1.What is rabies vaccine?
Rabies vaccine is a vaccine with a long history, the first to manufacture rabies vaccine was Pasteur in France, which successfully applied the method of successive transmission to weaken the viral force in 1882, and used the adapted virus species to manufacture the vaccine. The lyophilized purified rabies vaccine applied in China was made by fixing the rabies virus with the adapted strain 3aG, inoculating it into primary rat kidney cells, and harvesting the viral fluid after the virus proliferation reached its peak by culture.
The virus antigen was detected by ELISA and should be above 0.6 IU/ml. Formaldehyde solution was added to inactivate the virus, and the virus was purified by zinc acetate precipitation and sepharose 4FF column chromatography. Finally, aluminum hydroxide adsorbent is added, and the vaccine for rabies prevention is qualified after comprehensive testing.
2.What is the mechanism of action of rabies vaccine?
Rabies virus is a serotype, and the antigenic nature of rabies virus is the same all over the world. After rabies vaccination, neutralizing antibodies, hemagglutination inhibiting antibodies, complement binding antibodies and cytolytic antibodies can appear in the serum. These antibodies prevent direct transmission of the virus between cells and reduce the amount of virus proliferation. In addition to neutralizing antibodies, cellular immunity is also involved in the host’s defense against CNS viral infections, and these specific antibodies in the serum can also remove free rabies virus and prevent the virus from multiplying and spreading.
3.What are the targets of rabies vaccination?
(1) Non-bite (pre-exposure) vaccine recipients
People at high risk of rabies in epidemic areas, and workers who are exposed to the virus. For example, veterinarians in infected areas, animal breeders, animal managers, slaughterers, rabies virus experimenters, and vaccine manufacturers. Medical personnel in infectious disease departments, cavity workers, personnel with frequent contact with other mammals, children in severely infected areas, postal workers, travelers to infected areas, etc.
(2) Post-bite (post-exposure) prevention targets.
Anyone who has been bitten, scratched or licked by a rabid dog or other rabid animal or suspected rabid animal needs to be vaccinated against rabies, even if the bite or scratch is very light on the skin or mucous membrane.
4.How to apply rabies vaccine to a healthy person without bite?
Healthy people without bites can receive rabies vaccine at 0, 7 and 21 days for a total of 3 doses, a booster shot 1 year later, and a booster shot every 1-3 years thereafter. The injection site is the deltoid muscle of the upper arm, and for children, the anterior medial thigh area.
5.How to apply rabies vaccine after being bitten?
Rabies vaccination is the most important preventive measure for normal people after being bitten by a rabid animal or suspected rabid animal. The earlier the injection is given, the better, and the entire immunization process should be carried out according to the procedures specified in the instructions.
(1) Injection procedures for general bites.
General bites include mild abrasions or scratches without bleeding skin and broken skin being licked. A total of 5 injections for general bites should be given on the same day 0 (day 1, the day of injection), 3 (day 4, and so on), 7, 14, and 30 days with 1 rabies vaccine each (2 ML of liquid vaccine, 1 ML or 2 ML of lyophilized vaccine). The dosage for children is the same.
(2) Injection procedures for severe bites.
Severe bites include one or more bites to the head, face, neck and fingers, bites through the skin or licking and touching the mucous membranes. Patients with severe bites should be injected in double amount and combined with immune serum. In addition to the 5 injections as described above, the extra dose should be doubled on days 0 and 3, and the anti-rabies serum (40 IU/kg) should be used along with the rabies vaccine on day 0, or the antibody rabies immunoglobulin (20 IU/kg) should be used to infiltrate the bite locally and intramuscularly.
Where anti-rabies serum or immunoglobulin is used in combination, 2-3 doses of vaccine should be boosted after the full injection is completed, i.e. on the 15th and 75th day or the 10th, 20th and 90th day after the full injection.
6.What measures should be taken for rabid dog bite?
After being bitten by a rabid animal, the wound should be properly treated in a timely manner, and the bite should be thoroughly washed locally with soapy water and repeatedly rinsed off to flush out most of the virus immersed in it, and then the rabies vaccine should be injected as early as possible. For severe bites, in addition to thorough local cleaning and disinfection, the wound surrounding the application of rabies serum infiltration injection, followed by rabies vaccination, the works bitten should not be bandaged and sutured, as much as possible exposed.
7.What should I pay attention to during rabies vaccination?
During the rabies vaccination, no strenuous exercise should be done, and no alcohol and strong tea and coffee and other beverages with excitatory central nervous system should be consumed to avoid aggravating the reaction. During this period, immunosuppressive drugs such as hormones should not be used as much as possible to avoid affecting the production of antibodies.
8.What is the effect of immunization after rabies vaccination?
Rabies vaccination has played a significant role in reducing the incidence of the disease. The immune effect of rabies vaccination is directly related to the time of injection. After the bite, the earlier the injection, the better the immunization effect, and produce good antibody titers to obtain a better protection effect.
9.What are the contraindications of rabies vaccine?
(1) Since rabies is a disease that causes sex, all bites from rabid animals should be injected with rabies vaccine immediately, and there are no contraindications.
(2) Preventive injection before the bite can be postponed for women during pregnancy, acute febrile diseases, allergic constitution, steroid use and immunosuppression, as appropriate.
10.What is the reaction after rabies vaccination?
The rabies vaccine is safe and reliable, and there are generally no adverse reactions, only a few people may experience localized redness, swelling, hard nodules and hives. Only a few people may experience localized redness, swelling, sclerosis and hives. However, they can recover within a short period of time and do not require special treatment. Very few people may have more severe reactions, with a larger range of redness and swelling, accompanied by high fever, tiredness and other symptoms, which can be treated symptomatically or treated at the hospital.
11.Why can’t I drink coffee during rabies vaccination?
Because coffee contains neurostimulants, which can increase neuroreactivity and cause adverse reactions after vaccination. Therefore, you should not drink coffee or coffee-containing products during the rabies vaccination period.
12.Can I use other drugs during the rabies vaccination?
Other drugs can be used during rabies vaccination, such as antipyretics, anti-inflammatory drugs and analgesics. But you cannot use hormonal drugs, such as hydrocortisone, which is an immunosuppressant and can inhibit the immune response, which is not good for antibody production and cannot prevent rabies.
13.Can rabies be prevented if the rabies vaccine is not administered?
Failure to inject rabies vaccine according to the immunization program cannot produce sufficient amount of neutralizing antibodies, and the effect of rabies prevention is not guaranteed. If only 1-2 months are postponed, the number of shots can be made up, and those who can get on for 6 months should be reinjected.
14.How to reduce rabies vaccination reaction?
After receiving rabies vaccine, you cannot drink alcohol, strong tea, coffee, chocolate, etc. These substances can stimulate the body to increase reactivity.
15.How to enhance the immunity against rabies?
According to the principle of rabies virus infection and immunity, immunity against exposure must be automatic and passive immunity, i.e., the vaccine and antiserum are applied simultaneously. This is supplemented by rigorous local treatment of the bite wound. During the injection process, and then simultaneous injection of interferon preparations, the immunity to rabies can be improved and a more reliable immunoprophylactic effect can be obtained.
16.What is the strategy to control rabies?
The application of rabies vaccine to prevent rabies is a very successful means of prevention. Rabies is a human-animal disease, so immunization of humans also involves immunoprophylaxis of rabies in animals to control the spread of rabies.
17. Do people who have implemented pre-exposure immunization for rabid dog bites still need rabies vaccination?
For people who have implemented pre-exposure immunization, within 6 months, if they are bitten by a rabid animal, there is no need to inject anti-rabies serum again, only 2 injections of rabies vaccine can be given at an interval of 3 days to achieve immune protection.
18.Why do I need to inject anti-rabies serum after receiving rabies vaccine?
After the initial immunization with rabies vaccine, neutralizing antibodies are usually produced only 7-10 days after vaccination, and sometimes in the presence of neutralizing antibodies, the virus in the axonal nerve can also reproduce and be active. Therefore, antiserum is necessary as passive immunoprophylaxis after a bite, especially in people with severe injuries.
19.Will rabies occur if a person is not vaccinated against rabies after being bitten by a rabid animal?
Rabies may not always occur after being bitten by a mad animal without rabies vaccination. Whether rabies occurs is directly related to the type of animal that bit the person, the virulence of the virus contained, the amount of virus entering the body, the age of the injured person, the physical condition, the site of the bite, the severity of the injury, and the treatment of the wound after the bite.
20.How is rabies vaccine stored and transported?
The active ingredient of rabies vaccine is calculated by potency, and the potency is often affected by temperature. Therefore, the vaccine must be stored at 2-10°C to ensure that the potency does not decrease during the validity period. If the temperature is too high or too low, the potency will be affected and the immunity will be lost.
21.Can pregnant women receive rabies vaccine?
Generally speaking, anyone who is bitten by a rabid animal, including pregnant women, has the possibility of rabies, and the mortality rate after the onset of the disease is almost 100%. Therefore, rabies vaccination is extraordinarily important and should be the first priority, even if very few people have an abnormal reaction after the injection. Of course, pregnant women bitten by a rabid animal should also receive rabies vaccination promptly throughout.
22.Does the delayed rabies vaccination need to be replaced?
Those who are unable to receive rabies vaccine in time for any reason should receive a catch-up vaccination because the incubation period of rabies can be very long, and as long as the vaccination is given during the incubation period, it will be effective. For people with a short incubation period, it is no longer useful, and for people with a long incubation period, it has the effect of preventing the onset of the disease.
23.After being bitten by a crazy animal, do I need to be vaccinated again?
After being bitten or scratched by a mad animal, the whole rabies vaccine is injected, and then the body produces anti-rabies neutralizing antibodies, but this effective hangover time is short, if the bite is within 3-4 months from the previous vaccination, a booster injection of 2 shots is sufficient. If it has been more than 6 months, it should be re-immunized throughout.
24.Why do individuals still get sick after receiving rabies vaccine and serum?
After being bitten or scratched by a rabid animal, 5 rabies vaccines were injected and the anti-rabies serum was used in combination, and generally rabies will not develop. If rabies develops, the following reasons may exist.
(1) The wound was not cleaned promptly and thoroughly, so that the rabies virus multiplied in the wound and quickly invaded the nervous system. In this way, the injured person is inevitably sick even if the rabies vaccine is administered throughout and the anti-rabies serum is applied jointly.
(2) The rabies vaccine and serum were not given in a timely manner and it was too late, so that the rabies virus invading the body had already combined with the central nerve cells and the use of anti-rabies antibodies could not help.
(3) Failure to adhere to full immunization or insufficient dose per injection.
(4) Failure to immunize due to improper storage or expiration of the product.
(5) Infection with rabies virus, resulting in reduced immune function and disease.
25. Is rabies vaccination required when there is no injury to the skin after a bite from a rabid animal, but only tooth marks?
After being bitten by a rabid animal, as long as the skin is not broken, it is difficult for the virus in the saliva of the rabid animal to invade the body through the intact skin, but it is not possible to be paralyzed if there are teeth marks on the skin. Sometimes there is no skin damage visible though. In this case, the rabies virus may invade the body along with the tooth marks, therefore, you should immediately take off the bitten clothes for disinfection, the skin should be thoroughly washed with soapy water, rubbing alcohol, and also the whole rabies vaccination.
26.Why can’t rabies vaccination control rabies epidemic?
Rabies vaccination can only prevent the onset of rabies in individuals, and this means of prevention is passive, because rabies is mainly prevalent among animals such as dogs and cats, and vaccination of people only cannot change the prevalence of rabies among animals, and as long as there are crazy animals, rabies is inevitable in people, and the cycle of rabies virus in nature is still complex. In addition, the maintenance of immunity from rabies vaccination is still very limited, usually only 6-8 months, and there is no guarantee that 100% of rabies cases will not occur after rabies vaccination. Therefore, vaccination of humans alone cannot control rabies epidemics.
27. How long is the rabies vaccine valid for immunization?
The effectiveness of rabies prevention is based on the level of neutralizing antibodies and the rate of protection. After 5 vaccinations, the antibody titer should be ≥0.5 IU/ml to be effective, and the antibody level can be maintained for 6 months.