Rabies is such a horrible disease that even the most rabid anti-vaccine influencers would get a rabies vaccine if exposed. Unfortunately, they might still end up with rabies, as they forget an important part of rabies post-exposure prophylaxis!
As most people know, if you get exposed to rabies, as with tetanus, you need both a rabies shot (with rabies it is a series of shots) AND a shot of human rabies immune globulin (HRIG).
Ironically, while Steve Kirsch would get a rabies vaccine for himself, he advocates against people vaccinating their pets…
Rabies Post-Exposure Prophylaxis
Why do you need both?
After you are exposed to a rabid animal, the rabies virus will start replicating itself at the site of the bite or scratch.
It then enters peripheral nerves and works its way through your spinal cord to your brain.
In the brain, the rabies virus causes encephalitis and eventually kills you.
Now the key to understanding why you want both a shot of rabies immune globulin shot AND a series of rabies vaccines is that this whole process can take a very long time. In fact, the incubation period for rabies can be a few days to over 19 years!
Clearly, with a very short incubation period, just getting the vaccine after exposure isn’t going to protect you. The vaccine isn’t going to have time to create antibodies. That can take a few weeks.
“HRIG is administered only once at the beginning of the PEP course, and only to previously unvaccinated persons. This will provide immediate antibodies until the body can respond to the vaccine by actively producing antibodies of its own.”
Rabies Post-exposure Prophylaxis
And with a long incubation period, even up to 90 days (the time when 75% of people exposed to rabies develop symptoms) just getting an immunoglobulin shot might not protect you. The antibodies you got from the shot might have worn off before you had gotten rid of all of the rabies virus in your body.
So for best protection, you get both.
That way you can get rid of all of the rabies virus before it makes its way to your spinal cord and brain.
“Most common failures are due to deviations from WHO management recommendations and lack of essential biologicals. True failures, where all was done according to WHO recommendations, are fortunately extremely rare. Presented are seven such deaths. Other examples of common management deviations that resulted in deaths are also shown.”
Failures of post-exposure rabies prophylaxis
And you get both in the exact way that is recommended by health experts, plus proper wound care, or it might not work!
There is one way for a rabies vaccine to work without rabies immunoglobulin after a bite. You would have had to have also been vaccinated before the bite (pre-exposure vaccination). In this case, the post-exposure doses of rabies vaccine would act as a boosting dose. This works best, but is typically reserved for those who are at highest risk to get rabies.
When can you skip post-exposure rabies prophylaxis?
In most cases, it is only safe to skip post-exposure rabies prophylaxis after a bite or scratch if you can quarantine a domestic animal who doesn’t appear to be sick or you can quickly test a wild animal to make sure it doesn’t have rabies.
If you are still not convinced, know that in one study of breakthrough rabies infections, many of the people who developed rabies did not receive rabies immunoglobulin!
Still don’t know what to do? Your local and/or state health department can help you decide what to do after a possible exposure to rabies.
“Even though human rabies cases are rare, each year hundreds of thousands of animals are observed or tested for rabies, and 60,000 people require postexposure prophylaxis.”
Rabies in the United States: Protecting Public Health
Remember that the only reason that there are so few cases of human rabies in the United States these days is because most people follow the advice of health experts and get the proper post-exposure prophylaxis when necessary.
And while it is technically not a part of the rabies post-exposure prophylaxis plan, also keep in mind that animal bites can also be a risk for tetanus. So make sure your child doesn’t also need a tetanus shot after a bite.
More on Rabies Post-Exposure Prophylaxis
- What to Do If Your Child Is Exposed to Rabies
- What to Do if a Dog Bites Your Child
- How Many People Die With Rabies Each Year?
- A 6-year-old in Florida With Rabies Has Died
- A Rabies Case in Utah
- Human rabies despite post-exposure prophylaxis: a systematic review of fatal breakthrough infections after zoonotic exposures
- Failures of post-exposure rabies prophylaxis
- CDC – Rabies Pre-exposure Prophylaxis
- CDC – Rabies Post-exposure Prophylaxis
- MMWR – Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices
- CDC – Rabies in the United States: Protecting Public Health
- United Against Rabies
- Rabies is Proof That Vaccine Inequality is Nothing New – But it Can be Changed
- Claim That Rabies Has ‘Never Been Proven to Exist’ Is NOT True — It’s Been Known About For At Least 2,500 Years
- NRA lobbyist Marion Hammer says rabies vaccine doesn’t protect against strains from other states
Last Updated on September 11, 2024
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