II. Indications

  1. Post-exposure Prophylaxis
    1. See Rabies Postexposure Prophylaxis
    2. Given with Rabies Immunoglobulin
  2. Pre-Exposure Prophylaxis
    1. Veterinarians
    2. Animal control and wildlife professionals
    3. Lab workers
    4. Adventure travelers to Rabies endemic areas
    5. Archaeology work

III. Preparations

  1. General
    1. All preparations in U.S. produced in cell culture
    2. Safer than infected animal brain preparations
  2. HDCV (Imovax)
    1. Human Diploid Cells
    2. Risk of Serum Sickness risk on booster doses: 6%
  3. RVA (Rabies Vaccine Absorbed)
    1. Fetal rhesus diploid lung cells
  4. PCEC (RabAvert)
    1. Developed in chick Embryo
    2. New preparation with fewer side effects
    3. Contraindicated in severe egg allergy

IV. Adverse Effects

  1. Mild erythema, swelling, and local pain
  2. Headache
  3. Myalgias
  4. Serum Sickness (Type III) Hypersensitivity Reaction
    1. Seen with HDCV on booster dose

V. Protocol: Pre-Exposure Prophylaxis

  1. See Rabies Postexposure Prophylaxis
  2. Rabies Vaccine 1 ml IM deltoid days 0, 7, and 21-28

VI. Precautions

  1. Safe in HIV and Pregnancy

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