Rabies vaccination guide: re-exposure for more than 3 months

After receiving the rabies vaccine in a standardized manner, if the cat or dog bites, licks the mucosa, or breaks the wound again for more than 3 months, there is no need to re-vaccinate the full course of the vaccine. The wound should be washed with running water + soapy water for more than 15 minutes at the first time. After disinfection with iodine, a booster dose of rabies vaccine can be given on the 0th and 3rd days. Most people can obtain adequate protection.

Last week I met a young girl who had just graduated from the dog injury clinic in the community. She squatted by the triage table and rubbed her eyes. She had just completed five injections in December last year. When she was feeding the stray cat downstairs last month, she was scratched with a two-centimeter blood mark. After watching Douyin for half a night, she became more and more scared. She asked if she would need five more injections, and her arm would be swollen. In fact, this is a very typical situation of "re-exposure more than 3 months after full vaccination". According to the latest regulations, two booster shots are enough, and there is no need to suffer the full-course penalty.

Some people may ask about the WHO's guidelines. I read before that the World Health Organization said that there is no need for vaccination within 6 months of minor exposure? Are domestic requirements too strict? In fact, both guides are correct, but they are adapted to different popular environments. The WHO guidelines are based on data from most low-endemic areas around the world. However, the infection rate of free-range stray animals in China is relatively higher, so the prevention and control standards are tightened, which is equivalent to an extra layer of insurance. There is really no need to argue with the treating doctors on this issue. In China, just follow the 2021 version of the domestic disease control guidelines, which is very stable.

Of course, there are exceptions. Not everyone who has been exposed for more than 3 months only needs two injections. I once met a lupus patient who had been taking glucocorticoids for a long time. He was bitten on the face by a neighbor's dog. The wound was very deep. This kind of disease is caused by insufficient immune function. In addition, the exposed position is close to the central nervous system, so the risk is much higher than that of ordinary people. In addition to two booster shots, we also added rabies immune globulin. Also, if the animal that bit you is clearly a rabid dog or cat that is sick, you can also mention it to the doctor and let him or her judge whether to add passive immune preparations based on your situation. You don’t have to stick to the standard terms of the guidelines - the guidelines are dead, but the risk judgment is living.

Here are two pitfalls that people often step into: First of all, we must understand that what we call "full vaccination" refers to the 5 injections (0/3/7/14/28 days) or 4 injections (2-1-1 procedure) that you have received according to the regulations during the first vaccination. It does not count if you have received one or two booster injections before. In addition, there is no need to worry about whether the previous injection was Vero cells or diploid cells. This time the booster only needs to be a qualified rabies vaccine. It does not need to match the previous dosage form, and the effect is sufficient. There are also people who can’t remember the specific time of their last vaccination. It’s three to five days to three months. As long as the risk of exposure is not particularly low (for example, it was caught by a stray animal), they can just take the booster according to the standard of more than three months. There is no harm in getting one more shot. There is no need to gamble on the day.

I have also met many people who said, "My cat is vaccinated every year, so if it gets scratched, I don't need to vaccinate." Don't leave this to chance. Vaccination for domestic cats reduces the probability of disease itself, but you cannot be 100% sure whether it has sneaked out to fight with stray animals recently or whether it has been exposed to poisonous animals. The two booster shots only cost about 200 yuan. In exchange for 100% peace of mind, it is more cost-effective than winning a bet and losing your life. There was an English Shorthair raised by an uncle who had been vaccinated for three years. The cat scratched the corner of his eye and refused to take the injection. He was forced to have it by his wife. There was really no need to save such money.

As for the side effects of the booster injection that everyone is worried about, they are actually similar to the reactions of the previous full-course injection. At most, the vaccinated arm will hurt for a day or two. A few people may have a low-grade fever and fatigue. Drink more hot water and sleep and it will be over. Don't worry. If you are really not sure how to deal with your situation, it is much more reliable to go directly to the dog injury clinic near your home than to read the messy self-media articles all night - many online contents are still old guides from more than ten years ago and have long been out of date.