What Do You Do When the Rabies Vaccination Schedule is Off Schedule?

Discussion Rabies virus causes progressive encephalopathy and has a high fatality rate if not treated. Fortunately, post-exposure prophylaxis (PEP) regimens are highly effective. Any mammal is susceptible to rabies vaccine with domesticated dogs being important sources in some international locations and in the U.S. coyotes, fox, raccoon, and skunk and bats are important reservoirs. Rabies transmission from bats “…can occur from minor, seemingly unimportant, or unrecognized bites from bats.” Therefore contact should be minimized. PEP is considered for people who had significant contact, were known to be bitten or were in a room and might be unaware that the bat touched them or bit them. Examples would be a sleeping person or a child who was unattended and is now found to have a bat in the room. Current rabies vaccine schedule is a 4 dose series – Day 0, 3, 7 and 14. A fifth dose is given on day 28 for immunocompromised individuals. Vaccination is considered safe for pregnant women and should be given if PEP is indicated. Rabies immunoglobulin is also recommended to be given on Day 0. Once the PEP series is started it generally is continued. One reason to stop is if the bat tests negative for rabies, then the PEP can be stopped. It is recommended to consult current resources such as the Centers for Disease Control or local health department regarding current PEP treatment and individual circumstances. Learning Point It is important for the PEP to be giv...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news