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Rabies Vaccination

Two regimens for POST-exposure prophylaxis

Intradermal (ID) route: Updated Thai Red Cross regimen
Consists of:
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)
Abbreviation: 2-2-2-0-2

Intramuscular (IM) route: Essen regimen
Consists of:
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)
Abbreviation: 1-1-1-1-1

PRE-exposure regimen:
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.
Consists of:
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:
a. chloroquine/hydroxyl-chloroquine
b. Long term corticosteroids
c. other immune-suppressive therapy

Reference:
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