Rabies Post-Exposure Prophylaxis Protocol

If a person that has not been vaccinated is exposed to a rabid animal, the following is required for post exposure prophylaxis:

• Human Rabies Immune-Globulin (HRIG) on day 0, plus a series of Human Rabies Vaccines (HRV) on days 0, 3, 7, and 14 (immunocompromised patients should receive a 5th dose on day 28 and subsequent titer check).
• Persons with previous rabies vaccination [i.e., those who completed the series of the three vaccine pre exposure prophylaxis or the series of four/five vaccines and Human Rabies Immune Globulin post exposure prophylaxis (using Human Diploid Cell Vaccine, Rabies Vaccine Adsorbed, or Purified Chick Embryo Vaccines)], should receive two doses of rabies vaccine on days 0 and 3. The person does not need Human Rabies Immune Globulin.

Other recommended measures include:

• Immediately and thoroughly wash all bite wounds and scratches with soap and water.
• Tetanus prophylaxis should be considered.
• Risk of bacterial infections should be assessed and addressed.
• Animal Rabies Post-Exposure Prophylaxis summary of the recommendations below:
  • Advisory Committee on Immunization Practices (ACIP) Recommendations
  • CDC: Human Rabies Prevention 2008, Recommendations of the Advisory Committee on Immunization Practices (ACIP)