5.3 Re-Exposure (Rabies PEP of previously vaccinated persons)

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Re-exposure vaccination for rabies prophylaxis consists of repeating anti- Rabies vaccination as per national guidelines after re-exposing to a rabid (or suspected rabid) animal when one was already vaccinated before, as per schedule. According to WHO Guideline, If a rabid dog bites a previously immunized person within 3 months of completing an entire course of PEP or PrEP, no new course of PEP is required. For exposures occurring More than 3 months after a PEP or PrEP course, treated as Re-Exposure Prophylaxis for previously immunized individuals. For re-exposed patients who can show document of previous complete PrEP or PEP and people who discontinued a PEP series after at least two doses of rabies vaccine, the following vaccination regimen apply: (after 3 months)

Table 6: WHO recommended Re-Exposure: (Rabies PEP of previously vaccinated persons).1

N.B.

  • Local treatment of wound (s) should be ensured
  • No RIG is indicated for any of the schedules if reliable vaccination history is available (With Card)

Important points to be noted -

  • Administration of any type of ARV on the buttocks is not recommended
  • For any person who has had direct or indirect contact with a rabies patient, PEP is not recommended except in special situations when exposed to saliva or organs of a rabid person or animal.
  • Patients should be advised not to rub at the injection site after administration of the vaccine.
  • Patients must be advised to complete a entire course of vaccine as per the advised schedule.
  • All patients who receive rabies PEP should be given a document/ card, clearly stating the date, month & year of vaccination and the type of vaccine used.