Rabies vaccine: vaccination grades, dosage and side effects

Rabies can be defined as  ‘ A fatal viral infection, is usually acquired through the bite of an infected animal to the human beings’. Nearly all morbidity in human beings worldwide is due to the bite of a rabid dog, and rabies infection. The rabies occurs from the rabdo virus. Rabies vaccine has reduced the incidence of rabies morbidity.

Rabies vaccination is the active immunizing agent  used to prevent the infection caused by the rabies virus that carried by the animals. It is a killed rabies virus vaccine.

There are two types of rabies vaccinations:-

  1. Pre-exposure prophylaxis : this type of rabies vaccination is done for the persons who are at high risk of getting infected. Animal handlers, veterinarians, travelers, the persons who are in contact with the wild animals are likely to get infected.
  2. Post-exposure prophylaxis : this type of rabies vaccination prophylaxis is done to the patients who are exposed to the animal bites, indicated by bite, scratch, or lick.

Facts related to rabies vaccine:-

* The rabies  spreads through the pet animals as well as wild animals; dogs, bats, raccoons, skunks, cats, horses, swine, foxes and cattle are the usual ones. So it is better to immunize the domestic animals with rabies vaccine.
* A person who is bitten by the infected animal  should receive the rabies vaccine after the animal bite. If patient is known to be hypersensitive to the rabies vaccine, then the rabies vaccine should be administered under supervision with all the immediate measures for managing anaphylactic shock.
* Prophylactic use of the rabies vaccination should be avoided in children, adolescents, antenatal mother & adults on treatment for any acute illness.
* Pre exposure rabies vaccine is to be avoided if person is known to be allergic to rabies vaccine.
* The further rabies vaccination or  immunization is avoided in persons who had complications on rabies vaccine administration.

The immunization schedule is classified under some grades as:-

* Grade I : when the person is in contact with the animal but not in contact with the saliva or blood. For this kind scheduled rabies vaccination is not needed.
* Grade II : If the animal has licked or if any other kind of expose to the saliva and superficial, non- bleeding scratches made by the animal, immediate rabies vaccine immunization should be given according to the schedule B.
* Grade III :  includes all bites, bleeding scratches, all wounds on the head, neck, scapular region, extremities. Direct contact of animal saliva with mucous membrane of patient, immediate concomitant prophylaxis with rabies vaccine is needed according to schedule C.

The classification according to severity of expose to animal:-

Schedule A: In this type one injection of rabies vaccine of Prophylactic immunization prior to exposure is given. One injection is given IM on days 0,7,28 and 365.

Schedule B: Immunization vaccine  should be given after exposure but it is of somewhat long  coarse. One injection of  rabies vaccine IM is given on days 0,3,7,14,30 & if necessary it is given on day 90.

Special precautions for rabies vaccine administration:-

The person who has received rabies vaccine of doubtful potency and who has discontinued the course of injections has to receive the entire course of rabies vaccine according to exposure.  In case the person is re-exposed after 5 yrs., entire course should be completed according to grade of exposure.

Dosage and administration of rabies vaccine:-

There is no difference in the dose for children & adults. 1ml of rabies vaccine is given by intramuscular injection in the deltoid muscle (arm) or in the thigh in small children. The prescribed schedule should be followed strictly  even if some time has passed since the exposure.

rabies vaccine side effects:-

* This rabies vaccine doesn’t cause that much vital side effects, but it will cause generally mild and non serious side effects.
* There will be a mild pain, redness and swelling may occur at injection spot as a side effect.
* Rarely arthritis, gastrointestinal disorders or lymph node swelling may occur as  rabies vaccine side effects.
* Sometimes anaphylactic shock may occur.

Contraindications for rabies vaccine:-

If there are hypersensitivity reactions to the vaccine or acute febrile illness the rabies vaccine is contraindicated for pre-exposure prophylaxis. In case of pregnancy vaccine should be given if the level of risk is high for pre-exposure prophylaxis.

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