5.5 Contraindications and precautions to be taken in post-exposure prophylaxis

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There are no contraindications to PEP. PEP can be safely given to infants, pregnant women, Lactating women and immuno-compromised individuals, including children with HIV/AIDS and Covid patients. It should be given as indicated by the nature of the exposure in a setting in which the staff is adequately trained in its administration and the management of possible adverse reactions, as for any other vaccination. As for all vaccinations, recipients should be kept under medical supervision for at least 15-20 minutes after vaccination.

Post Exposure Prophylaxis is life-saving in all animal exposures for all age groups. A complete course of vaccination and immunoglobulins in category III exposure must be administered, even if they have received any dose of COVID-19 vaccine. It can be given on the same day, at different sites.

PrEP can be deferred based on individual risk assessment. PrEP may be initiated with a minimum gap of 2 weeks after completing a course of Covid vaccination. In the current context of the Covid pandemic, Covid vaccination shall be prioritized to PrEP. (Rabies Prophylaxis During Covid -19 Pandemic, Dr. M. K Sudarshan, APCRI, 2021).