Latest Rabies Vaccination Guidelines

According to the latest rabies prevention and control technical guidelines released by the National Administration of Disease Control and Prevention in 2023, if an ordinary healthy person is scratched and bitten by an animal, and there is only a red mark but no broken skin, there is no need to be vaccinated at all.； Level II exposure with only skin rupture and no bleeding only requires rabies vaccination, and does not require immune globulin. ； Only level III exposure with obvious bleeding, penetrating injuries, or wounds on the head, face, neck, or mucous membranes being licked requires the combination of vaccine + rabies immune globulin. If you are bitten within half a year after the full course of vaccination, there is no need to re-vacculate. Two shots will be given every six months to one year, and three shots will be given every 1 to 3 years. The full course of vaccination will be required after three years.

I used to work in the dog injury clinic of the district disease control center for more than half a year. I saw too many people who were so frightened by short videos of rabies cases that they queued up all night long. Even if they were just touched by their own cat, they had to get a full set of vaccinations.； Or you are so heartless that if you are bitten by a wild dog at the entrance of the village, you just put a band-aid on it and don't take it seriously. Based on the actual situation encountered on the front line, I will give you the places that are not explained clearly in the guide and are most likely to get into trouble.

What many people are most confused about is how to determine what level of exposure they have. In fact, there is no need to memorize the definition. You can rub the wound with alcohol. If it doesn't hurt at all, it means the skin is not broken and it belongs to Level I. Just apply it twice and there is no need to go to the hospital. Last summer, I met a girl who was petting the orange cat downstairs. Her paws swiped the back of her hand, leaving only a pale white mark. She didn’t even feel it when she applied alcohol at home, and she insisted on registering for vaccinations. I gave her ten minutes of education before persuading her to go back, which saved me hundreds of dollars. If it hurts when you rub it, it means the dermis is broken, it belongs to level II, and you need to get vaccinated. ； If obvious bleeding and exudation can be seen, it is grade III and immunoglobulin must be added. Oh, by the way, if you are taking hormones and have an immune deficiency such as AIDS, even if it is only level II exposure, you will still need to take immune globulin, so don’t save the money.

Speaking of which, some people must ask whether the ten-day observation method is reliable. This is also a point of great controversy in the industry. Guidelines from European and American countries clearly recommend that as long as the cat or dog that bites you does not die of rabies within 10 days, you can completely stop the remaining vaccinations without any risk of infection. However, many doctors at the primary level of disease control in China are more conservative. They feel that the immune coverage of domestic free-range animals is low, and many people cannot accurately observe the status of the animals. They will recommend giving the injection first and then observing. My personal practical experience is that if the cats and dogs are domesticated in the city, there are clear records of annual rabies vaccinations. You can observe them while administering the vaccine. If the cats and dogs are alive and kicking within 10 days, the subsequent injections will not need to be administered, which will save you money and less suffering. But if it is a free-range dog in the countryside, a wild dog of unknown origin, or an animal that bites you and quickly develops abnormal symptoms such as fear of water and mania, then don't hesitate and finish the whole process honestly, and don't bet on the one in 10,000 chance.

There are also many people who come to get vaccinated whenever they are bitten by an animal. It is really unnecessary. Rodents and lagomorphs such as hamsters, chinchillas, and rabbits do not carry rabies virus at all. Just disinfect them after being bitten, and there is no need to fight them at all. Last week, a junior high school student came over crying after being bitten by a golden bear at home. I showed him the clear rules in the guide, and then he went back with a smile. Unless you are bitten by a bat, you must get a full set of injections regardless of whether there is a wound or not. This is a special case, don’t get confused.

Many people ask whether pregnant women can be vaccinated and whether vaccination of children will affect their IQ. These are rumors that have been circulating for many years. The latest guidelines have made it clear that the rabies vaccine is an inactivated vaccine, which is completely safe for pregnant women, fetuses, infants and young children, and will not affect development. If you are really exposed, you should get it, and don't force it. I once met an expectant mother who was 3 months pregnant. She was scratched by her dog. She hesitated for 3 days and did not dare to come because she was afraid of affecting the baby. In the end, she came for a vaccination and nothing happened. Now the baby is half a year old and very healthy. It is even more outrageous to say that vaccination will make you stupid. At most, the injection site will hurt for a day or two, and you will have a slight fever, which will subside in a day or two, and the nervous system will not be touched at all.

By the way, now the rabies vaccine is no longer the 5-injection method that required 5 injections in the past. There is also a more convenient 2-1-1 procedure: one injection in each arm on day 0, one injection in each arm on day 7 and day 21. A total of only 3 injections are enough. The effect is exactly the same as the 5-injection method. If you are afraid of trouble, you can ask the local clinic in advance whether there is a vaccine with this procedure, so as to save you from running back and forth.

Finally, I would like to remind everyone that if you are really scratched or bitten, immediate wound treatment is more important than vaccination. Alternately rinse with soapy water and running water for more than 15 minutes, and then disinfect with iodophor, which can wash away more than 90% of the viruses. I met a young man before who was bitten by a dog and didn't deal with it immediately. He just put a band-aid on the wound and came to get vaccinated. The wound became suppurated and had to be debrided first. The pain made him grin. It was a completely unnecessary suffering.

Anyway, there is no need to panic too much about rabies. Nowadays, the immunity rate of domestic animals in cities is very high, and the probability of infection is extremely low. If you are really unsure, go to the nearby dog ​​injury clinic and let the doctor take a look. Don’t blindly search Baidu to scare yourself. After all, when you see a doctor on Baidu, you can’t really get started with cancer.