Question
Rabies vaccines.
Answer
Rabies vaccines:
- Modern cell-culture/embryonated-egg-based vaccines (the current standard): Human Diploid Cell Vaccine (HDCV), Purified Chick Embryo Cell Vaccine (PCECV), and Purified Vero Cell Rabies Vaccine (PVRV) — all safe, effective, inactivated vaccines used for both pre-exposure and post-exposure prophylaxis in humans, given via the intramuscular Essen regimen (days 0, 3, 7, 14, 28) or the dose-sparing intradermal updated Thai Red Cross regimen (two sites per visit on days 0, 3, 7, 28).
- Older, now largely obsolete nerve-tissue vaccines — e.g., Sheep brain vaccine/Semple vaccine — associated with a higher risk of neuroparalytic adverse reactions and no longer recommended, having been replaced by the modern cell-culture vaccines above.
Pre-exposure prophylaxis: recommended for individuals at high occupational risk (veterinarians, animal handlers, laboratory workers with rabies virus exposure risk), using the same modern cell-culture vaccines in an abbreviated schedule.
Post-exposure prophylaxis: active vaccination (as above) is combined with Rabies Immunoglobulin (RIG), infiltrated around the wound, for Category III exposures (Category II needs vaccine alone, with RIG added only for immunodeficient individuals as a specific exception), alongside immediate, thorough wound washing — active vaccination alone generates the patient’s own durable antibody response, while RIG provides immediate passive protection before that active response develops.