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rabies vaccine (human diploid cell)

Generic Name: rabies vaccine (human diploid cell) (RAY beez vax EEN (HUE man DYE ploid sel))
Brand Name: Imovax Rabies

What is rabies vaccine?

Rabies is a serious disease caused by a virus. Rabies occurs mainly in animals, but a human can get rabies after being bitten by an infected animal. There may be no symptoms at first, but weeks or even months later rabies can cause pain, headaches, tiredness, irritability, fever, hallucinations, seizures, and paralysis. Rabies can be fatal.

You are more likely to be exposed to the rabies virus if you are a veterinarian, animal handler, rabies laboratory worker, or if you come into contact with animals that may carry the virus (including cats, dogs, foxes, skunks, raccoons, bobcats, coyotes, and bats). Traveling to certain countries may also increase your risk of exposure to rabies.

Rabies human diploid cell vaccine is used to protect people who have been bitten by animals (post-exposure) or otherwise may be exposed to the rabies virus (pre-exposure).

This vaccine works by exposing you to a small dose of the virus, which causes the body to develop immunity to the disease. Rabies vaccine is for use in adults and children.

Like any vaccine, the rabies vaccine may not provide protection from disease in every person.

What is the most important information I should know about rabies vaccine?

You should not receive a booster vaccine if you had a life threatening allergic reaction after the first shot.

What should I discuss with my healthcare provider before receiving rabies vaccine?

You should not receive this vaccine if you have ever had a life threatening allergic reaction to a rabies vaccine.

Before receiving this vaccine, tell the doctor if you have:

  • a weak immune system (caused by disease or by using certain medicine);

  • any type of infection or severe illness; or

  • an allergy to neomycin.

It is not known whether this vaccine will harm an unborn baby. However, if you are at a high risk for infection with rabies during pregnancy, your doctor should determine whether you need this vaccine.

It is not known whether this vaccine passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is a rabies vaccine given?

This vaccine is given as an injection (shot) into a muscle. You will receive this injection in a doctor's office or clinic setting.

For pre-exposure prevention of rabies, you will need to receive a total of 3 shots. The second shot is usually given 7 days after the first, followed by a third shot 2 or 3 weeks later.

If you have a continued risk of exposure to rabies, you may need to receive the preventive vaccine series every 2 years. If you work around live rabies virus, such as in a laboratory or a vaccine production area, you may need a booster vaccine every 6 months. You might need frequent blood tests to determine your need for further preventive vaccination.

For post-exposure prevention after you have been bitten or exposed to rabies, you will need to receive a total of 4 shots. The first shot is given as soon as possible, and the rest are usually given on Days 3, 7, and 14. With the first shot you may also receive a separate injection of rabies immune globulin (im-YOON GLOB-yoo-lin). This injection is given directly into or near the bite wound or injury where the rabies virus is likely to have entered your body.

For people who have received a rabies vaccine in the past: You will need only 2 rabies vaccine injections for post-exposure prevention, spaced 3 days apart. You will not need the immune globulin shot.

The timing of this vaccination is very important for it to be effective. Your individual booster schedule may be different from these guidelines. Follow your doctor's instructions or the schedule recommended by the health department of the state you live in.

Be sure to receive all recommended doses of this vaccine or you may not be fully protected against disease.

What happens if I miss a dose?

Call your doctor for instructions if you miss a booster dose or if you get behind schedule.

What happens if I overdose?

An overdose of rabies vaccine is unlikely to occur.

What should I avoid while receiving rabies vaccine?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Rabies vaccine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You should not receive a booster vaccine if you had a life-threatening allergic reaction after the first shot.

Keep track of any and all side effects you have after receiving this vaccine. When you receive a booster dose, you will need to tell the doctor if the previous shot caused any side effects.

Becoming infected with rabies is much more dangerous to your health than receiving this vaccine. However, like any medicine, this vaccine can cause side effects but the risk of serious side effects is extremely low.

Call your doctor at once if you have rare but serious side effects, such as:

  • a very high fever;

  • fever, vomiting, skin rash, joint pain, general ill feeling;

  • tingling or a prickly feeling in your fingers or toes;

  • weakness or unusual feeling in your arms and legs; or

  • problems with balance or eye movement, trouble speaking or swallowing.

Common side effects may include:

  • pain, swelling, itching, or redness where the shot was given;

  • headache;

  • dizziness;

  • muscle pain; or

  • nausea, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report vaccine side effects to the US Department of Health and Human Services at 1-800-822-7967.

See also: Side effects (in more detail)

Rabies vaccine dosing information

Usual Adult Dose for Rabies Prophylaxis:

Pre-Exposure Prophylaxis:
-Primary vaccination: 3 doses, 1 mL each, IM, on days 0, 7, and 21 or 28
-Booster vaccination: 1 dose, 1 mL, IM

Post-Exposure:
-Previously unvaccinated: 5 doses, 1 mL each, IM, on days 0, 3, 7, 14, and 28
-Previously vaccinated, known antibodies: 2 doses, 1 mL each, IM, on days 0 and 3

Comments:
-Do not interrupt or discontinue because of local or mild systemic reactions; these can usually be managed with anti-inflammatories, antihistamines, and anti-pyretics.
-In people at high risk of exposure, periodically check titers to determine the need for a booster dose. For lab workers/vaccine makers who work with live virus, check titers every 6 months; for other high exposure patients (veterinarians, animal control, cavers, etc.) check every 2 years.
-Administer post-exposure doses immediately after exposure.
-Rabies immune globulin may be given on day zero with the first post-exposure dose in previously unvaccinated patients; not recommended for previously vaccinated patients.
-Post exposure, previously vaccinated: if immune status is unknown, the full 5 doses may be needed.

Usual Pediatric Dose for Rabies Prophylaxis:

Pre-Exposure Prophylaxis:
-Primary vaccination: 3 doses, 1 mL each, IM, on days 0, 7, and 21 or 28
-Booster vaccination: 1 dose, 1 mL, IM

Post-Exposure:
-Previously unvaccinated: 5 doses, 1 mL each, IM, on days 0, 3, 7, 14, and 28
-Previously vaccinated, known antibodies: 2 doses, 1 mL each, IM, on days 0 and 3

Comments:
-Do not interrupt or discontinue because of local or mild systemic reactions; these can usually be managed with anti-inflammatories, antihistamines, and anti-pyretics.
-In people at high risk of exposure, periodically check titers to determine the need for a booster dose. For lab workers/vaccine makers who work with live virus, check titers every 6 months; for other high exposure patients (veterinarians, animal control, cavers, etc.) check every 2 years.
-Administer post-exposure doses immediately after exposure.
-Rabies immune globulin may be given on day zero with the first post-exposure dose in previously unvaccinated patients; not recommended for previously vaccinated patients.
-Post exposure, previously vaccinated: if immune status is unknown, the full 5 doses may be needed.

What other drugs will affect rabies vaccine?

Before receiving this vaccine, tell your doctor about all other vaccines you have recently received.

Also tell the doctor if you have recently received drugs or treatments that can weaken the immune system, including:

  • an oral, nasal, inhaled, or injectable steroid medicine;

  • medicine to treat or prevent malaria;

  • chemotherapy or radiation cancer treatments;

  • medications to treat psoriasis, rheumatoid arthritis, or other autoimmune disorders; or

  • medicines to treat or prevent organ transplant rejection.

If you are using any of these medications, you may not be able to receive the vaccine, or may need to wait until the other treatments are finished.

This list is not complete. Other drugs may interact with this vaccine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about this vaccine. Additional information is available from your local health department or the Centers for Disease Control and Prevention.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01.

Date modified: June 01, 2017
Last reviewed: November 22, 2016

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