DrugindexOnline^{2nd edition}

Some commonly used brand names are:

In the U.S.—

• Imovax ²
• Imovax I.D. ²

Other commonly used names are: HDCV RVA

Note:

For quick reference, the following rabies vaccines are numbered to match the corresponding brand names.

This information applies to the following vaccines:
1.	Rabies Vaccine Adsorbed†‡
2.	Rabies Vaccine, Human Diploid Cell§
† Not commercially available in Canada
‡ Generic name product may be available in the U.S.
§ Generic name product may be available in Canada

Category

• Immunizing agent, active—Rabies Vaccine Adsorbed; Rabies Vaccine, Human Diploid Cell

Description

Rabies (RAY-beez)Vaccine is an active immunizing agent used to prevent infection caused by the rabies virus. The vaccine works by causing your body to produce its own protection (antibodies) against the rabies virus.

Rabies vaccine is used in two ways. Rabies vaccine is given to persons who have been exposed (for example, by a bite, scratch, or lick) to an animal that is known, or thought, to have rabies. This is called post-exposure prophylaxis. Rabies vaccine may also be given ahead of time to persons who have a high risk of getting infected with rabies virus. These persons include veterinarians, animal handlers, travelers who will spend more than 1 month in countries having a high rate of rabies infection, and persons who live, work, or take vacations in wild areas of the country where they are likely to come into contact with wild animals. This is called pre-exposure prophylaxis.

Rabies infection is a serious, and often fatal, infection. In the U.S., rabies in wild animals, especially raccoons, skunks, and bats, accounts for most cases of rabies passed on to humans, pets, and other domestic animals. In Canada, the animals most often infected with rabies are foxes, skunks, bats, dogs, and cats. Horses, swine, and cattle also have been known to become infected with rabies. In much of the rest of the world, including Latin America, Africa, and Asia, dogs account for most cases of rabies passed on to humans.

If you are being (or will be) treated for a possible rabies infection while traveling outside of the U.S. or Canada, contact your doctor as soon as you return to the U.S. or Canada, since it may be necessary for you to have additional treatment.

This vaccine is to be administered only by or under the supervision of your doctor or other health care professional. It is available in the following dosage form:

• Parenteral
• Injection (U.S. and Canada)

Before Receiving This Vaccine

In deciding to use a vaccine, the risks of using the vaccine must be weighed against the good it will do. This is a decision you and your doctor will make. For rabies vaccine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to rabies vaccine, or to cow (bovine) serum, human albumin, kanamycin, monkey proteins, neomycin, polymyxin B, or thimerosal, since some of these may also be present in the vaccine. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies on effects in pregnancy have not been done in either humans or animals. However, the use of rabies vaccine in pregnant women has not been reported to cause problems.

Breast-feeding—Rabies vaccine has not been reported to cause problems in nursing babies.

Children—This vaccine is not expected to cause different side effects or problems in children than it does in adults.

Older adults—Many vaccines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of rabies vaccine in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. While you are receiving rabies vaccine, it is especially important that your health care professional know if you are taking any of the following:

• Cancer medicines or
• Corticosteroids (i.e., cortisone-like medicines) or
• Medicine to prevent malaria, such as chloroquine (Aralen), hydroxychloroquine (Plaquenil), or mefloquine (Lariam), or
• Radiation therapy—These treatments may reduce the useful effect of the vaccine

Other medical problems—The presence of other medical problems may affect the use of rabies vaccine. Make sure you tell your doctor if you have any other medical problems, especially:

• Illness, severe, with fever—The symptoms of the condition may be confused with the possible side effects of the vaccine

• Immune deficiency condition (or family history of)—May decrease the useful effects of the vaccine

Proper Use of This Vaccine

In order for rabies vaccine to work properly, it is very important that you do not miss any doses . Keep your appointments with your doctor.

Dosing—The dose of rabies vaccine will be different for different patients. The number of injections and the time between injections depend on the reason for which you are receiving rabies vaccine.

• For rabies vaccine adsorbed
• For injection dosage form:
  • For post-exposure prophylaxis if you have never received rabies vaccine before:
    • Adults and children—One dose on the first day, then one dose three, seven, fourteen, and twenty-eight days later for a total of five doses. The vaccine is injected into the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle. On the first day, you will also receive an injection of another medicine (rabies immune globulin).
  • For post-exposure prophylaxis if you have received rabies vaccine before:
    • Adults and children—One dose on the first day, then one dose three days later for a total of two doses. The vaccine is injected into the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.
  • For pre-exposure prophylaxis if you have never received rabies vaccine before:
    • Adults and children—One dose on the first day, then one dose seven and twenty-one or twenty-eight days later for a total of three doses. The vaccine is injected into the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.
  • For pre-exposure prophylaxis if you have received rabies vaccine before (also known as a booster dose):
    • Adults and children—One dose injected into the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.

• For rabies vaccine, human diploid cell
• For injection dosage form:
  • For post-exposure prophylaxis if you have never received rabies vaccine before:
    • Adults and children—One dose on the first day, then one dose three, seven, fourteen, and twenty-eight days later for a total of five doses. The vaccine is injected into the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle. On the first day, you will also receive an injection of another medicine (rabies immune globulin).
  • For post-exposure prophylaxis if you have received rabies vaccine before:
    • Adults and children—One dose on the first day, then one dose three days later for a total of two doses. The vaccine is injected into the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.
  • For pre-exposure prophylaxis if you have never received rabies vaccine before:
    • Adults and children—One dose on the first day, then one dose seven and twenty-one or twenty-eight days later for a total of three doses. The vaccine is injected into, or under the skin of, the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.
  • For pre-exposure prophylaxis if you have received rabies vaccine before (also known as a booster dose):
    • Adults and children—One dose injected into, or under the skin of, the muscle (deltoid) in the upper arm. Very young or small children may have the vaccine injected into the upper leg (thigh) muscle.

Missed dose—If you miss a dose of this vaccine, contact your doctor as soon as possible .

Precautions While Receiving This Vaccine

This vaccine may cause some people to become dizzy. Make sure you know how you react to this vaccine before you drive, use machines, or do anything else that could be dangerous if you are dizzy.

Side Effects of This Vaccine

Along with its needed effects, a vaccine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if either of the following side effects occur:

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the vaccine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 08/31/1994

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