Questions & Answers

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What kind of vaccine is the rabies vaccine?
Although the two brands of vaccine available in the U.S. are prepared in different ways, both of them are made from inactivated, or killed, virus. Both types are considered equally safe and effective. The vaccine is given in the deltoid muscle as a series of 3-5 shots.

Who should get this vaccine?
Rabies vaccine is recommended for

• Persons in high-risk occupational groups, such as veterinarians, animal handlers, and certain laboratory workers
• Persons whose activities bring them in frequent contact with rabies virus or potentially rabid bats, raccoons, skunks, cats, dogs, or other species at risk for having rabies
• International travelers who are likely to come in contact with animals in areas where dog rabies is common, especially if they will have limited access to appropriate medical care

Can the vaccine protect you if you've already been exposed to rabies?
Yes. The vaccine is only routinely recommended for persons in groups at high-risk of exposure. Vaccinating the entire population against a rare disease they are unlikely to ever encounter isn't practical, yet anyone could have an unexpected encounter with a bat or other potentially infected animal. Fortunately, because rabies usually has a long incubation period, the body has time to respond and develop antibodies to a vaccine given after an exposure.

What does the postexposure treatment include?
An exposed person who has never received any rabies vaccine will first receive a dose of rabies immune globulin (a blood product that contains antibodies against rabies), which gives immediate, short-term protection. This shot should be given in or near the wound area.

They should also be given a series of rabies vaccinations. The first dose should be given as soon as possible after the exposure. Additional doses should be given on days three, seven, and 14 after the first shot. These shots should be given in the deltoid muscle of the arm. Children can also receive the shots in the muscle of the thigh. Properly administered postexposure treatment for rabies has never been known to fail.

The rabies vaccine is recommended for me because I'm an animal control officer. How does being treated after an exposure differ from getting vaccinated before an exposure?
Treatment after an exposure requires receiving a dose of rabies immune globulin and four doses of vaccine. Vaccination before exposure requires only three doses of vaccine and no immune globulin. Booster doses of vaccine are recommended for some persons at high risk of rabies exposure. Check with your health department.

Is an immunized person totally protected if bitten by a rabid animal?
No. A vaccinated person should receive two more doses of rabies vaccine; one dose immediately and one three days later.

What's the advantage of being immunized against rabies if you still have to receive additional doses of vaccine if you're exposed?
Being vaccinated simplifies treatment by eliminating the need for rabies immune globulin and decreasing the number of doses of vaccine needed after an exposure. This is important because many people at high risk may be working in areas where they may not be able to get immediate medical attention, or where immunizing products are not readily available. Being vaccinated might also provide protection against unknown exposures to rabies (bat bite, etc.)

Should I be concerned about rabies if I'm traveling outside the United States?
Yes. Rabies is a big problem in many other countries, especially in Asia, Africa, and Central and South America. Not only is dog rabies common there, but postexposure treatment for humans may be hard to obtain. If you are traveling to a country where rabies is common, you should talk to your health care provider about the possibility of being protected against rabies before your trip. Vaccination may be recommended depending on your planned activities and length of stay. Contact with all animals, including dogs and cats, should be avoided when traveling abroad.

Can a pregnant woman receive rabies vaccine if exposed to rabies?
Yes, she definitely needs to be protected against rabies disease; no fetal abnormalities have been reported with the rabies vaccine. She can even receive routine pre-exposure vaccination against rabies if her risk of exposure is high.

Who recommends this vaccine?
The Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), and the American Thoracic Society all recommend this vaccine.

How safe is this vaccine?
Reactions after receiving the currently available vaccines are not common. Mild local reactions such as pain, redness, and itching at the injection site have been reported among 30%-74% of persons receiving the vaccine. More general reactions (e.g., headache, nausea, muscles aches, etc.) have been reported in 5%-40% of persons receiving the vaccine. Studies showed that most local reactions were mild and resolved spontaneously within a few days. Local pain at the injection site was the most frequently reported adverse reaction occurring in 21%-77% of persons vaccinated. Mild systemic reactions such as fever, headache, dizziness, and gastrointestinal symptoms were reported in 6.8%-55.6% of recipients. Serious reactions after vaccination are rare.

What side effects have been reported with this vaccine?
Most reactions to this vaccine are mild. Allergic reactions including swelling and non-serious difficulty breathing occurred in 6% of patients who received a booster dose of one type of rabies vaccine.

Who should NOT receive the rabies vaccine?
The rabies vaccine is not recommended for routine use in the general population. Anyone for whom the vaccine is recommended should not receive a dose when they are moderately or severely ill.

Can the vaccine cause rabies?
No.

Questions and answers about rabies disease

Technically reviewed by the Centers for Disease Control and Prevention, August 2009