Rabix-vc 1ml

Indications

The rabies vaccine is suitable for the prevention of immunity against rabies and the treatment of patients with suspected exposure to rabies.

• Pre-exposure vaccination:
• Professional groups that are frequently contaminated
• Veterinarians (including veterinary school students) (including veterinary school students)
• Technicians who assist veterinarians
• Personnel in a laboratory handling rabies-infected materials
• Personnel from slaughterhouses and breeders
• Naturalists and workers in sexually abused areas
• Babies who are at high risk of contracting rabies
• Immunization following exposure:
• Treatment of subjects bitten or suspected of being bitten by rabies-infected animals
• Contact subjects are treated.

Pharmacology

When rabies immunoglobulin is administered, it may cause either immediate or delayed hypersensitivity reactions. The most common initial responses are hypotension, dyspnea, and urticaria. Delay reactions include inflammation, fever, pruritis, rash or urticaria, adenopathy, and arthralgia.

Dosage & Administration

• Transfer the contents of the supplied diluent into the vial containing the freeze-dried preparation to reconstitute the vaccine. Don't move. The solution should be homogeneous, clear, and particle-free after reconstitution. After reconstitution, the vaccine must be injected immediately, and the syringe must be discarded.
   
• Administration Method Rabies vaccine should be administered intramuscularly in the deltoid muscle in adults and the anterolateral aspect of the thigh muscle in children under the age of one year. It should never be injected into the gluteus maximus. Injecting intravenously is not recommended.
• Intradermal administration method: A 0.1 mL dose of Rabies vaccine (per site) should be administered intradenmally in the upper arm, over the deltoid.
• Pre-exposure immunization: 1 mL for adults and children.
• Primary vaccination: The WHO recommends one intramuscular injection on days DO, D7, D21, or D28, followed by a booster dose one year later.
   

Boosters: After that, one injection every 5 years or when the titer is less than 0.5 lU/ml.
Post-exposure immunization:

• Local treatment of the wound
• Vaccination of non-immunized subjects

Intramuscular schedules: One Intramuscular (IM) dose comprised of 1 ml.
Standard intramuscular (1-1-1-1-1) regimen:

• Day 0: 1 injection of 1 ml
• Day 3: 1 injection of 1 ml
• Day 7: 1 injection of 1 ml
• Day 14: 1 injection of 1 ml
• Day 28: 1 injection of 1 ml Or

Abbreviated multisite (2-1-1) regimen:

• Day 0: 2 injections each of 1 ml at separate sites
• Day 7: 1 injection of 1 ml
• Day 21:1 injection of 1 ml

Intradermal schedules: One intradermal (ID) dose is comprised of 0.1 ml.

Thai Red Cross (2-2-2-0-1-1) schedule:

• Day 0: 2 injections each of 0.1 ml at separate sites
• Day 3: 2 injections each of 0.1 ml at separate sites
• Day 7: 2 injections each of 0.1 ml at separate sites
• Day 28: 1 injection of 0.1 ml Day 90:1 injection of 0.1 ml (optional).

Or

WHO Modified Thai Red Cross (2-2-2-0-2) schedule:

• Day 0: 2 injections each of 0.1 ml at separate sites
• Day 3: 2 injections each of 0.1 ml at separate sites
• Day 7: 2 injections each of 0.1 ml at separate sites
• Day 28: 2 injections each of 0.1 ml at separate sites

In case of severe (WHO category 3) wounds, rabies immunoglobulin should be administered as soon as possible with the first dose of the rabies vaccine. The anti-rabies immunoglobulin should be used as local wound soakage injections as much as possible, with the rest part for muscle injection. The rabies vaccine should be administered in the different injection sites.

Vaccination of immunized subjects: 

If the vaccine was administered in less than 5 years of exposure (cell culture rabies vaccine): 2 injections one on each of DO, D3. If vaccine administered in more than 5 years of exposure or incomplete vaccination: 5 injections on DO, D3, D7, D14 and D28 with the administration of immunoglobulin if required. Post-exposure vaccination must be administered on the basis of severity under medical supervision.

WHO guidelines on post-exposure treatment depending on wound severity-

Touching or feeding of animals, licks on intact skin: 

Recommended treatment: None, if reliable case history is available.

Nibbling of uncovered skin, minor scratches, superficial bites (except on the head, neck, shoulder girdle. arms, or hands) or abrasions without bleeding, licks on broken skin:

Recommended treatment: Administer vaccine immediately on Day 0, D3, D7, D14, and D28.Stop treatment if the animal remains healthy throughout the observation period of 10 days or if the animal is killed humanely and found to be negative by appropriate laboratory techniques.

Single or multiple transdermal bites or scratches especially on the head, neck, shoulder girdle, arms, or hands. Contamination of mucus membrane with saliva (i.e. licks on broken skin):
Recommended treatment: Administer rabies immunoglobulin immediately with the first dose of rabies vaccine. Administer rabies vaccine on Day 0, D3, D7, D14, and D28 or D90 (optional). Stop treatment if the animal remains healthy throughout the observation period of 10 days or if the animal is killed humanely and found to be negative by appropriate laboratory techniques

Administrations:

Prompt and gentle thorough washing with soap or detergent and flushing the wound with running tap water for at least 15 minutes.

After washing, disinfectants like either ethanol (700 ml/l) or tincture, or an aqueous solution of iodine or povidone-iodine must be applied.

Don’t bandage or suture the wound.

Co-administration: Corticosteroids and immunosuppressive treatment may interfere with antibody production and cause vaccination failure. In these cases, a titration of neutralizing antibodies should be performed.

Interaction

Vaccine effectiveness may be reduced if immunosuppressants are used at the same time.

Contraindications

The rabies vaccination is not recommended in the following situations:

Pre-exposure symptoms include severe fever, febrile infection, acute illness, and chronic illnesses that worsen with time.

Hypersensitivity responses to the rabies vaccination or any of its components have been documented. Post-exposure

Because rabies is a fatal illness, any contraindication to exposure, treatment, or anti-rabies therapy should be carefully examined before rejecting an individual for anti-rabies treatment.

Side Effects

Minor local responses such as discomfort, erythema, edema, pruritus, and induration might occur at the injection site and can persist for up to 48 hours. Shivering, fainting, asthenia, dizziness, respiratory signs (dyspnoea, wheezing), fever, stomach discomfort, vomiting, and allergic skin responses are all symptoms of a moderate fever (urticaria, rash, itching).

Pregnancy & Lactation

Pregnancy. The possibility of rabies vaccination administration during pregnancy is uncertain. Pregnancy is not regarded as a contraindication to post-exposure prophylaxis due to the severity of the illness.

It is unknown if the vaccination is secreted in human breast milk during lactation. Breastfeeding is not regarded as a contraindication due to the severity of the illness.

Precautions & Warnings

The rabies vaccine is suitable for the prevention of immunity against rabies and the treatment of patients with suspected exposure to rabies.

 Pre-exposure immunization:

•  Professional groups exposed to frequent contamination
•  Veterinarians (including veterinary school students)
•  Technicians working with veterinarians
•  Laboratory personnel handling materials contaminated with the rabies virus
•  Slaughterhouse personnel and breeders
•   Workers and naturalists in sexually affected areas
•  Babies who are specifically exposed to the risk of rabies

 Immunization after exposure:

•  Treatment of subjects bitten or suspected of being bitten by animals with rabies
•  Treatment of contact subjects.

Storage Conditions

Keep out of the reach and sight of children. Store at +2 °C to +8 °C. Transportation should also be at +2 °C to +8 °C. Protect from light. Do not freeze