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ies
– Post-exposure rabies vaccination
A co m p lete rabies vaccinatio n series is ind icated fo r C atego ry II and I II exp o sures. I t
sho uld be started o n D 0 and co ntinued to co m p letio n if the risk o f rabies has no t been
exclud ed4 .
S everal d ifferent ty p es o f rabies vaccine are available. V accines p rep ared fro m cell
culture (C C V ), e.g. hum an d ip lo id cells (H D C V ), V ero cells (P V R V ) o r chick
em bry o
cells (P C E C V ) m ust rep lace nerve tissue vaccines (N TV ). There are several p o ssible
vaccinatio n p ro to co ls: ch eck and fo llo w natio nal reco m m end atio ns. Th e sh o rtest
regim ens am o ng tho se end o rsed by the W H O are sho wn as exam p les:
Post-exposure vaccination regimens
No pre-exposure vaccination o r Complete
Unknown vaccination status o r pre-exposure
Incomplete pre-exposure vaccination o r vaccination
Complete pre-exposure vaccination with a NTV with a CCV
Intramuscular (IM) Intradermal (ID)* IM o rID*
2-0-1-1 2-2-2-0-2 1-1
A d m inister in the d elto id U se o nly P V R V o r P C E C V
m uscle (antero lateral thigh in vaccine
child ren < 2 y ears), never in the
gluteal m uscle
O ne IM d o se = 0 .5 o r 1 m l O ne ID d o se = 0 .1 m l O ne IM d o se =
0 .5 o r
1 m l (d ep end ing o n
(d ep end ing o n the the m anufacturer)
m anufacturer)
O ne ID1 ddoo ssee = 0 .1 m l
D0
2 d o ses 2 d o ses 1 d o se
D3 (o ne d o se in each arm o r thigh) (1 d o se in each arm )
2 d o ses
D7 (1 d o se in each arm )
1 d o se 2 d o ses
D21 (in the arm o r thigh) (1 d o se in each arm )
1 d o se
D28 (in the arm o r thigh)
2 d o ses
(1 d o se in each arm )
+ RIG on Day 0, if indicated No RIG
* Inco rrect ID technique results in failure o f P E P : if co rrect ID technique canno t be assured , use the IM
regim en.
Either through observation of the captured animal (if domestic) or through laboratory diagnosis of the animal
4
(killed). The WHO recommends a 10-day observation period of the animal, if captured. If no signs of rabies
develop during the observation period, the risk of rabies is excluded, and rabies vaccination is discontinued.
Laboratory diagnosis of the dead animal involves sending the head to a specialised laboratory, which confirms or
excludes rabies in the animal. If laboratory diagnosis is negative, risk of rabies is excluded, and rabies
vaccination is discontinued.
196
– Post-exposure rabies vaccination
A co m p lete rabies vaccinatio n series is ind icated fo r C atego ry II and I II exp o sures. I t
sho uld be started o n D 0 and co ntinued to co m p letio n if the risk o f rabies has no t been
exclud ed4 .
S everal d ifferent ty p es o f rabies vaccine are available. V accines p rep ared fro m cell
culture (C C V ), e.g. hum an d ip lo id cells (H D C V ), V ero cells (P V R V ) o r chick
em bry o
cells (P C E C V ) m ust rep lace nerve tissue vaccines (N TV ). There are several p o ssible
vaccinatio n p ro to co ls: ch eck and fo llo w natio nal reco m m end atio ns. Th e sh o rtest
regim ens am o ng tho se end o rsed by the W H O are sho wn as exam p les:
Post-exposure vaccination regimens
No pre-exposure vaccination o r Complete
Unknown vaccination status o r pre-exposure
Incomplete pre-exposure vaccination o r vaccination
Complete pre-exposure vaccination with a NTV with a CCV
Intramuscular (IM) Intradermal (ID)* IM o rID*
2-0-1-1 2-2-2-0-2 1-1
A d m inister in the d elto id U se o nly P V R V o r P C E C V
m uscle (antero lateral thigh in vaccine
child ren < 2 y ears), never in the
gluteal m uscle
O ne IM d o se = 0 .5 o r 1 m l O ne ID d o se = 0 .1 m l O ne IM d o se =
0 .5 o r
1 m l (d ep end ing o n
(d ep end ing o n the the m anufacturer)
m anufacturer)
O ne ID1 ddoo ssee = 0 .1 m l
D0
2 d o ses 2 d o ses 1 d o se
D3 (o ne d o se in each arm o r thigh) (1 d o se in each arm )
2 d o ses
D7 (1 d o se in each arm )
1 d o se 2 d o ses
D21 (in the arm o r thigh) (1 d o se in each arm )
1 d o se
D28 (in the arm o r thigh)
2 d o ses
(1 d o se in each arm )
+ RIG on Day 0, if indicated No RIG
* Inco rrect ID technique results in failure o f P E P : if co rrect ID technique canno t be assured , use the IM
regim en.
Either through observation of the captured animal (if domestic) or through laboratory diagnosis of the animal
4
(killed). The WHO recommends a 10-day observation period of the animal, if captured. If no signs of rabies
develop during the observation period, the risk of rabies is excluded, and rabies vaccination is discontinued.
Laboratory diagnosis of the dead animal involves sending the head to a specialised laboratory, which confirms or
excludes rabies in the animal. If laboratory diagnosis is negative, risk of rabies is excluded, and rabies
vaccination is discontinued.
196
