Have you heard that some folks are worried that ‘they’ are spraying rabies vaccines into the air?
Are They Spraying the Rabies Vaccine Into the Air?
Hopefully you already understand that no one is spraying vaccines into the air.
Just think about all of the work that has gone into getting us a nasal spray flu vaccine, which must be kept refrigerated… Do you really think that we could make an effective vaccine that could simply be sprayed into the air?
The oral rabies vaccine (ORV) baits baits are coated with fishmeal and distributed in one-inch square cubes or two-inch plastic sachets. Bait photo by John Forbes, USDA-APHIS-Wildlife Services.
And if we could spray vaccines onto people, why would we spray the rabies vaccine? Why not spray flu or measles vaccines instead?
“Oral rabies vaccine (ORV) baits will be distributed in northeastern Maine beginning on or about August 3 through August 7 as part of ongoing, cooperative rabies control efforts aimed at reducing the incidence of raccoon rabies.”
USDA Distributes Oral Rabies Vaccine for Wildlife in Northeast Maine
While we can’t spray rabies vaccines on people, what we can do is distribute oral rabies vaccines, by air and ground, to combat raccoon rabies.
“The vaccine packets will be distributed by airplanes in rural, wooded areas. Personnel from Wildlife Services will distribute vaccine baits from vehicles in the more populated areas.”
USDA Distributes Oral Rabies Vaccine for Wildlife in Northeast Maine
Combined with getting our pets vaccinated and the use of rabies post-exposure prophylaxis, combating rabies in wild animals helps us all avoid rabies.
What happens if you get a vaccine a few days too early?
You may even know about the minimum ages or minimum intervals between vaccines, but what happens if your child gets a vaccine just a few days early?
Is There a Grace Period for Getting Vaccines?
Fortunately, in most cases, getting a vaccine just a little early isn’t going to mean that the vaccine dose has to be repeated.
“Doses administered too close together or at too young an age can lead to a suboptimal immune response. However, administering a dose a few days earlier than the minimum interval or age is unlikely to have a substantially negative effect on the immune response to that dose. Known as the “grace period”, vaccine doses administered ≤4 days before the minimum interval or age are considered valid; however, local or state mandates might supersede this 4-day guideline.”
General Best Practice Guidelines for Immunization: Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP)
That’s because the Advisory Committee on Immunization Practices (ACIP) allows a 4-day grace period for most vaccines. So if your child got their vaccines 3 or 4 days before their 1st birthday, instead of on or after turning 12 months old, they would still count!
It is important to keep in mind that:
day 1 is the day before the day that marks the minimum age or minimum interval for a vaccine.
if a vaccine is given 5 or more days too early, beyond the grace period, then the interval to the next dose starts from the day that invalid dose was given. For example, if the second dose of Hib is given two weeks after the first dose (instead of the minimum 4 weeks), then you don’t repeat this invalid dose in two weeks (four weeks from the first dose), but instead wait an additional four weeks from the invalid second dose
live vaccines must be given at least 28 days apart if they are not given at the same time and the grace period can not be used to shorten this interval
Most importantly, in place since 2002, the grace period protects kids from having to repeat vaccines because of minor vaccine scheduling errors.
Most people aren’t overly worried about rabies these days, at least not in the United States.
In the mid-1950s, rabies control programs began to get more and more dogs vaccinated against rabies.
Is that because rabies isn’t around anymore?
Of course not. It is because a rabies vaccine has long been available both to prevent our pets from getting rabies from wild animals and to protect us if we are ever bitten by an animal that might have rabies.
Hopefully, especially after the recent rabies death of the 6-year-old in Florida, everyone understands that rabies is still around.
When Was the Last Time Someone Died from Being Bitten by a Rabid Dog in the United States?
Since 2008, at least 21 people have died of rabies in the United States, mostly after getting exposed to rabid bats.
There were more than a few exposures from dogs with rabies too. In fact, the last rabies death after a dog bite was not very long ago – it was in May 2017.
Exposure to rabid dogs typically happened while the person was out of the United States.
Does that mean that something isn’t working with our rabies prevention plans?
When you take a closer look at the statistics about rabies deaths after dog bites, it becomes clear where the problem is.
“In 1950, for example, 4,979 cases of rabies were reported among dogs, and 18 cases were reported among humans. Between 1980 and 1997, 95 to 247 cases were reported each year among dogs, and on average only two human cases were reported each year in which rabies was attributable to variants of the virus associated with indigenous dogs . Thus, the likelihood of human exposure to a rabid domestic animal in the United States has decreased greatly.”
Human Rabies Prevention – United States, 1999 Recommendations of the Advisory Committee on Immunization Practices (ACIP)
Most rabies deaths in the United States from dogs occur in people who get bitten while they are traveling outside the country.
So when was the last human rabies death from a rabid domestic dog in the United States?
A 7-year-old girl died after she was bitten by a rabid dog in Texas in June 1979. Before that, in 1968, a 13-year-old boy died after getting bit by a rabid dog in Kansas.
That’s a long time ago.
Does that mean the rabies vaccine isn’t necessary anymore?
Rabies Vaccines Work
Of course not! That means the rabies vaccines works!
Two Indonesian boys proudly show off their puppy and her vaccination record. Photo by the rabiesalliance.org.
There are two reasons that we don’t see human rabies deaths from dog bites in the United States anymore, unless the bites occur in another country:
Most of us vaccinate our pets – fewer dogs and cats with rabies means that there are fewer chances for us to get bit and get rabies.
Most folks get proper treatment if they are exposed to an animal that could possibly have rabies, whether it is an unvaccinated dog or cat, or a raccoon, skunk, fox, coyote, or bat. In fact, about 40,000 to 50,000 people in the United States get rabies post-exposure prophylaxis each year.
If you don’t believe this, just look back at what rabies was like in the pre-vaccine era, when dogs and cats would get rabies, and so would their owners. In the early 1960s and 1950s, rabies deaths from dog bites were more common, about 10 each year.
“The number of rabies-related human deaths in the United States has declined from more than 100 annually at the turn of the century to one or two per year in the 1990’s. Modern day prophylaxis has proven nearly 100% successful.”
CDC on Rabies in the U.S.
To understand just why rabies vaccines still so necessary, you can also look at what is still happening around the world where rabies vaccines aren’t used as commonly as they are in more industrialized countries.
“Despite substantial gains in tackling this neglected disease, more than 20,000 people still die from rabies every year, mostly in Asia and Africa.”
Schneider et al on Substantial reductions in rabies, but still a lot to be done
In addition to the deaths from folks traveling outside the United States, there are many more rabies deaths in people, mostly children, who live in areas where rabies is still endemic.
Hopefully these deaths will end soon too, as experts from WHO, Food and Agriculture Organization (FAO), International Organisation for Animal Health (OIE) and the Global Alliance for Rabies Control (GARC) work together in the United Against Rabies collaboration to achieve “Zero human Rabies deaths by 2030.”
Because it has an animal reservoir, the rabies virus will likely always be around, and won’t be eradicated like smallpox, but hopefully we can one day control rabies by having fewer rabies exposures (vaccinate more of our pets) and we can eliminate dog-transmitted rabies deaths.
We won’t get there if folks continue to push myths and propaganda about rabies and the rabies vaccine.
What to Know About Controlling Rabies and Rabies Deaths
It has been a long time since someone in the United States died with rabies from a domestic dog bite, but that is simply a testament to the fact that vaccines work.
More on Controlling Rabies and Rabies Deaths
Human Rabies in the United States, 1960 to 1979: Epidemiology, Diagnosis,
The French immunization schedule is published in the Bulletin épidémiologique hebdomadaire and has never included the rotavirus vaccine.
So did France take the rotavirus vaccine off of their schedule?
Technically, France hadn’t yet added the rotavirus vaccine to their schedule, but it had been available since 2006 and they did formally recommend infants get vaccinated beginning in November 2013.
That recommendation was suspended in April 2015, after they recorded 47 cases of intussusception over an 8 year period. This included 14 cases that required surgery and tragically, two deaths, including one child who died at home without getting any medical care. The other developed intussusception after the third dose of vaccine, which is not usually linked to any increased risk.
It is important to note that at least 80 other countries, including the United States, Finland, Germany, Norway, and the UK, haven’t stopped using the rotavirus vaccine.
Why not?
Because the risks of a natural rotavirus infection are much greater than the risk of intussusception. In other words, the benefits of the vaccine exceed its risks.
In France alone, for example, it is estimated that rotavirus vaccines could prevent 30,000 emergency room visits, 14,000 hospitalizations, and 8 to 17 deaths each year, all in children under the age of three years.
And even without the rotavirus vaccine, there are about 200 to 250 spontaneous intussusceptions each year in France. Fortunately, infants with intussusception can almost always be successfully treated, often without surgery.
Why Did France Take the Rotavirus Vaccine off Their Schedule?
It actually makes no sense that France stopped recommending that infants get vaccinated with one of the rotavirus vaccines.
The decision was widely condemned and there are calls to reassess the decision and put the rotavirus vaccine back on the schedule in France.
“After the surprising decision of the CTV-HCSP of April 2015 to suspend its own recommendation for widespread vaccination against Rotavirus (following a false and misleading pharmacovigilance report) against the international recommendations, we advise you to read the meta-analysis on efficacy (in comparative studies) and the effectiveness (field efficacy) of these vaccines.”
The benefits of the rotavirus vaccines far outweigh its risks.
“The estimated benefits of vaccination in our study greatly exceed the estimated risks and our results should contribute to provide further evidence for discussions around rotavirus vaccination in France.”
Larmrani et al A benefit–risk analysis of rotavirus vaccination, France, 2015
Why did France take the rotavirus vaccines off their schedule?
In 1885, four boys from New Jersey went all of the way to France to get Pasteur’s new rabies vaccine, which wasn’t yet available in the US.
That’s a good question.
Another good question? How many infants have died of rotavirus infections since they did? And when will they put the vaccine back on the schedule? Fortunately, the rotavirus vaccines are still available in France, they weren’t banned as some folks say.
Of course, this isn’t the first time that France impulsively suspended a vaccine.
In 1998, France suspended the routine vaccination of teens against hepatitis B because of the possible association of the vaccine with multiple sclerosis. This was done amid “pressure from anti-vaccine groups and reports in the French media have raised concerns about a link between HBV immunisation and new cases or relapses of MS and other demyelinating diseases,” even though “scientific data available do not support a causal association between HBV immunisation and central nervous system diseases, including MS.”
“In 1998, official concerns were first voiced over a possible association between hepatitis B virus (HBV) vaccination and multiple sclerosis (MS). Despite a number of studies that have demonstrated no such association, ten years on the French population’s confidence in the vaccine remains shaken and immunization rates of infants have stagnated beneath 30%. With a chronic carriage of the virus estimated at 0.68%, it seems unlikely that France will be able to control the circulation of the virus. ”
Marta Balinska on Hepatitis B vaccination and French Society ten years after the suspension of the vaccination campaign: how should we raise infant immunization coverage rates?
Do you know where all of this has left France now?
With high rates of vaccine-preventable disease (15,000 cases of measles in 2011, with 16 cases of encephalitis and 6 deaths) and a move towards vaccine mandates. As of January 2018, all infants and toddlers in France must receive DTaP, Hib, HepB, pneumococcal, MMR, and meningococcal C vaccines.
What to Know About France Taking the Rotavirus Vaccine off Their Schedule
In no longer recommending the rotavirus vaccines, officials in France actually put infants at greater risk for sickness and death.
More on France Taking the Rotavirus Vaccine off Their Schedule
