With more and more people around who have pets, questions about rabies vaccines are often asked. Have you encountered any of the following questions? Do you know the norms for handling them?
1. What types of rabies vaccines are available? What is the difference between them?
There are refined VERO cell rabies vaccine and refined gopher kidney cell rabies vaccine in use in China; both are inactivated vaccines. In addition to the rabies vaccine, patients with severe animal bites require rabies antiserum and rabies immunoglobulin (HRIG), which are passive immunization agents used to neutralize the rabies virus for rapid protection.
The main component of rabies antiserum is immunoglobulin. Rabies antiserum and rabies immunoglobulin can sometimes be considered synonymous, but they are of different origin.
The source of HRIG is homologous and has no allergic reactions, so it is not necessary to do skin test. In addition to occasional local pain and low fever, there is no serum disease and other adverse reactions, but the price is more expensive.
2.When do I need to receive rabies vaccine and antivenom at the same time and what are the precautions?
The high exposure level should be played.
Rabies exposure is divided into three levels according to the mode of exposure and the degree of exposure.
(1) Contact with or feeding of animals, or intact skin being licked is level I.
(2) Light bite on bare skin, or minor scratch or abrasion without bleeding is Grade II.
(3) Single or multiple penetrating skin bites or scratches, or broken skin being licked, or open wounds or mucous membranes being contaminated is Grade III.
Confirmed as level II exposed person and immunocompromised, or level II exposure is located in the head and face and the injured animal can not be determined healthy, according to the disposal of level III exposure.
In cases of Grade III exposure, post-exposure vaccination must be combined with antiserum. Local infiltration and intramuscular injection of anti-rabies serum (40 IU/kg body weight) or rabies immunoglobulin (20 IU/kg body weight) should be given at the same time as the vaccine on the day of injury.
For those who use anti-rabies serum or immunoglobulin in combination, two to three additional injections of vaccine must be given after the full vaccination is completed, i.e. one additional injection on the 15th, 75th or 10th, 20th or 90th day after the full injection.
3. Can children who are receiving scheduled immunizations receive rabies vaccination? Yes.
Children undergoing planned immunization can receive rabies vaccine according to normal immunization procedures. Other vaccines can also be given during the rabies vaccination period in accordance with normal immunization procedures, but priority is given to rabies vaccination.
4.Does the rabies vaccine have to be given within 24 hours of a rabid dog or suspected rabid dog bite to be effective?
In principle, the earlier the vaccination, the better the effect.
As long as the vaccine is effective before the vaccine takes effect, that is, before the vaccine stimulates the body to produce sufficient immunity, the vaccine can play an effective role. In this case, the dose of the previous injection or the first two injections should be doubled.
5.What should I do if I am a day or several days late for vaccination without following the procedure?
There is no need to follow the procedure again, but the vaccination schedule needs to be adjusted.
When there is a delay of one day or several days in the injection of a certain vaccine, the vaccination time of the subsequent vaccination will be postponed accordingly according to the interval of the original immunization program after the delay.
6.Can different brands of rabies vaccine be mixed, and can domestic and imported ones be mixed?
Try to use the same brand of vaccine.
According to the regulations, the same brand of rabies vaccine should be used as much as possible to complete the entire vaccination. If this is not possible, the use of a different brand of qualified rabies vaccine should continue to complete the full course of vaccination according to the original procedure, and in principle, the attendee should not bring the rabies vaccine to a different location for injection. However, clinical observation of mixing different brands of vaccines will not affect their preventive effect.
7.What are the injection sites and precautions for vaccination?
The injection site for adults is the intramuscular injection of the deltoid muscle of the upper arm, and for infants under 2 years of age, the injection can be given in the anterolateral thigh muscle. Injections in the buttocks are prohibited. Slight local reactions such as redness or mild hard nodules may occur, and fever is rarely seen.
Allergic reactions can be treated with appropriate anti-allergic treatment. Those who are allergic to streptomycin and neomycin should be used with caution. Alcohol, cola, coffee, strong tea and stimulating food should be avoided during the vaccination process.
8.How can I get rabies vaccine if I am bitten by an animal again during the vaccination period?
Differentiate according to the time of re-bite. Wound treatment should be done first, promptly and thoroughly after any one exposure. In general, antibody levels in the body can be maintained for at least 1 year after full rabies vaccination.
If re-exposure occurs during the immunization process, continue to follow the original procedure and complete the full course of vaccination without increasing the dose; those re-exposed within six months of full immunization generally do not need to be re-immunized; those re-exposed within six months to one year of full immunization should receive one dose of vaccine on days 0 and 3; those re-exposed within 1-3 years should receive one dose of vaccine on days 0, 3, and 7; those over 3 years should be Full vaccination.
Passive immunization: Those who have completed the full course of rabies vaccination (cell culture vaccine) according to the pre-exposure (post-exposure) procedure no longer need to use passive immunization preparations.
9. Is rabies vaccination required for dog bites that have been routinely vaccinated? Yes.
Even if an animal is up to date with its annual rabies vaccination, a person bitten by it still needs rabies vaccination. Because the protection rate of animals after rabies vaccination is not 100%, there may still be cases of rabies virus, so after being bitten by a dog that has been vaccinated against rabies, you still need to receive rabies vaccination on time.
10. Should I get rabies vaccination for a human bite? It is not necessary to fight.
The host animals for rabies include: all warm-blooded mammals, which also include humans. When a person is bitten by an animal with rabies, the virus in the animal’s saliva reaches the brain center along the nervous system and multiplies inside, causing the person to develop the disease, and only after the disease develops does the virus disperse into the saliva and other glands of the person. Therefore, even if a person is bitten by a dog but does not develop the disease, there is no rabies virus in his or her glands. In other words, a person only needs rabies vaccination if he or she is bitten by a rabid person who has developed the disease. If one is sure that one is not bitten by a rabid person, rabies vaccination is not required either.
Although rabies vaccination may not be required for human bites, there are more than 1,000 types of bacteria in the human mouth, and special attention should be paid to infection when dealing with human bite wounds.
11. Can pregnant women get the rabies vaccine? No. Pregnant women can also receive the vaccine.
According to the instructions for use of human rabies vaccine in the “Biological Products Regulations” issued by the State Drug Administration in 2000 and the 2009 edition of the “Code of Practice for the Prevention and Treatment of Rabies Exposure”, there are no contraindications to post-exposure immunization. Theoretically, none of the components of rabies vaccine affect the chromosomes of human germ cells, endanger humans at the genetic level, or affect the mental development or physical development of the embryo or fetus.
Current research indicates that qualified rabies vaccines do not adversely affect pregnant women and do not affect the fetus. Rabies vaccine is an inactivated virus vaccine, and inactivated virus cannot cross the placental barrier and does not cause fetal abnormalities; no studies conducted at home or abroad have found that rabies vaccine causes miscarriage, premature birth or teratogenicity.
However, Article 26 of the 2009 edition of the Code of Practice for the Prevention and Treatment of Rabies Exposure also states that “Pre-exposure immunization may be postponed at the discretion of pregnant women, those with acute febrile illnesses, those with allergies, and those using steroids and immunosuppressive drugs. What do you mean by discretion? My understanding is that if it can be ruled out that the injured animal belongs to the species with rabies, then it can be left out, but if not, it should be vaccinated for safety.