Rabies Vaccine

Rabies is a viral infection of the central nervous system caused by the rabies virus. It is almost universally fatal once symptoms develop. The virus is transmitted through the saliva of an infected animal, typically via a bite, but also through scratches that break the skin or contact with saliva on mucous membranes such as the eyes, nose or mouth. Dogs are responsible for the vast majority of human cases globally. Other animals that can transmit the virus include monkeys, cats, bats, foxes and jackals.

The primary pre-exposure course consists of three doses of Rabipur, given on day 0, day 7 and day 21 or 28. All three doses are needed to complete the course. Booster doses may be required for those who remain at ongoing risk, typically after one year for those with continued exposure, and then every five years or according to antibody titre testing.

No. Pre-exposure vaccination does not replace the need for post-exposure treatment. Anyone bitten, scratched or licked on broken skin by an animal in a rabies-endemic country must still seek medical attention promptly, even if they have completed the full vaccination course.
What pre-exposure vaccination does is significantly simplify the post-exposure regimen. Vaccinated people do not need rabies immunoglobulin (a blood product that is frequently unavailable in many endemic countries) and require only two post-exposure vaccine doses rather than four. This is clinically important in remote settings where access to medical care may be delayed.

The rabies vaccine is not routinely provided on the NHS for travellers. It is available through NHS occupational health services for certain professionals, such as veterinarians, bat handlers, wildlife workers and laboratory staff who work with live virus. For travellers, private vaccination is the standard route.

After completing the three-dose primary course, protection is considered durable. For those at continued occupational or travel risk, a booster is generally recommended after one year, then every five years, or following antibody titre testing to confirm adequate immunity. For travellers who have completed the course and are not at ongoing exposure, a single booster before a future high-risk trip is usually sufficient.

Children travelling to rabies-endemic countries are considered at higher risk than adults for two reasons: they are more likely to be bitten, and they are less likely to report an animal contact to an adult. For this reason, rabies vaccination is particularly recommended for children travelling to endemic areas, especially on extended or adventurous trips. Rabipur can be given to children from birth. We vaccinate children at all our clinics; please let us know when booking so we can allow appropriate appointment time.

Rabies is present in most of Asia, including India, Nepal, Sri Lanka, Pakistan, Bangladesh, Thailand, Vietnam, Indonesia, the Philippines and China. It is also widespread across sub-Saharan Africa and parts of North Africa and Latin America. High-income countries including the UK, Ireland, Australia, New Zealand and Japan are free of terrestrial animal rabies. Travellers to any country where dog rabies is endemic should consider vaccination if their itinerary involves animal contact or time in rural areas.

Because the primary course requires three doses over 21 to 28 days, vaccination should ideally begin at least four to five weeks before departure to allow the full course to be completed before you travel. If your departure is sooner, a partial course still provides some protection and can be completed on return or during travel where appropriate medical supervision is available. Contact us to discuss your timeline.

Act immediately. Wash the wound thoroughly with soap and running water for at least 15 minutes. Apply an antiseptic, such as iodine solution or 70 per cent alcohol, if available. Seek medical attention as quickly as possible, regardless of whether you have been vaccinated. If you have completed the pre-exposure course, you need two further vaccine doses and no RIG. If you have not been vaccinated, you need four doses of vaccine plus RIG on day 0. Do not wait to see whether symptoms develop. By the time symptoms appear, rabies is almost always fatal.

Side effects are usually mild. Soreness, redness or swelling at the injection site is the most commonly reported reaction. Mild headache, fatigue or a low-grade fever in the day or two following each dose is also reported. Serious reactions are rare. Your clinician will advise on what to expect before each dose.

Yes. Rabipur can be given at the same appointment as most other travel vaccines. If you are having multiple vaccines, your clinician may choose to use separate sites or stagger certain doses. A combined travel health appointment covering rabies alongside hepatitis A, typhoid, meningitis ACWY and other vaccines is common and straightforward to arrange.

Dogs are responsible for the overwhelming majority of human rabies deaths and are the primary concern for travellers. Monkeys are a significant risk in tourist areas across Asia, particularly in Thailand, Bali and India, where feeding monkeys is common and bites and scratches occur regularly. Bats are a source of bat lyssaviruses in many parts of the world. As a general rule, avoid handling, feeding or approaching any wild or stray animal abroad, even if it appears healthy. Rabid animals do not always appear unwell.