What If There Is A Serious Problem
An allergic reaction could occur after the vaccinated person leaves the clinic. If you see signs of a severe allergic reaction , call 9-1-1 and get the person to the nearest hospital.
For other signs that concern you, call your health care provider.
Adverse reactions should be reported to the Vaccine Adverse Event Reporting System . Your health care provider will usually file this report, or you can do it yourself. Visit the VAERS website atwww.vaers.hhs.gov or call 1-800-822-7967. VAERS is only for reporting reactions, and VAERS staff do not give medical advice.
Preparations Authorized For Use In Canada
- IMOVAXÂ®Rabies . Sanofi Pasteur Ltd.
- RABAVERTÂ®, Bavarian Nordic A/S
- IMOGAMÂ®Rabies Pasteurized , Sanofi Pasteur Ltd.
- HYPERRABÂ®S/D , Grifols Therapeutics Inc.
- HyperRABÂ®, Grifols Therapeutics LLC.*
- KamRABTM , Kamada Ltd.*
- * NACI has not yet deliberated on the use of KamRABâ¢ or HyperRABÂ®. NACI will review these immunizing agents and update the chapter in due course. For information regarding the use of these immunizing agents in the interim, please refer to the product monograph available through Health Canada’s Drug Product Database.
RabIg is a solution of anti-rabies Ig for IM administration, prepared from the pooled human plasma of screened donors immunized with rabies vaccine. RabIg is available on an emergency basis through local public health officials.
For complete prescribing information, consult the product leaflet or information contained within the product monograph available through the Health Canada’s Drug Product Database. Refer to Contents of Immunizing Agents Authorized for Use in Canada in Part 1 for a list of vaccines and passive immunizing agents authorized for use in Canada and their contents.
What Are The Side Effects Of The Vaccine
As with most vaccines the most common side effect is soreness and redness at the site of the injection. More severe reactions are rare and often related to allergies to the ingredients in the vaccine. Contact your health care provider if you are having any health effects which you think might be related to the vaccine.
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What If The Animal Is Not Available For Observation Or Testing
If you have been bitten or otherwise exposed to the saliva of an animal that is not available for observation or testing, contact your physician, local public health unit or state public health department and local law enforcement. If it was a domestic dog, cat, or ferret, try to locate the animal or the owner of the animal. If the animal cannot be located, speak with your physician, as you may need to start preventive treatment for rabies which will include the rabies vaccine.
What Are Rabies Immune Globulin And Rabies Vaccine
Rabies immune globulin provides immediate, short-term protection against the virus that causes rabies. RabIg contains large amounts of antibodies taken from donated human blood. Antibodies are proteins that a persons immune system makes to fight germs, such as bacteria and viruses.
Rabies vaccine provides long lasting protection against infection from the rabies virus. The vaccine is made from killed rabies virus and cannot cause rabies. In B.C., the rabies vaccine is provided free to those who have been exposed to an animal that may have rabies. It is also provided free to students attending a Canadian Veterinary College or Animal Health Training Centre.
RabIg and rabies vaccine are approved by Health Canada.
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Is Rabies In Humans Treatable
Luckily, if you treat rabies between exposure and the first symptoms, it can be treated with 100% effectiveness. After symptoms start developing, it’s too late. Rabies is very uncommon, but due to the severity of the virus, it’s important to take every precaution rather than risk getting rabies.
If you’ve been bitten, scratched, or licked by an animal with a risk of rabies, clean the wound immediately to prevent secondary infection and dress the wound. Then, go to the hospital and explain the situation. Report the bite to your public health unit.
After exposure to rabies , you’ll be given several doses of the rabies vaccine. The course takes one month, or four rabies shots, if you’ve never had a rabies shot before. If you’ve had a prior vaccine, you can take two doses within a few days.
Downtime during recovery is minimal, beyond caring for the bite to prevent infection and regular visits to the hospital for the vaccine.
Human Diploid Cell Vaccine For Post
The product information for human diploid cell vaccine states that it should not be administered intravenously or intradermally.
ATAGI recommends that the intradermal route is an acceptable alternative to the intramuscular route for pre-exposure prophylaxis.
The product information for human diploid cell vaccine recommends serological testing to determine when the antibody titre is below an acceptable level and a pre-exposure booster is needed.
ATAGI recommends boosters between 6 months and 3 years for people at continuing occupational risk. See People with ongoing occupational exposure to lyssaviruses are recommended to receive booster doses of rabies vaccine in Recommendations.
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Where Do I Get The Vaccine For Rabies
You can get the rabies vaccine from any hospital. If you spend a lot of time working with animals, such as at a wildlife sanctuary or at a humane society, you can get the vaccine as a preventative measure. Regular booster shots will be necessary.
In addition, you can easily get your vaccine after exposure at any hospital or urgent care center. If they don’t have the vaccine on hand, they can direct you to a nearby location that does.
Serological Testing For People Who Received Pre
Serological testing for people who received pre-exposure prophylaxis by the intradermal route
If pre-exposure prophylaxis was received by the intradermal route, check the rabies antibody level 24 weeks after finishing the pre-exposure course to ensure that VNAb levels are 0.5 IU per mL. Seek expert advice via state or territory health authorities if the titre is < 0.5 IU per mL.
If there will be insufficient time before travel for serological testing to be performed, the intramuscular route for vaccination should be used.
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What Happens If My Dog Cat Or Ferret Is Bitten Or Fights With A Wild Animal Or Another Animal That May Have Rabies
If the animal that bit your pet can be captured, have the animal’s brain tested for rabies. If the test is negative for rabies and your pet has not been vaccinated, you should vaccinate your pet immediately.
If the biting animal tested positive for rabies and the pet is current on its rabies vaccination, the pet should be given a booster vaccine immediately. The pet should be kept under the owner’s control and observed for 45 days.
If the biting animal tested positive for rabies and your pet has never been vaccinated, the recommendation is to put the pet down. If you are unwilling to euthanize the pet, it must be vaccinated as soon as possible and quarantined for 4 or 6 months.
If the biting animal tested positive for rabies and the pet is NOT current on its rabies vaccination , it should immediately receive a booster vaccine and be kept under the owner’s control and observed for 45 days.
If the animal cannot be captured, assume it is rabid and proceed as described above.
Human Diploid Cell Vaccine And Pre
The product information for human diploid cell vaccine recommends a routine 6th dose at 90 days in a post-exposure prophylaxis regimen.
ATAGI recommends that people who are immunocompromised can receive a 5th dose at day 28.
ATAGI recommends that people who are immunocompromised and have a VNAb titre < 0.5 IU per mL after the 5th dose of post-exposure prophylaxis can receive further doses.
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Human Rabies Immune Globulin
Human rabies immune globulin is infiltrated around the site of the bite, and provides rapid passive immune protection with a half-life of approximately 21 days. It is administered only once, on the first day of the PEP regimen . No more than the recommended dosage of HRIG should be given because excessive HRIG can partially suppress active production of antibody. If the HRIG was not administered on Day 0, it may be administered up to and including Day 7 of the PEP regimen. Beyond Day 7, HRIG is not indicated, as the patientâs antibody response to the vaccine occurs in that timeframe.
- The recommended dosage of HRIG is 20 IU/kg body weight for all ages including children.
- Infiltrate as much of the HRIG as possible into and around the bite wound.
- Administer the remaining HRIG intramuscularly at a site distant from the first vaccination site, generally in the quadriceps or deltoids.
- If there is no wound, such as following a bat-in-the-bedroom exposure, then administer the entire dose of HRIG in the quadriceps or deltoids.
Who Needs To Get The Rabies Vaccine
People at risk of rabies
The rabies vaccine is recommended for people at high risk of coming in contact with rabies. For example, you may need the rabies vaccine if you:
- Work as a veterinarian or animal handler
- Are a veterinary student
- Study the rabies virus
- Are traveling to other countries where rabies is common
The vaccine is given in 3 doses. The second dose is given 7 days after the first dose, followed by a third dose 21 or 28 days after the first.
Vaccination after an animal bite
If youre bitten by an animal that could have rabies, you can get the rabies vaccine to keep you from developing the disease. A doctor can help decide if you need the vaccine.
If you havent been vaccinated for rabies before, youll need 4 doses of the vaccine. Youll get the first dose right away, followed by additional doses:
- 3 days after the first dose
- 1 week after the first dose
- 2 weeks after the first dose
Youll also get a shot called Rabies Immune Globulin with the first dose to help your body fight the virus faster.
If youve already had the rabies vaccine, youll need 2 doses after an animal bite youll get the first dose right away, followed by a second dose 3 days after the first. You wont need the Rabies Immune Globulin shot.
If you think you or someone in your family needs the rabies vaccine, talk with a doctor.
Some people should not get the rabies vaccine or may need to wait to get it. Be sure to tell your doctor before getting vaccinated if you:
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As A Local Law Enforcement Official What Can I Do Protect The Public From Rabies
If your jurisdiction has rabies vaccination ordinances and leash laws, enforcing these ordinances will help reduce the risk of rabies in your communities. Enforcing the proper confinement of animals that have bitten a person helps ensure that the animal will not escape during the observation period, so a veterinarian can declare the animal in question healthy. It also minimizes the risk for other people or animals to be exposed to the confined animal and helps prevent people from getting unneeded rabies shots.
Vaccine And Immunoglobulin Safety And Adverse Events
Refer to Adverse Events Following Immunization in Part 2 for additional general information.
Common and local adverse events
Local injection site reactions such as pain, erythema, swelling, pruritus and induration at the injection site were reported in 60% to close to 90% of recipients. Mild systemic reactions such as headache, nausea, abdominal pain, muscle aches and dizziness were reported in about 6% to 55% of recipients.
Local injection site reactions were reported in 11% to 57% of recipients, consisting of pain, tenderness, swelling, erythema and induration at the injection site lasting for 2 to 3 days. Systemic reactions are generally less common and may consist of malaise, myalgia, arthralgia, headache and fever. Lymphadenopathy, nausea and rash have been reported occasionally.
Local injection site pain, erythema and induration are commonly reported following administration of RabIg, as are systemic reactions such as headache and low-grade fever. The majority of reported events were mild.
Less common and serious or severe adverse events
Serious adverse events are rare following immunization and, in most cases, data are insufficient to determine a causal association.
Anaphylaxis following immunization with PCECV has been rarely reported. Temporally associated neurologic events have also been very rarely reported but causal association with vaccination has not been established.
Contraindications and precautions
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Who Should Not Be Immunised Against Rabies
- If you have an illness causing a high temperature it is best to postpone vaccination until after the illness.
- You should not have a booster if you have had a severe allergic reaction to this vaccine in the past.
- You should not have a rabies vaccination if you have had a severe allergic reaction to one of the components in the vaccine in the past.
If you are pregnant or breast-feeding you may still be advised to have the vaccine if the risk of exposure to rabies is high.
What Causes A Rabies Infection In Humans
Any mammal is a potential carrier for rabies, but dogs are the most common carrier. Other potential rabies carriers include cats, bats, raccoons, mongooses, and even tigers!
It’s for this reason that it’s important that your dog or cat gets the rabies vaccine! Rabies is fatal not just to humans but also to animals and presents a serious risk to both you and your pet. Make sure your pet insurance covers this preventative vaccine!
Rabies infection can only be passed through saliva. It can’t be spread by the blood, feces, or urine of an infected animal. For this reason, a bite from an infected animal is the most common source of infection.
Rabies can also be transmitted if saliva gets into a wound, or enters the mouth or eyes. Humans can’t spread rabies to each other, the disease only spreads from animals to humans. While some scientists theorize that human-to-human transmission is possible, there are no recorded cases of it ever occurring.
Rabies is entirely treatable, even after exposure, with minimal downtime and side effects. However, if left untreated it’s fatal.
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Who Should Be Immunised Against Rabies
If you’re travelling abroad, you can find out if immunisation against rabies is recommended for any countries you are planning to visit from the NHS website Fitfortravel.
People who are at risk of infection with rabies are advised to have the rabies vaccine as a precaution. In the UK, people whose work puts them at risk of rabies are entitled to vaccination on the NHS:
- People working with the rabies virus in laboratories.
- People who work with imported animals.
- People who regularly handle species of bats in the UK.
- People whose work might bring them into contact with rabid animals.
- Healthcare workers who come into contact with patients with rabies.
- People working abroad in high-risk countries who may be in contact with animals with rabies.
In addition, people travelling to areas where there is a high risk of rabies may be advised to have the vaccine. This is not available on the NHS and must be paid for. This includes:
Travellers to parts of the world at risk of rabies where medical treatment may not be available. For example:
Vaccines for travellers are available through GP surgeries, some pharmacies, and travel clinics. Information on the risk of rabies in the country you are travelling to is available from a number of organisations. For example, the National Travel Health Network and Centre, and Public Health England . Whether you need rabies vaccination will depend on:
People Who Are Travelling
You should consider being vaccinated against rabies if you’re travelling to an area of the world where rabies is common and:
- you plan to stay for a month or more, or there’s unlikely to be quick access to appropriate medical care
- you plan to do activities that could put you at increased risk of exposure to animals with rabies, such as running or cycling
It takes up to 4 weeks to complete the vaccine course, so you need to start it at least 1 month before you plan to leave.
Pregnant women are advised to have the rabies vaccine if the risk of exposure to rabies is thought to be high and there’s limited access to medical care.
Use the TravelHealthPro website to find out if there’s a risk of rabies in the country you’re travelling to.
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Exposure Risk And Indications For Pep
Depending on the severity of the contact with the suspected rabid animal, administration of a full PEP course is recommended as follows:
|Table: Categories of contact and recommended post-exposure prophylaxis|
All category II and III exposures assessed as carrying a risk of developing rabies require PEP.This risk is increased if:
- the biting mammal is a known rabies reservoir or vector species
- the exposure occurs in a geographical area where rabies is still present
- the animal looks sick or displays abnormal behaviour
- a wound or mucous membrane was contaminated by the animals saliva
- the bite was unprovoked
- the animal has not been vaccinated.
The vaccination status of the suspect animal should not be the deciding factor when considering to initiate PEP or not when the vaccination status of the animal is questionable. This can be the case if dog vaccination programmes are not being sufficiently regulated or followed out of lack of resources or low priority.
WHO continues to promote human rabies prevention through the elimination of rabies in dogs, dog bite prevention strategies, and more widespread use of the intradermal route for PEP which reduces volume and therefore the cost of cell-cultured vaccine by 60% to 80%.
Lyssaviruses In Bats Worldwide
Bats anywhere in the world are a potential source of lyssaviruses and a potential risk for acquiring rabies, depending on how a person is exposed.
ABLV has not been isolated from bats outside Australia.
However, bats in other countries have closely related lyssaviruses. For example, bats in some parts of Europe can have European bat lyssavirus 1 and European bat lyssavirus 2. At least 4 people have died from European bat lyssavirus variants. None of them had a record of prophylactic rabies immunisation.60,62
There are rare reports of bat lyssavirus infections in other animals79-81 .
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