Rabies

Transmission 

Rabies is caused by members of the virus Lyssavirus genus and is transmitted by bite, scratch or through saliva exposure, for example, to eyes, nose or mouth from domestic and wild and warm-blooded mammals —particularly dogs.

The risk of rabies to most travellers is small; those at risk include:

  • Those unable to easily access medical care at their destination, including access to rabies vaccine/immunoglobulin
  • If at continued risk for more than one month
  • Those participating in activities such as running/cycling
  • Handlers of imported animals, bats, or health workers who have direct contact with rabies infected animals or patients

Vaccination schedule

Brand Vaccine information Primary course Booster
Rabies vaccine BP (inactivated)
  • Inactivated
  • No licensed minimum age 
  • Single doses on day zero, seven and 28 — third dose may be given earlier on day 21

Single dose — 12 months after primary course completion and repeated every three-to-five years for continued exposure

Rabipur
(inactivated)

  • Inactivated
  • For all age groups
  • Three doses, with full immunity after day 28
The booster dose should be administered in line with official recommendations.

The information below is based on Public Health England recommendations; individual Summaries of Product Characteristics should be referred to for manufacturer recommendations regarding individual brands or contact the NPA Pharmacy Services Team for specific advice.

Acute illness

If a patient is suffering from an acute illness, pre-exposure immunisation should be postponed until they have recovered. Patients with minor infections without fever or systemic upset do not need to postpone their vaccination schedule. 

Administration with other vaccines

Rabies vaccines can be given at the same time as other vaccines, including other travel vaccines, as long as they are administered at different sites. 

Immunocompromised patients

Rabies vaccine should be given to patients who are immunocompromised if they are travelling to an area of risk and who would have limited access to post-exposure treatment, however it may not be as effective. Specialist advice may be required. 

Pregnancy and breast-feeding

Rabies vaccine should only be considered in pregnant women and breast-feeding mothers if the risk of exposure to rabies is high and they would be unable to have rapid access to post-exposure prophylaxis. When it is indicated, post-exposure treatment should be given to pregnant and breastfeeding women.