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What care will I receive?

Wound Care

Regardless of the risk of rabies, bite wounds can cause serious injury such as nerve or tendon laceration and local and system infection. Your doctor will determine the best way to care for your wound, and will also consider how to treat the wound for the best possible cosmetic results.

For many types of bite wounds, immediate gentle irrigation with water or a dilute water povidone-iodine solution has been shown to markedly decrease the risk of bacterial infection.

Wound cleansing is especially important in rabies prevention since, in animal studies, thorough wound cleansing alone without other postexposure prophylaxis has been shown to markedly reduce the likelihood of rabies.

You should receive a tetanus shot if you have not been immunized in ten years. Decisions regarding the use of antibiotics, and primary wound closure should be decided together with your doctor.

Rabies Postexposure Vaccinations

For people who have never been vaccinated against rabies previously, postexposure anti-rabies vaccination should always include administration of both passive antibody and vaccine.

The combination of human rabies immune globulin (HRIG) and vaccine is recommended for both bite and nonbite exposures, regardless of the interval between exposure and initiation of treatment.

People who have been previously vaccinated or are receiving preexposure vaccination for rabies should receive only vaccine.

Adverse reactions to rabies vaccine and immune globulin are not common. Newer vaccines in use today cause fewer adverse reactions than previously available vaccines. Mild, local reactions to the rabies vaccine, such as pain, redness, swelling, or itching at the injection site, have been reported. Rarely, symptoms such as headache, nausea, abdominal pain, muscle aches, and dizziness have been reported. Local pain and low-grade fever may follow injection of rabies immune globulin.

The vaccine should be given at recommended intervals for best results. Talk to your with your doctor or state or local public health officials if you will not be able to have shot at the recommended interval. Rabies prevention is a serious matter and changes should not be made in the schedule of doses.

People cannot transmit rabies to other people unless they themselves are sick with rabies. The prophylaxis you are receiving will protect you from developing rabies, and therefore you cannot expose other people to rabies. You should continue to participate in your normal activities.

Postexposure Vaccinations

Rabies postexposure prophylaxis consists of a dose of human rabies immune globulin and rabies vaccine given on the day of the exposure, and then a dose of vaccine given again on days 3, 7, and 14.

If a person has previously received postexposure vaccinations or received preexposure vaccinations, only two doses of vaccine (on the day of exposure and then 3 days later) are needed. Human rabies immune globulin is not required. Your doctor and local health department will be able to guide you through the process.

Also see: Preexposure Vaccinations

Rabies Biologics Currently Available—United States, 20181

Human Rabies Vaccine

Biologic Product name/ Manufacturer Potency
Human diploid cell vaccine (HDCV)*,, Imovax®/ Sanofi Pasteur > 2.5 international units (IU) of rabies antigen
Purified chick embryo cell vaccine (PCECV)*,, RabAvert®/ Novartis Vaccines and Diagnostics >2.5 IU of rabies antigen

*Dose: Single dose vial of vaccine should be reconstituted with accompanying sterile diluent to final volume of 1mL before administration.

Administration Route: Intramuscular in the deltoid area for adults, in the deltoid area or the anterolateral aspect of the thigh for children. Do NOT use the gluteal area for HDCV or PCECV.

Indications: Pre-exposure2 AND post-exposure prophylaxis.

Rabies Immunoglobulin

Biologic Product name/ Manufacturer Potency Dose
Human immunoglobulin*, Imogam® Rabies-HT / Sanofi Pasteur 150 IU/mL 20 IU/kg
Human immunoglobulin*, KEDRAB3 / Kedrion Biopharma and Kamada Ltd 150 IU/mL 20 IU/kg
Human immunoglobulin*, HyperRab™ S/D / Grifols3 150 IU/mL  20 IU/kg
Human immunoglobulin*, HyperRab®3,4 / Grifols3 300 IU/mL4  20 IU/kg4

*Administration Route: Local infiltration around wound, with remaining immunoglobulin administered intramuscularly in an anatomical site distant from where vaccine was placed.

Indications: Post-exposure prophylaxis with human rabies immunoglobulins is indicated for ONLY those persons who 1) did not receive appropriate pre-exposure prophylaxis2 and 2) have not previously received post-exposure prophylaxis for rabies in accordance with ACIP recommendations.

1Rabies biologics marketed in other countries are not included here.

2Pre-exposure prophylaxis is indicated for specific populations who are at increased risk for rabies exposure such as veterinarians and rabies research laboratory workers.

3Licensed by the U.S. Food and Drug Administration after development of the 2010 ACIP Rabies Guidelines.

4Note HyperRab® immunoglobulin product has a different concentration compared to all other rabies immunoglobulins (including the very similarly named HyperRab™ S/D) – requiring lower volumes to administer the recommended dose of 20 IU/kg ; care should be taken to ensure the correct dose of immunoglobulin is administered to ensure adequate immune response.