Two regimens for POST-exposure prophylaxis
Intradermal (ID) route: Updated Thai Red Cross regimen
0.1 ml intradermally
4 visits: 2 doses are given at each visit, hence: 8 doses
Days 0, 3, 7 & 28 (day 0 is the day of first dose)
Intramuscular (IM) route: Essen regimen
0.5 ml (some brands need 1 ml) intramuscularly
5 visits: single dose is given at each visit, hence: 5 doses
Days 0, 3, 7, 14 & 28 (day 0 is the day of first dose)
Recommended for those at high risk of rabies e.g. laboratory staff, dog handlers,close contacts of rabies patients, wild life wardens, animal catchers, travellers from rabies free area to endemic area etc.
Single dose of 0.1mL, by ID route on days 0, 7 and 21 or 28
Who should receive intra-muscular vaccine and not ID?
1. Immuno-compromised individuals
2. Individuals receiving:
b. Long term corticosteroids
c. other immune-suppressive therapy
1. Government of India, National rabies control programme, National guidelines on rabies prophylaxis, National Centre for Disease Control, 2019, Delhi, India.
2. Government of Himachal Pradesh: GUIDELINES FOR RABIES PROPHYLAXIS AND INTRADERMAL RABIES VACCINATION IN HIMACHAL PRADESH, 2019. Directorate of Health Service, Swasthya Sadan, Kasumpti, Shimla-171009
signs & symptoms of rabies in brief: http://www.ihatepsm.com/blog/signs-and-symptoms-rabies-brief
Categorization of animal bite: http://www.ihatepsm.com/blog/post-%E2%80%93-exposure-prophylaxis-rabies
Steps of immediate wound management in animal bite: http://www.ihatepsm.com/blog/steps-immediate-wound-management
Rabies Vaccination: http://www.ihatepsm.com/blog/rabies-vaccination