The Difference Between Post- and Pre-Exposure Rabies Vaccines (and When You Need Them)
If you’ve been following the news lately, you may have heard of the Capitol Hill fox that bit a total of nine people , including a congressman and a reporter. As amusing as the sightings of the fox are, the story has taken a more serious turn in recent days when the fox was caught and found to have rabies.
When I was in high school, I had to undergo a series of post-exposure tests for rabies after a cat bite. I stopped to help a kitten that was hit by a car, only for the kitten to bite me and run away, which meant I had no way of knowing if she had rabies or not.
Although the post-exposure shots seemed like overkill, especially since it meant going to the local emergency room on a Friday night, where I got two injections (one in each buttock). These initial shots were then followed by three more, given one at a time over the next two weeks.
As inconvenient as these vaccinations are, the post-exposure rabies series is an effective treatment that, when applied immediately, is almost 100% effective. Here’s what you need to know about the risk of rabies and why you might need to get vaccinated against it.
What you need to know about rabies
If left untreated, rabies has a fatality rate of 99.9%. This is not a virus you want to deal with as it attacks your central nervous system, destroying it in the process. An estimated 59,000 people die from rabies each year , mostly in countries where there is no widespread rabies vaccination for dogs and post-exposure rabies vaccine is not available.
Humans usually acquire rabies from the bites or scratches of infected animals, with bat or unvaccinated dog bites being among the most common routes of infection. In the US, rabies deaths are very low, with five deaths last year, the highest in a decade.
There are very few survivors of an active rabies infection, and the only treatment available is coma induction, during which the patient is treated with antivirals . Even this treatment, which was introduced decades ago, is only partially successful, and death is still the most likely outcome.
However, if a person exposed to rabies immediately receives a series of post-exposure rabies vaccinations, the vaccination is nearly 100% effective .
What a series of post-exposure rabies reports looks like
In the past, a series of post-exposure cases of rabies required a shot in the stomach. Fortunately, this is no longer the case: the first two injections are made in the buttocks, and the rest in the arm.
The first two shots , given either on or as close to the day of infection as possible, are a dose of rabies vaccine along with a dose of human rabies immunoglobulin. Immunoglobulin offers short-term help to fight any possible virus in your body, while the vaccine prompts your immune system to start producing antibodies against the rabies virus.
After the first two vaccinations, three more doses of the vaccine are administered on days 3, 7 and 14.
Why You Might Need a Rabies Vaccination Prior to Exposure
The rabies vaccine is expensive, so most people only get it after a potential exposure. However, people working in high-risk settings may require pre-exposure vaccination . Potentially dangerous occupations include veterinarians or wildlife specialists.
The Centers for Disease Control and Prevention also recommends considering a pre-exposure vaccination if you are traveling to a remote area where medical care is difficult to obtain, or if you spend more than a month in an area with a high level of canine rabies.
The pre-exposure vaccine series consists of three shots given over the course of a month. These initial vaccinations may be followed by booster doses, with the timing and frequency of booster doses depending on the risk of exposure.