Latest Rabies Vaccination Guidelines 2024 Edition

1. The vaccination standards implemented in China in 2024 are based on the latest WHO guidelines and the "Technical Guidelines for Rabies Prevention and Control" updated by CDC at the end of 2023. There are no subversive adjustments, but many redundant requirements in the past have been optimized; 2. Secondary exposure (scratches, abrasions, licking of damaged skin without bleeding) only requires vaccination, and no immune globulin is required; 3. People who have had a full history of rabies vaccination do not need to take immune globulin no matter how long the interval is before they are exposed again, and only need 1-2 booster shots; 4. The ten-day observation method is an officially recognized operation, but it is only applicable to observable domestic animals. It must be observed while being vaccinated and cannot wait 10 days before starting vaccination; 5. There are no absolute taboos for vaccination, and eating spicy food, drinking coffee, and exercising normally will not affect the effect.

Yesterday, I was helping a friend to get a report from a community health service center near my home. I happened to encounter a little boy in school uniform being dragged by his mother. He had a shallow cat scratch on his wrist, but there was no bleeding. As soon as the mother came up, she told the nurse, "Give us the most expensive one, and start the immune globulin. The child will be safe and nothing will happen." To be honest, I have encountered this kind of scene at least three times in the past six months. Either I am too panicked and want to fight for anything, or I am so worried that I am bitten by a stray dog ​​and think, "My dog ​​is vaccinated and I don't need to be vaccinated." The polarization is particularly serious.

In fact, the easiest way to judge whether to vaccinate is to see if the skin is broken: if the animal just licked the intact skin, nothing will happen, just flush it; if there are red marks or scratches but no bleeding, it belongs to Level 2, and you should get the vaccine honestly; if there is blood, deep wounds, or bites on the head, face, and neck, which are close to the central nervous system, you need to add immune globulin. Oh, by the way, if you are touched by a bat, regardless of whether there is a wound or not, it is recommended to treat it as a Level 2 exposure. The probability of this thing being poisonous is much higher than that of cats and dogs, so don’t be careless.

Speaking of which, someone must be asking about the ten-day observation method. There is a lot of quarrel on the Internet right now. One group says, "The ten-day observation method is nonsense. Cats and dogs that survive 10 days do not mean that people are fine." In fact, the official attitude has always been very clear: the scope of application of the ten-day observation method is particularly narrow. You must be able to find the offending animal, such as a neighbor's or your own, and it has clear records of more than two valid rabies vaccinations. In this case, you can follow the procedure and observe the animal's condition. If it is still alive and kicking after 10 days, you can stop the remaining injections if you don't want to. But if it’s a stray cat or dog that you can’t find where it’s gone, or a wild animal, don’t hesitate and finish the entire injection process honestly. If you win the bet, you’ll save a few injections. If you lose the bet, you’ll lose your life. There’s no need.

The current vaccination procedure is also flexible. Instead of only 5 injections, if you find it troublesome to go to the hospital, you can choose the "2-1-1" 4-injection method: two injections on the first day, one in each arm, one on the 7th day and one on the 21st, a total of 3 times. Oh, by the way, if you have already received a full injection before, whether it is 5 or 4 injections, and are exposed later, as long as it is not a particularly serious penetrating injury, just give 2 injections to strengthen it. There is no need to start from the beginning, let alone immune globulin, 3 days apart. This is particularly clear in the 2024 version of the guide. Many people have said before that the full injection should be repeated after 3 years. This has been changed long ago.

In the past two years, I often went to the stray animal rescue center to help, so I took pre-exposure prophylaxis, three injections on the 0th, 7th, and 21st days. Last year, the rescued cat scratched a big wound and started bleeding. When I went to the vaccination site, the nurse asked me about my full vaccination history, so she only gave me two booster shots, which saved me more than a thousand dollars in immunoglobulin. If you are a friend who often works with animals, you can really get a pre-exposure prophylaxis in advance. It is not expensive. Three shots only cost a few hundred yuan, which saves you trouble in the future.

Many people also ask whether they should eat anything after vaccination, whether they can eat spicy food, drink alcohol, or exercise. The old saying before was that you can’t do this and you can’t do that. When I was vaccinated for the first time, I couldn’t bear to eat hot pot for a month and almost suffocated to death. The guidelines have been updated a long time ago. These things will not affect the effectiveness of the vaccine. As long as you are not allergic to these things, it will be fine if you eat them, and you don’t get so drunk that your immune system collapses. Normal diet and exercise are completely fine.

In fact, domestic rabies prevention and control has been done very well. In 2023, the number of rabies cases nationwide will only be more than 90, which is more than 90% lower than ten years ago. As long as you handle it according to the regulations, there will be almost no accidents. You don’t need to be scared to death when being scratched by a cat, and don’t take it too seriously. Oh, by the way, there is another misunderstanding. Many people think that you can only get rabies if you are bitten by a dog. In fact, warm-blooded animals such as cats, foxes, weasels, and bats may be poisonous. You should also pay attention to scratches and bites from these animals. You do not need to fight if you are bitten by rodents such as rats and rabbits. There are currently no cases of these animals spreading rabies. This is also clear in the latest guidelines.

In the final analysis, the rabies vaccine is not that complicated. If you are not sure, go to the nearest community health service center and ask. Don’t frighten yourself by searching for messy information on the Internet, and don’t take chances. After all, if this disease really occurs, the mortality rate is 100%. You should pay for what you have to spend, so don’t save it.