Latest Rabies Vaccination Guidelines

Second-level exposure only requires rabies vaccination, and third-level exposure requires rabies immune globulin. The protection rate of full-scale standardized vaccination is close to 100%.； There is no need to blindly take booster shots, and don’t miss out on basic shots by luck. 】

Yesterday, I saw a sophomore girl in the emergency department. She came in with a finger wrapped in a disinfectant wipe. Her eye circles were as red as a rabbit. She said she had been scratched by a stray cat downstairs. According to online research, the incubation period of rabies is 20 years, and she had to take the most expensive imported vaccine plus immune globulin. I looked at her wound and saw that the superficial skin was a little red but there was no bleeding. It was a proper secondary exposure and no protein was needed at all. There was no statistical difference in the effectiveness of the ordinary domestic inactivated vaccine and the imported one. The girl took the first shot with some doubts. She even sent me a message today to say that the cat was still wandering downstairs. She felt more relieved.

In fact, many people's understanding of the rabies vaccine is either excessive panic or excessive contempt, both of which are easy to get into trouble. For example, there is a lot of debate on the Internet about "Is the 10-day observation method reliable?" To be honest, both sides are reasonable: WHO clearly mentioned that the 10-day observation method is applicable, provided that you can confirm that the animal that bit you has been vaccinated with a regular veterinary rabies vaccine for two consecutive years, and you can observe its health status for 10 consecutive days. In this case, you can give the first two injections. If the animal is alive and kicking within 10 days, the subsequent injections can be stopped, which can save a lot of trouble. But if you are bitten by a wild dog that comes from nowhere at the entrance of the village, and the dog turns around and disappears, leaving you unable to observe at all, then don’t worry, just follow the process and complete the process without risking your life.

Some people also asked me if I had been vaccinated before, so if I was caught in the future, I would not need to take it. Neither. I saw a volunteer at an aid station who had just completed the treatment three months ago and was bitten by a mad dog again. He came over and asked if he wanted to be vaccinated. I told him directly that he didn’t even need to refill the injection. The current standard is that if you are exposed within six months after full vaccination, as long as it is not a particularly serious penetrating injury, you do not need to re-injection. ； Just 2 injections every six months to a year will be enough, 3 injections every 1-3 years, and you will need to re-inject the whole process after 3 years. There is no need to re-inject 5 injections as soon as you are caught. It is completely useless even if your wallet cannot bear it. Oh, by the way, there are two procedures available for routine vaccination: the traditional 5-shot method is to give one shot each on days 0, 3, 7, 14, and 28. The "2-1-1" procedure is to give two shots on the same day and one shot each on days 7 and 21. There is no difference in the effect. Which one you choose depends on your convenience.

I will also give you some information on the side effects that many people are worried about and whether special groups can take it. I have met many pregnant women or nursing mothers who dare not hit a cat if they are scratched, for fear of affecting their children. It is really unnecessary. The current rabies vaccines are inactivated vaccines that will not affect fetal development and will not be passed on to the baby through breast milk. They can be safely vaccinated during pregnancy and lactation. Most of the adverse reactions are redness and swelling at the vaccination site and a slight fever, which will disappear on their own in two or three days. The probability of severe allergies is lower than if you win 5 million, so don't be afraid.

There is also a very common misunderstanding. Many people who love cats and dogs feel that they often touch animals. Should they get vaccinated in advance? I generally say it on a case-by-case basis. If you are a veterinarian, a stray animal rescuer, or a traveler who often goes on wild adventures, it is indeed recommended to take 3 injections of pre-exposure prophylaxis in advance. If you encounter severe exposure later, you do not need to take immune globulin. Just two additional injections are enough. It is very cost-effective. But if you just pet the neighbor's cat occasionally and don't encounter stray animals a few times a year, there is really no need to spend this money, and medical resources are not such a waste.

Finally, to be honest, although rabies is 100% fatal, it is also completely preventable. There is no need to be frightened by the crazy comments on the Internet and make you anxious all day long, and don’t think that “it’s just a small wound without bleeding and it’s okay”. If the dog is bitten, rinse it with soapy water for more than 15 minutes and disinfect it with iodophor. Then go to the dog injury clinic of a regular hospital for evaluation by a doctor. Hit it when it needs to be hit, and don't hit it blindly if it shouldn't. It's that simple.