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

• 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

• 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

• 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

• 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.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

To report suspected adverse reactions, contact the Vaccine Adverse Event Reporting System (VAERS) at: https://vaers.hhs.gov

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Administer immediately after reconstitution.
• The deltoid is the preferred site for adults and children.
• The anterolateral aspect of the thigh may be preferable for infants and small children.
• Gluteal administration may result in lower antibody titers.

• Refrigerate; do not freeze.

• The manufacturer product information should be consulted.
• The dried vaccine is creamy white to orange; reconstituted vaccine is pink to red.