Indications And Dose
Pre-exposure prophylaxis ▶BY INTRAMUSCULAR INJECTION ▶Child: 1 mL for 2 doses (on days 0 and 7), followed by 1 mL for 1 dose (on day 28), to be administered in deltoid region or anterolateral thigh in infants, for those at continuous risk, measure plasma- concentration of antirabies antibodies every 6 months and give a booster dose if the titre is less than 0.5 units/mL, final dose may be given from day 21, if insufficient time before travel ▶Adult: 1 mL for 2 doses (on days 0 and 7), followed by 1 mL for 1 dose (on day 28), to be administered in deltoid region, for those at continuous risk, measure plasma-concentration of antirabies antibodies every 6 months and give a booster dose if the titre is less than 0.5 units/mL, final dose may be given from day 21, if insufficient time before travel Pre-exposure prophylaxis booster dose (for patients at frequent risk of exposure) ▶BY INTRAMUSCULAR INJECTION ▶Child: 1 mL after 1 year for 1 dose, to be given 1 year after primary course is completed, then 1 mL every 3–5 years, to be administered in deltoid region or anterolateral thigh in infants, the frequency of booster doses may alternatively be determined according to plasma-concentration of antirabies antibodies ▶Adult: 1 mL for 1 dose, to be given 1 year after primary course is completed, then 1 mL every 3–5 years, to be administered in deltoid region, the frequency of booster doses may alternatively be determined according to plasma-concentration of antirabies antibodies Pre-exposure prophylaxis booster dose (for patients at infrequent risk of exposure) ▶BY INTRAMUSCULAR INJECTION ▶Child: 1 mL for 1 dose, to be given 10 years after primary course is completed, administered in deltoid region or anterolateral thigh in infants ▶Adult: 1 mL for 1 dose, to be given 10 years after primary course is completed, administered in deltoid region Post-exposure prophylaxis of fully immunised individuals (who have previously received pre-exposure or post- exposure prophylaxis with cell-derived rabies vaccine) ▶BY INTRAMUSCULAR INJECTION ▶Child (administered on expert advice): 1 mL for 1 dose, followed by 1 mL after 3–7 days for 1 dose, to be administered in deltoid region or anterolateral thigh in infants, rabies immunoglobulin is not necessary ▶Adult (administered on expert advice): 1 mL for 1 dose, followed by 1 mL after 3–7 days for 1 dose, to be administered in deltoid region, rabies immunoglobulin is not necessary Post-exposure treatment for unimmunised individuals (or those whose prophylaxis is possibly incomplete) ▶BY INTRAMUSCULAR INJECTION ▶Child (administered on expert advice): 1 mL 5 times a month for 1 month, doses should be given on days 0, 3, 7, 14, and the fifth dose is given between day 28–30, to be administered in deltoid region or anterolateral thigh in infants, depending on the level of risk (determined by factors such as the nature of the bite and the country where it was sustained), rabies immunoglobulin is given to unimmunised individuals on day 0 or within 7 days of starting the course of rabies vaccine, the immunisation course can be discontinued if it is proved that the individual was not at risk ▶Adult (administered on expert advice): 1 mL 5 times a month for 1 month, doses should be given on days 0, 3, 7, 14, and the fifth dose is given between day 28–30, to be administered in deltoid region, depending on the level of risk (determined by factors such as the nature of the bite and the country where it was sustained), rabies immunoglobulin is given to unimmunised individuals on day 0 or within 7 days of starting the course of rabies vaccine, the immunisation course can be discontinued if it is proved that the individual was not at risk
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