Vaccine Rabies

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14D. VACCINES AND ANTI-SERA in 14. IMMUNOLOGY & ALLERGY
VACCINE RABIES
VACCINE

Indications & Dose: POST-EXPOSURE TREATMENT AGAINST RABIES IN FULLY IMMUNIZED INDIVIDUALS IM/Intradermal Adult 2 doses each of 0.1mL separated by 3 days Child Same as adult dose | POST-EXPOSURE TREATMENT AGAINST RABIES IN UNIMMUNIZED INDIVIDUALS IM Adult 1 dose (0.1mL) given on days 0, 3, 7, 14 & 28 (total of 5 doses); alternatively 2 doses on day 0, followed by 1 dose on days 7 & 21 (total of 4 doses) Child Same as adult dose | Intradermal Adult 8-site regimen: 1 dose of 0.1mL administered at 8 separate sites on day 0, followed by 1 doses of 0.1mL in each upper arm & each lateral thigh on day 7, and 1 dose of 0.1mL in one upper arm on days 30 & 90; or 2-site regimen: 1 dose of 0.1mL at 2 sites on days 0, 3, 7, and 28 (total of 8 doses) Child Same as adult dose | PRE-EXPOSURE PROPHYLAXIS AGAINST RABIES IM Adult 3 doses each of 0.1mL, on days 0, 7 & 28 (day 28 preferable, but administration may be advanced towards day 21 if time is limited), Booster dose given at intervals dictated by regular testing for rabies antibodies & where serological testing is unavailable, booster vaccination every 5yrs may be an acceptable alternative Child Same as adult dose | Intradermal Adult 3 doses, each of 0.1mL, on days 0, 7 & 28 (administration may be advanced towards day 21 if time is limited); Booster dose given at intervals dictated by regular testing for rabies antibodies & where serological testing is unavailable, booster vaccination every 5yrs may be an acceptable alternative Child Same as adult dose

Contra: hypersensitivity, severely immunosuppressed children

Precautions: acute illness, neurological conditions, alcohol/disinfectant

ADR: Serious: myalgia, influenza-like symptoms, arthralgia, convulsions, hypersensitivity reactions, bronchospasm, angioedema, anaphylaxis, lymphangitis, lymphadenopathy, encephalitis, Others: malaise, chills, urticaria, dyspnea, wheezing, loss of appetite, pain, inflammation, redness, an induration/sterile abscess, GI disturbances, fever, headache, irritability, fatigue, dizziness, paresthesia, asthenia, drowsiness, rash

DDI: Serious Hydroxy chloroquine/Chloroquine reduces antibody response to vaccine

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