscle aches, and dizziness. Rare but serious adverse effects include anaphylaxis. ## Key Drug Interactions * **Immunosuppressive Medications:** May decrease the immune response to rabies vaccine. If possible, delay immunosuppressive therapy until after completion of PEP. * **Antimalarial Drugs (e.g., Chloroquine):** May interfere with the antibody response to rabies vaccine. For individuals receiving PrEP who are taking antimalarials, an alternative vaccine schedule (days 0, 3, 7, 14, 28) may be considered. ## Monitoring * Monitor for signs and symptoms of allergic reactions. * For PrEP, monitor antibody titers every 2 years if ongoing risk is present. ## Clinical Pearls * RIG should be administered on the same day as the first vaccine dose if possible. * Intramuscular administration is crucial for efficacy. * Clarify the patient's vaccination history accurately, as it dictates the PEP regimen. * The specific brand and type of rabies vaccine available may influence local protocols; consult institutional guidelines. *** *This information is intended for healthcare professionals and does not replace current prescribing information. Always verify the most up-to-date drug information with the official product labeling and local protocols.*