Rabies Vaccine

Rabies vaccine is an immunization used to prevent rabies in people who have been bitten by an animal or otherwise exposed to the rabies virus.

• Rabies vaccine is available under the following different brand names: HDCV, Imovax, and rabies vaccine human diploid cell culture.

Adult and Pediatric Dosage Forms and Strengths

Lyophilized powder for reconstitution

• 2.5 International Unit/1mL

Dosage Considerations – Should be Given as Follows:

Pre-exposure

Adult:

Primary

• 1 mL intramuscular (IM) (deltoid region) 3times
• 1 injection on each of days 0, 7, and 21 or 28

Booster

• 1 mL IM (deltoid region) to maintain a serum titer greater than 1:5 serum dilution by RFFIT
• Test serum for rabies antibodies q6month

Pediatric:

• 1 mL IM (deltoid region, in small children and infants anterolateral region of thigh) 3 times, one injection on each of days 0, 7, and 21 or 28

Post-exposure

• Adult: Centers for Disease Control (CDC) recommendations: 1 mL intramuscular (IM) (in deltoid region) 4 times
• One injection each on days 0, 3, 7, and 14 in conjunction with administration of human rabies immune globulin (HRIG) on day 0
• HRIG: 20 IU/kg; if anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered intramuscularly (IM) at an anatomical site distant from vaccine administration
• Immunosuppressed patients: Administer 1 mL IM x5 doses on days 0, 3, 7, 14, and 28 with HRIG

Pediatric:

• CDC recommendations: 1 mL intramuscularly (IM) (in the deltoid or gluteal muscle, in small children and infants anterolateral region of thigh) on days 0, 3, 7, and 14 postexposure with human rabies immune globulin (HRIG) on day 0
• HRIG: 20 IU/kg; if anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered IM at an anatomical site distant from vaccine administration
• Immunosuppressed patients: Administer 1 mL IM x5 doses on days 0, 3, 7, 14, and 28 with HRIG

Postexposure (Previously Immunized)

Adult:

• 1 mL intramuscular (IM) (deltoid region) 2 times
• One injection each on days 0 and 3

Pediatric:

• If previously immunized, give 2 doses (1 mL each) on days 0 and 3 postexposure without HRIG

Administration

• Using the longer of the 2 needles supplied, transfer the entire contents of the diluent vial into a vaccine vial
• Mix gently to avoid foaming
• The white, freeze-dried vaccine dissolves to give a clear or slightly opaque suspension
• Withdraw the total amount of dissolved vaccine into the syringe and replace the long needle with a smaller needle for intramuscular (IM) injection

Additional Information

• Up-to-date vaccination schedules are available at www.cdc.gov/nip/publications

Common side effects of Rabies Vaccine include:

• Injection site reactions (pain, soreness, swelling, redness, itching, burning)
• Nausea
• Vomiting
• Abdominal/stomach pain
• Diarrhea
• Headache
• Fatigue
• Localized enlarged lymph nodes
• Sore throat
• Low-grade fever
• Chills
• Muscle ache or pain
• Dizziness
• Feeling unwell (malaise)

Serious side effects of rabies vaccine include:

• Fever above 104 degrees
• Weakness or prickly feeling in your fingers or toes
• Problems with balance or eye movement
• Trouble speaking or swallowing

Postmarketing side effects of rabies vaccine reported include:

• Guillain-Barre syndrome (rare)
• Anaphylaxis (rare)
• Encephalitis (very rare)
• Meningitis (very rare)
• Retrobulbar neuritis

This is not a complete list of side effects and other serious side effects may occur. Call your doctor for information and medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

Rabies Vaccine has no known severe interactions with other drugs.

• Severe interactions of Rabies Vaccine include:
  • belimumab
• Rabies Vaccine has serious interactions with at least 37 different drugs.
• Moderate interactions of rabies vaccine include:
  • certolizumab pegol
  • daclizumab
  • hydroxyurea
  • mercaptopurine
  • methotrexate
  • rabies immune globulin, human (RIG)
• Mild interactions of rabies vaccine include:
  • chloroquine

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

This medication contains the rabies vaccine. Do not take HDCV, Imovax, and rabies vaccine human diploid cell culture if you are allergic to the rabies vaccine or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Documented hypersensitivity to neomycin

Effects of Drug Abuse

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Rabies Vaccine?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Rabies Vaccine?"

Cautions

None.

Pregnancy and Lactation

• Use rabies vaccine with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• If exposure to rabies is suspected while breastfeeding, nursing a baby is not a priority as far as immunization is concerned. Consult your doctor.