Version April 2023
Preexposure prophylaxis (CDC/ACIP [Rao 2022]): Note: Advisory Committee on Immunization Practices (ACIP) recommendations are based on risk category. The 5 risk categories (level 1: highest risk; level 5: lowest risk) are based on the nature of possible exposure, relevant rabies biogeography, and status of long-term immunogenicity (based on previous rabies vaccination or rabies antibody titers). See ACIP recommendations for details (CDC/ACIP [Rao 2022]). Refer to local/state health departments and the CDC for additional guidance.
Primary series: IM: 1 mL/dose for 2 doses administered on days 0 and 7. Note: Recommended for risk categories 1 through 4.
Booster dose: IM: 1 mL/dose if antibody titer is <0.5 units/mL; recommendations vary based on risk category:
Risk category 1: Check antibody titers every 6 months; administer booster dose if needed.
Risk category 2: Check antibody titers every 2 years; administer booster dose if needed.
Risk category 3: Check antibody titers once during the 1 to 3 years after completion of primary series; administer booster dose if needed. Alternatively, may administer a single booster dose no sooner than day 21 and no later than year 3 after 2-dose primary series (with no titer monitoring).
Risk category 4: No booster dose indicated.
Persons who are immunocompromised: Assess antibody titer ≥1 week (preferably 2 to 4 weeks) after administration of primary 2-dose series and every booster vaccination. If 2 booster doses fail to elicit antibody titer ≥0.5 units/mL, contact state or local health department for guidance.
Postexposure prophylaxis (CDC/ACIP [Rupprecht 2010]): Note: All postexposure management should begin with immediate cleansing of the wound with soap and water.
Previously vaccinated persons: Note: Previously vaccinated persons are persons who have received an ACIP-recommended preexposure or postexposure vaccination regimen or who have received another vaccine regimen with documentation of rabies antibody titer considered adequate.
IM: 1 mL/dose for 2 doses administered on days 0 and 3.
Unvaccinated persons: Note: Administer the first dose (day 0) in combination with rabies immune globulin.
Immunocompetent: IM: 1 mL/dose for 4 doses administered on days 0, 3, 7, and 14.
Immunocompromised: IM: 1 mL/dose for 5 doses administered on days 0, 3, 7, 14, and 28.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Rabies virus vaccine: Pediatric drug information")
Preexposure prophylaxis:
Note: ACIP recommendations vary based on risk of being exposed to rabies virus. The 5 risk categories (level 1: highest risk to level 5: lowest risk) are based on the nature of possible exposure, relevant rabies biogeography, and status of long-term immunogenicity (based on previous rabies vaccination or rabies antibody titers). See ACIP recommendations for details (CDC/ACIP [Rao 2022]). Refer to local/state health departments and the CDC for additional guidance.
Primary series: Infants, Children, and Adolescents: IM: 1 mL/dose for 2 doses administered on days 0 and 7. Note: Recommended for risk categories 1 through 4.
Booster dose: Infants, Children, and Adolescents: IM: 1 mL/dose if antibody titer is <0.5 units/mL; recommendations vary based on risk category:
Risk category 1: Check antibody titers every 6 months; administer booster dose if needed.
Risk category 2: Check antibody titers every 2 years; administer booster dose if needed.
Risk category 3: Check antibody titers once during the 1 to 3 years after completion of primary series; administer booster dose if needed. Alternatively, may administer a single booster dose no sooner than day 21 and no later than year 3 after 2-dose primary series (with no titer monitoring).
Risk category 4: No booster dose indicated.
Persons who are immunocompromised (regardless of risk category): Assess antibody titer ≥1 week (preferably 2 to 4 weeks) after administration of primary 2-dose series and every booster vaccination. If two booster doses fail to elicit antibody titer ≥0.5 units/mL, contact state or local health department for guidance.
Postexposure prophylaxis:
Note: All postexposure management should begin with immediate cleansing of the wound with soap and water (for ~15 minutes); immunization should begin as soon as possible after exposure (CDC/ACIP [Rupprecht 2010]).
Previously vaccinated persons: Note: Previously vaccinated persons are individuals who have previously received an ACIP-recommended preexposure or postexposure vaccination regimen or who have received another vaccine regimen with documentation of adequate rabies antibody titer.
Infants, Children, and Adolescents: IM: 1 mL/dose for 2 doses administered on days 0 and 3 (CDC/ACIP [Rupprecht 2010]).
Unvaccinated persons: Note: Administer the first dose (day 0) in combination with rabies immune globulin (CDC/ACIP [Rupprecht 2010]).
Infants, Children, and Adolescents:
Immunocompetent: IM: 1 mL/dose for 4 doses administered on days 0, 3, 7, and 14 (CDC/ACIP [Rupprecht 2010]).
Immunocompromised: IM: 1 mL/dose for 5 doses administered on days 0, 3, 7, 14, and 28 (CDC/ACIP [Rupprecht 2010]).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Suspension Reconstituted, Intramuscular:
Imovax Rabies: 2.5 units/mL (1 ea) [contains albumin human, neomycin sulfate]
Imovax Rabies: 2.5 units/mL (1 ea) [contains albumin human, neomycin sulfate, phenol]
RabAvert: 2.5 units (1 ea) [contains albumin human, chicken protein, edetate (edta) disodium, gelatin (bovine), neomycin]
RabAvert: 2.5 units (1 ea) [contains albumin human, chicken protein, edetate (edta) sodium (tetrasodium), gelatin (bovine), neomycin]
RabAvert: 2.5 units (1 ea [DSC]) [contains albumin human, edetate (edta) disodium, neomycin, polygeline]
Suspension Reconstituted, Intramuscular [preservative free]:
Imovax Rabies: 2.5 units/mL (1 ea [DSC], 1 mL [DSC]) [contains albumin human, neomycin sulfate]
No
Imovax Rabies is grown in human diploid cell culture.
RabAvert is grown in purified chick embryo cell culture (PCEC).
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Suspension Reconstituted, Intramuscular:
Imovax Rabies: 2.5 units/mL (1 ea)
In the United States, the appropriate Centers for Disease Control and Prevention (CDC)-approved Vaccine Information Statement (VIS) should be provided to the patient/caregiver before administering each dose of this vaccine. If purchased under CDC contract, the VIS must be provided and the VIS edition date and date it was provided to the patient/caregiver should be recorded. VIS is available at http://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html.
IM: Administer IM into the deltoid muscle. Use proper injection technique in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration (Cross 2016; Foster 2013). Avoid administration into the gluteal area; may result in lower response. Postexposure prophylaxis should begin with immediate cleansing of wounds with soap and water; if available, a virucidal agent (eg, povidone-iodine solution) should be used to irrigate the wounds. Do not mix rabies vaccine and human rabies immune globulin in the same syringe, and do not administer in the same anatomical site. Do not mix with other vaccines or injections; separate needles and syringes should be used for each injection. To prevent syncope related injuries, patients should be vaccinated while seated or lying down (ACIP [Kroger 2022]). US law requires that the date of administration, the vaccine manufacturer, lot number of vaccine, Vaccine Information Statement (VIS) edition date and date it was provided, and the administering person's name, title, and address be recorded.
For patients at risk of hemorrhage following intramuscular injection, the vaccine should be administered intramuscularly if, in the opinion of the physician familiar with the patient's bleeding risk, the vaccine can be administered by this route with reasonable safety. If the patient receives antihemophilia or other similar therapy, intramuscular vaccination can be scheduled shortly after such therapy is administered. A fine needle (23 gauge or smaller) can be used for the vaccination and firm pressure applied to the site (without rubbing) for at least 2 minutes. The patient should be instructed concerning the risk of hematoma from the injection. Patients on anticoagulant therapy should be considered to have the same bleeding risks and treated as those with clotting factor disorders (ACIP [Kroger 2022]).
IM: Reconstitute immediately before administration. Administer IM into the anterolateral thigh for neonates, infants, and small children as appropriate and into the deltoid muscle for children and adolescents (CDC/ACIP [Rao 2022]; manufacturer's labeling). Use proper injection technique in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration (Cross 2016; Foster 2013). Do not administer to the gluteal region; may decrease efficacy. Do not mix rabies vaccine and human rabies immune globulin in the same syringe, and do not administer in the same anatomical site. Do not mix with other vaccines or injections; separate needles and syringes should be used for each injection. To prevent syncope-related injuries, adolescents should be vaccinated while seated or lying down (ACIP [Kroger 2022]). US law requires that the date of administration, the vaccine manufacturer, lot number of vaccine, Vaccine Information Statement (VIS) edition date and date it was provided, and the administering person's name, title, and address be recorded.
For patients at risk of hemorrhage following IM injection, the vaccine should be administered IM if, in the opinion of the physician familiar with the patient's bleeding risk, the vaccine can be administered by this route with reasonable safety. If the patient receives antihemophilia or other similar therapy, IM vaccination can be scheduled shortly after such therapy is administered. A fine needle (23-gauge or smaller) should be used for the vaccination and firm pressure applied to the site (without rubbing) for at least 2 minutes. The patient should be instructed concerning the risk of hematoma from the injection. Patients on anticoagulant therapy should be considered to have the same bleeding risks and treated as those with clotting factor disorders (ACIP [Kroger 2022]).
Rabies disease prevention: Preexposure and postexposure vaccination against rabies.
Advisory Committee on Immunization Practices (ACIP) recommendations:
Preexposure prophylaxis (PrEP) : Vaccination recommendations are based on a person's level of risk for being exposed to rabies virus. The 5 risk categories (level 1: highest risk; level 5: lowest risk) are based on the nature of possible exposure, relevant rabies biogeography, and status of long-term immunogenicity (based on previous rabies vaccination or rabies antibody titers). See ACIP recommendations for details (CDC/ACIP [Rao 2022]). Refer to local/state health departments and the CDC for additional guidance.
Postexposure prophylaxis (PEP): Recommendations for use of PEP for a given scenario are based on risk-benefit assessment, including assessment of the risk of actually acquiring rabies versus the risk of providing PEP (ie, likelihood and severity of possible adverse effects). Consideration should include the type of exposure, epidemiology of rabies in the area, species of the animal, circumstances of the incident, and the availability of the exposing animal for observation or rabies testing. Postexposure vaccination is used in both previously vaccinated and previously unvaccinated individuals, though number of doses may vary. Refer to local/state health departments for additional guidance, particularly in nonroutine scenarios (CDC/ACIP [Manning 2008]; CDC/ACIP [Rao 2022]; CDC/ACIP [Rupprecht 2010]).
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>10%:
Central nervous system: Dizziness, headache, malaise
Dermatologic: Injection site pruritus
Gastrointestinal: Abdominal pain, nausea
Hematologic & oncologic: Lymphadenopathy
Local: Erythema at injection site, pain at injection site, swelling at injection site
Neuromuscular & skeletal: Myalgia
Frequency not defined:
Cardiovascular: Cardiovascular toxicity, edema, palpitations, swelling of injected limb (extensive)
Central nervous system: Chills, encephalitis, fatigue, Guillain-Barre syndrome, meningitis, neuropathy, paralysis (may be transient; includes neuroparalysis), paresthesia (transient), retrobulbar neuritis, seizure, vertigo
Dermatologic: Pruritus, urticaria (including urticaria pigmentosa)
Endocrine & metabolic: Hot flash
Gastrointestinal: Diarrhea, vomiting
Hematologic & oncologic: Adenopathy
Hypersensitivity: Anaphylaxis, hypersensitivity reaction, serum sickness
Local: Hematoma at injection site
Neuromuscular & skeletal: Arthralgia, arthritis (one joint), limb pain, multiple sclerosis, myelitis, weakness
Ophthalmic: Visual disturbance
Respiratory: Bronchospasm, dyspnea, wheezing
Miscellaneous: Fever >38°C (100°F)
Preexposure prophylaxis: Life-threatening hypersensitivity to rabies vaccine or any component of the formulation
Postexposure prophylaxis: There are no contraindications listed in the manufacturer's labeling.
Concerns related to adverse effects:
• Anaphylactoid/hypersensitivity reactions: Once postexposure prophylaxis has begun, administration should generally not be interrupted or discontinued due to local or mild systemic adverse events; anti-inflammatory, antihistamine, and antipyretic agents are typically sufficient to manage local or mild systemic reactions. Continuation of vaccination following severe systemic reactions should consider the person's risk of developing rabies. Report serious reactions to the state health department or the manufacturer/distributor.
• Immune complex-like reactions (serum sickness): An immune complex reaction is possible ~2 to 21 days following booster doses of HDCV (Imovax). Symptoms may include arthralgia, arthritis, angioedema, fever, generalized urticaria, malaise, nausea, and vomiting.
• Neurologic reactions: Rare cases of Guillain-Barre syndrome (transient neuroparalytic illnesses that resolves without sequelae in 12 weeks, potentially fatal encephalitis, meningitis, transient paralysis, myelitis, retrobulbar neuritis, and multiple sclerosis) have been reported.
• Shoulder injury related to vaccine administration: Vaccine administration that is too high on the upper arm may cause shoulder injury (eg, shoulder bursitis, tendinopathy) resulting in shoulder pain and reduced range of motion following injection. Use proper injection technique for vaccines administered in the deltoid muscle (eg, injecting in the central, thickest part of the muscle) to reduce the risk of shoulder injury related to vaccine administration (Cross 2016; Foster 2013).
• Syncope: Syncope has been reported with use of injectable vaccines and may result in serious secondary injury (eg, skull fracture, cerebral hemorrhage); typically reported in adolescents and young adults and within 15 minutes after vaccination. Procedures should be in place to avoid injuries from falling and to restore cerebral perfusion if syncope occurs (ACIP [Kroger 2022]).
Disease-related concerns:
• Bleeding disorders: Use with caution in patients with a history of bleeding disorders (including thrombocytopenia); bleeding/hematoma may occur from IM administration; if the patient receives antihemophilia or other similar therapy, IM injection can be scheduled shortly after such therapy is administered (ACIP [Kroger 2022]).
Special populations:
• Altered immunocompetence: Consider deferring immunization during periods of severe immunosuppression (eg, patients receiving chemo/radiation therapy [including high-dose corticosteroids]); response to vaccination may be reduced. Withhold nonessential immunosuppressive agents during postexposure prophylaxis; if possible, postpone pre-exposure prophylaxis until the immunocompromising condition is resolved. If a person remains immunocompromised and requires preexposure prophylaxis (PrEP) vaccination, administer the rabies vaccine and check antibody titers ≥1 week (preferable 2 to 4 weeks) after 2-dose PrEP series and any booster doses; booster dose(s) may be needed for suboptimal antibody titer. Participation in high-risk activities should be deferred until adequate antibody titers are confirmed (CDC/ACIP [Rao 2022]).
• Pediatric: Apnea has occurred following intramuscular vaccine administration in premature infants; consider clinical status implications. In general, preterm infants should be vaccinated at the same chronological age as full-term infants (ACIP [Kroger 2022]).
Concurrent drug therapy issues:
• Anticoagulant therapy: Use with caution in patients receiving anticoagulant therapy; bleeding/hematoma may occur from IM administration (ACIP [Kroger 2022]).
• Vaccines: In order to maximize vaccination rates, the ACIP recommends simultaneous administration (ie, >1 vaccine on the same day at different anatomic sites) of all age-appropriate vaccines (live or inactivated) for which a person is eligible at a single clinic visit, unless contraindications exist. The ACIP prefers each dose of a specific vaccine in a series come from the same manufacturer when possible (ACIP [Kroger 2022]).
Dosage form specific issues:
• Albumin: Products may contain albumin and therefore carry a remote risk of transmitting Creutzfeldt-Jakob or other viral diseases.
• Imovax Rabies: Contains neomycin.
• RabAvert: Contains amphotericin B, bovine gelatin, egg and chicken protein, chlortetracycline, and neomycin.
Other warnings/precautions:
• Antipyretics: Antipyretics have not been shown to prevent febrile seizures; antipyretics may be used to treat fever or discomfort following vaccination (ACIP [Kroger 2022]). One study reported that routine prophylactic administration of acetaminophen prior to vaccination to prevent fever decreased the immune response of some vaccines; the clinical significance of this reduction in immune response has not been established (Prymula 2009).
• Appropriate use: Rabies vaccine should not be used in persons with a confirmed diagnosis of rabies; use after the onset of symptoms may be detrimental (ACIP [Manning 2008]). Postexposure vaccination may begin regardless of the length of time from documented or likely exposure, as long as clinical signs of rabies are not present; however, it is ideal to start the treatment as soon as possible.
• Effective immunity: Vaccination may not result in effective immunity in all patients. Response depends upon multiple factors (eg, type of vaccine, age of patient) and may be improved by administering the vaccine at the recommended dose, route, and interval. Vaccines may not be effective if administered during periods of altered immune competence (ACIP [Kroger 2022]).
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Acetaminophen: May diminish the therapeutic effect of Vaccines. Management: Consider avoiding routine prophylactic use of acetaminophen before or during vaccine administration when possible. Acetaminophen is still recommended to treat fevers and/or pain that occurs after vaccination. Risk D: Consider therapy modification
Aminoquinolines (Antimalarial): May diminish the therapeutic effect of Rabies Vaccine. Management: If coadministration is unavoidable during rabies post-exposure vaccination, give a 5th dose of the rabies vaccine. If coadministration is unavoidable during rabies pre-exposure vaccination, ensure antibody titers are greater than or equal to 0.5 IU/mL. Risk D: Consider therapy modification
Anti-CD20 B-Cell Depleting Therapies: May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Cladribine: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Give inactivated vaccines at least 2 weeks prior to initiation of cladribine when possible. Patients vaccinated less than 14 days before initiating or during cladribine should be revaccinated at least 3 months after therapy is complete. Risk D: Consider therapy modification
Corticosteroids (Systemic): May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Elivaldogene Autotemcel: May enhance the adverse/toxic effect of Vaccines. Specifically, there may be a greater risk for contracting an infection from any live vaccine. Elivaldogene Autotemcel may diminish the therapeutic effect of Vaccines. Management: Administration of vaccines is not recommended in the 6 weeks before myeloablative conditioning, and until hematologic recovery after elivaldogene autotemcel treatment. Risk X: Avoid combination
Fingolimod: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Vaccine efficacy may be reduced. Complete all age-appropriate vaccinations at least 2 weeks prior to starting fingolimod. If vaccinated during fingolimod therapy, revaccinate 2 to 3 months after fingolimod discontinuation. Risk D: Consider therapy modification
Immunosuppressants (Cytotoxic Chemotherapy): May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Immunosuppressants (Miscellaneous Oncologic Agents): May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Immunosuppressants (Therapeutic Immunosuppressant Agents): May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Methotrexate: May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Propacetamol: May diminish the therapeutic effect of Vaccines. Management: Consider avoiding routine prophylactic use of propacetamol before or during vaccine administration when possible. Propacetamol is still recommended to treat fevers and/or pain that occurs after vaccination. Risk D: Consider therapy modification
Rabies Immune Globulin (Human): May diminish the therapeutic effect of Rabies Vaccine. Management: Do not administer additional or repeated doses of rabies immune globulin once rabies vaccine has been administered. The rabies immune globulin should also not be administered in the same site as the vaccine. Risk D: Consider therapy modification
Siponimod: May diminish the therapeutic effect of Vaccines (Inactivated/Non-Replicating). Management: Avoid administration of vaccines (inactivated) during treatment with siponimod and for 1 month after discontinuation due to potential decreased vaccine efficacy. Risk D: Consider therapy modification
Teplizumab: May diminish the therapeutic effect of Rabies Vaccine. Management: Complete rabies vaccination at least 2 weeks before initiation of immunosuppressant therapy if possible. If combined, check for rabies antibody titers, and if vaccination is for post exposure prophylaxis, administer a 5th dose of the vaccine. Risk D: Consider therapy modification
Animal reproduction studies have not been conducted. Pregnancy is not a contraindication to postexposure prophylaxis. Pre-exposure prophylaxis during pregnancy may also be considered if risk of rabies is great. Inactivated vaccines have not been shown to cause increased risks to the fetus (ACIP [Kroger 2022]).
It is not known if rabies vaccine is excreted in breast milk; the manufacturer recommends that caution be exercised when administering rabies vaccine to breastfeeding women. Administration does not affect the safety of breastfeeding for the mother or the infant. Breastfeeding infants should be vaccinated according to the recommended schedules (ACIP [Kroger 2022]).
Monitor for anaphylaxis and syncope for 15 minutes following administration (ACIP [Kroger 2022]). If seizure-like activity associated with syncope occurs, maintain patient in supine or Trendelenburg position to reestablish adequate cerebral perfusion.
Evaluation of antibody response to vaccination is not recommended for otherwise healthy persons who complete the preexposure or postexposure regimen. Serologic testing to determine if the rabies antibody titer is at an acceptable level is recommended as part of preexposure prophylaxis for persons in the following risk categories as defined by the CDC (see CDC guidelines for details). Booster vaccination may be recommended if titer is below the acceptable level of <0.5 units/mL (CDC/ACIP [Rao 2022]):
Risk category 1: Check antibody titers every 6 months.
Risk category 2: Check antibody titers every 2 years.
Risk category 3: Check antibody titers 1 to 3 years after completion of primary series. Alternatively, may administer a single booster dose between 3 weeks and 3 years following the first vaccine dose in the 2-dose series (with no titer monitoring).
Risk categories 4 and 5: No antibody titer monitoring recommended.
Persons who are immunocompromised: Assess antibody titer ≥1 week (preferably 2 to 4 weeks) after administration of primary series and every booster vaccination. If 2 booster doses fail to elicit antibody titer ≥0.5 units/mL, contact state or local health department.
Adequate adaptive immune response: Rabies antibody titers of ≥0.5 international units/mL (CDC/ACIP [Rao 2022]) or complete virus neutralization at a 1:5 serum dilution by the rapid fluorescent focus inhibition test (RFFIT) (ACIP [Manning 2008]).
Rabies vaccine is an inactivated virus vaccine which promotes immunity by inducing an active immune response. The production of specific antibodies requires about 7-10 days to develop. Rabies immune globulin or antirabies serum, equine (ARS) is given in conjunction with rabies vaccine to provide immune protection until an antibody response can occur.
Onset of action: IM: Rabies antibody: ~7 to 10 days
Peak effect: ~30 to 60 days
Duration: ≥1 year
Suspension (reconstituted) (Imovax Rabies Intramuscular)
2.5 units/mL (per each): $510.52
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