What is the role of passive and active immunizations against rabies?

Updated: Jun 21, 2019
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Before the onset of rabies symptoms, passive and active immunizations are effective in preventing progression to full-blown rabies.

If the patient has had no prior rabies vaccination, if he or she is of unknown status, rabies vaccine and immunoglobulin should be administered as follows (these dosages being applicable to products available in the United States):

  • Rabies vaccine IM (deltoid) - 1 mL on days on days 0, 3, 7, and 14 (if immunocompromised, add an additional dose: 1 mL IM deltoid on days 0, 3, 7, 14, and 28)

  • Rabies immunoglobulin - 20 IU/kg infiltrated as much as feasible around and under the bite wound; if any left over, give IM (gluteus)

If the patient has had prior rabies vaccination, vaccine should be administered as follows (this dosage again being applicable to US vaccine): Rabies vaccine IM (deltoid) 1 mL on days on days 0 and 3.


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