Rabies Vaccine, Purified Chick Embryo Cell Dosage

Usual Adult Dose for Rabies Prophylaxis

Preexposure Prophylaxis:
1 mL IM for a total of 3 doses on days 0, 7, and 21 or 28.

Postexposure prophylaxis:
Not previously vaccinated:
1 mL IM for a total of 5 doses on days 0, 3, 7, 14, and 28. Rabies immune globulin should also be administered on day 0 at 20 units/kg.

Previously vaccinated:
1 mL IM for a total of 2 doses on days 0 and 3. Do not administer rabies immune globulin.

Booster:
1 mL IM every 2 years or as indicated by antibody titers. People with continuing high risk of exposure such as certain veterinarians, should have their serum tested for rabies antibodies every 2 years; others working with live rabies in laboratories or vaccine production facilities and who are at risk of inapparent exposure should be tested every 6 months.

Usual Pediatric Dose for Rabies Prophylaxis

Preexposure Prophylaxis:
1 mL IM on days 0,7, and 28.

Postexposure prophylaxis:
Not previously vaccinated:
1 mL IM on days 0, 3, 7, 14, and 28. Rabies immune globulin should also be administered at 20 units/kg.

Previously vaccinated:
1 mL IM on days 0 and 3. Do not administer rabies immune globulin.

Booster:
1 mL IM every 2 years or as indicated by antibody titers. People with continuing high risk of exposure such as certain veterinarians, should have their serum tested for rabies antibodies every 2 years; others working with live rabies in laboratories or vaccine production facilities and who are at risk of inapparent exposure should be tested every 6 months.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Precautions

Preexposure vaccination should be deferred in patients who are currently sick, convalescent, or in the incubation stage of an infectious or febrile illness.

The vaccine is not indicated for subcutaneous, intradermal, or intravascular injection. Inadvertent intravascular injection may cause severe systemic reactions including shock. Injection into the gluteal region should be avoided because lower antibody titers may result.

The expected immune response may not occur in patients who are immunosuppressed which predisposes them to developing rabies. Administration of immunosuppressants should be avoided during postexposure rabies prophylaxis, unless they are considered essential for the treatment of another illness. In this case, serum antibody titers should be measured to ascertain that an adequate protective response has developed.

The purified chick embryo cell (PCEC) vaccine contains bovine gelatin, trace amounts of chicken protein, neomycin, chlortetracycline, and amphotericin B which may cause allergic reactions in patients with hypersensitivity to these substances. Patients who have had allergic reactions that are not anaphylactic or anaphylactoid in nature to chicken, eggs, or feathers are not necessarily at increased risk of developing allergic reactions to rabies PCEC vaccine.

The risk of developing a fatal infection should be considered before making the decision to discontinue rabies vaccination when severe anaphylactic or neuroparalytic reactions occur. The State Health Department or Centers for Disease Control and Prevention may be consulted for advice on managing serious reactions.

Dialysis

No adjustment recommended

Other Comments

In adults and small children, the IM vaccine should be injected into the deltoid muscle. In infants and small children the mid-lateral aspect of the thigh may be preferable.

Adverse reactions should be reported to the U.S. Department of Health and Human Services Vaccine Adverse Event Reporting System. Reporting forms and information regarding the completion of the form can be obtained at 1-800-822-7967 (USA).