Where can you vaccinate for free ? Rabies vaccine please, not the flue vaccine

[Sheryl]

As you said you received 2 injections, only one will have been the tetanus. The other likely was rabies especially as you were told you need a series. But the scheduling is wrong. Current protocol is:

 

1 injection on days 0, 3, 7, 14 and 28 (for a total of 5)

 

OR

 

2 injections each time on days 0,3,7 and 28

 

Is  at all possible that you misunderstood the follow up dates?

 

I suggest you get your complete medical records from the hospital so that you can be sure what you had. Then, unless them misunderstanding about dates was on your end, take the records with you to another hospital on day 3, 7 and 28 to complete the series.

 

 

[Lorry]

14 minutes ago, Sheryl said:

2 injections each time on days 0,3,7 and 28

That would be the injections into the skin.  He seems to had an injection intramuscular.

 

You are right about those 2 injections he got today, I just thought about it, but you were faster. He should do exactly as you said. 

 

He should also get RIG, not so easy in a small government hospital 

Edited January 29, 2023 by Lorry

[Denim]

58 minutes ago, Lorry said:

That's intramuscular.

 

I suspected this

 

Yes, but I wouldn't go to the same one. 

It is very,  very substandard in Thailand not to  give rabies injection.

Well....panic over. Thanks to that most common of things .................a misunderstanding.

 

As soon as I got to the hospital emergency department the doctor recognized me and asked

 

" Why did you go home ? You forgot your medication and appointment for next jabs  ? "

 

Turns out , while I was waiting after the jabs I thought I should ask the receptionist if I should have handed her the little appointment slip the doctor originally gave me.( says Tetanus in Thai ) ) No she said and is that all the paperwork you were given , if so you can go home , which I did !! Should have waited a little longer.

 

Now I have the correct schedule of 4 jabs.( PVRV )

 

1st today

2nd on 1st of February

3rd  on 5th of February

4th  on 28th of February

 

They also collared me for 355 baht which includes some anti biotics.

 

Thanks Lorry for confirming my suspicions. 

 

 

 

 

 

 

Edited January 29, 2023 by Denim

[Lorry]

16 minutes ago, Denim said:

Well....panic over. Thanks to that most common of things .................a misunderstanding.

 

As soon as I got to the hospital emergency department the doctor recognized me and asked

 

" Why did you go home ? You forgot your medication and appointment for next jabs  ? "

 

Turns out , while I was waiting after the jabs I thought I should ask the receptionist if I should have handed her the little appointment slip the doctor originally gave me.( says Tetanus in Thai ) ) No she said and is that all the paperwork you were given , if so you can go home , which I did !! Should have waited a little longer.

 

Now I have the correct schedule of 4 jabs.( PVRV )

 

1st today

2nd on 1st of February

3rd  on 5th of February

4th  on 28th of February

 

They also collared me for 355 baht which includes some anti biotics.

 

Thanks Lorry for confirming my suspicions. 

 

 

 

 

 

 

This schedule is ok if the dog is still healthy in 10 days. If the dog  dies (not probably) you would need an additional injection on 14th of February. (I take it that these are IM injections, not intradermal (into the skin))

 

According to WHO guidelines,  you should also get RIG. In Thailand,  they don't follow these guidelines, they have their own guidelines and they give it not often. 

[connda]

On 8/19/2021 at 4:26 PM, samtab said:

hi,

do you know if Thai can vaccinate for free for rabies ? and where ?

is it important when bitten by a street dog ? what is the chance that the dog has rabies in Thailand ?

thank you.

You're not going to get free rabies vaccines.  You'll need a series of 5 if you haven't had them before.  3 if you've had an initial series. 

 

Go to a government clinic.  They're not going to break the bank.  They cost something like 250 to 500 THB. 

On 8/21/2021 at 5:58 AM, Sheryl said:

Free for a Thai at the government hospital where they are registered and yes, it is important if bitten by a stray dog (or any dog nto known for sure to be fully vaccinated). Rabies is endemic in Thailand.

Not free for farangs.  But a government clinic is the cheapest place to go.  I work with a lot of dogs and cats, many of them stray.  Nips just come with the territory.  I keep my rabies boosters up to date at our local government hospital in our Amphur (interesting as I've been called an "anti-vaxxer" more than once over the last couple of years <laughs>).  On the plus side, our village has a annual rabies program where they vaccinate all the animals in the village that they can find.  Now - those shots are free (public service for the public good).  With 7 dogs of my own, I'm happy for the free shots for the pooches. 

 

[Denim]

1 hour ago, Lorry said:

This schedule is ok if the dog is still healthy in 10 days. If the dog  dies (not probably) you would need an additional injection on 14th of February. (I take it that these are IM injections, not intradermal (into the skin))

 

According to WHO guidelines,  you should also get RIG. In Thailand,  they don't follow these guidelines, they have their own guidelines and they give it not often. 

The dog has only been with us 5 weeks and is perfectly healthy but as he had drawn blood I decided to play it safe.

Yes, they were deep injections. Thanks again for your advice.

[Sheryl]

1 hour ago, Lorry said:

That would be the injections into the skin.  He seems to had an injection intramuscular.

 

 

No, rbies vaccine for adults is IM

 

https://www.cdc.gov/rabies/medical_care/vaccine.html

[Lorry]

51 minutes ago, Sheryl said:

No, rbies vaccine for adults is IM

 

https://www.cdc.gov/rabies/medical_care/vaccine.html

In the picture below,  on the right side,  you see the schedule with 5 IM = intramuscular injections on 5 different days, 0.5 ml PVRV vaccine each time,  as you wrote:

 

2 hours ago, Sheryl said:

1 injection on days 0, 3, 7, 14 and 28 (for a total of 5

 

On the left side,  you see the TRC-ID (=Thai Red Cross intradermal) schedule, with 4 days of injections,  2 intradermal (= into the skin) injections each day, only 0.1ml PVRV vaccine each time. 

As you wrote:

 

2 hours ago, Sheryl said:

 

2 injections each time on days 0,3,7 and 28

Intradermal vaccination (into the skin) is preferred in many developing countries. 

 

Your  link to the US CDC describes a different kind of vaccine (HDCV, not PVRV; 1.0 ml, not 0.5 ml) with a different schedule (day 0-3-7-14).

 

PVRV is what is used in Thailand and what the WHO recommends. 

Edited January 29, 2023 by Lorry

[steven100]

On 8/19/2021 at 5:08 PM, samtab said:

Anybody knows where to get it cheap around Pattaya/chonburi ? I will pay it for a Thai and would prefer to avoid a big hospital...

it's not free ...... Rabies vaccine is not free.....    go to the clinic and get the shots ...

[Sheryl]

22 hours ago, Lorry said:

 

PVRV is what is used in Thailand and what the WHO recommends. 

 

There are several rabies vaccines approved for use in Thailand and all of them AFAIK  (including the TRCS produced one) can be administered either IM or intradermal.

[Lorry]

6 hours ago, Sheryl said:

There are several rabies vaccines approved for use in Thailand and all of them AFAIK  (including the TRCS produced one) can be administered either IM or intradermal.

That's correct. 

And all of them are PVRV (purified Vero cell rabies vaccine), like Verorab or Speeda.

AFAIK Thailand doesn't use the vaccines that show up in your CDC link, HDCV (human diploid cell vaccine) and PCECV (purified chick embryo cell vaccine, Rabipur). PVRV, on the other hand, is not available in the US.

[Lorry]

On 1/29/2023 at 5:11 PM, Lorry said:

This schedule is ok if the dog is still healthy in 10 days. If the dog  dies (not probably) you would need an additional injection on 14th of February

I have to retract this statement.  The schedule the hospital gave is ok.

They already follow the new WHO guidelines from 2018.

The Essen-regimen as seen in the picture I posted above and as quoted by Sheryl

On 1/29/2023 at 4:29 PM, Sheryl said:

1 injection on days 0, 3, 7, 14 and 28 (for a total of 5)

has been shortened to a total of 4: 0, 3, 7, and only 1 injection between 14 and 28. 

 

(The TRCS intradermal schedule has also been shortened. The Zagreb-regimen remains the same).

 

 

 

03-rabies-rao-508.pdf WER9316-201-219.pdf

Edited January 30, 2023 by Lorry

[Denim]

On 1/29/2023 at 4:29 PM, Sheryl said:

 

 

2 injections each time on days 0,3,7 and 28Is  

 

 

Ok ....second visit today and it seems I am in fact on the two ID shots per visit.

 

Another 243 baht paid. ( Will be over a thousand when finished )

 

Again, big thanks to Sheryl and Lorry for valuable and up to date information

 

Same as shown in green box:

 

Edited February 1, 2023 by Denim

[Denim]

One other thing I have had confirmed. Two old sayings :

 

The road to perdition is paved with good intentions 

No good deed goes unpunished

 

The next stray dog that turns up, puppy or not will be sent packing !!

 

[LosLobo]

On 1/29/2023 at 9:22 PM, connda said:

You're not going to get free rabies vaccines.  You'll need a series of 5 if you haven't had them before.  3 if you've had an initial series. 

WHO stipulates "one dose to be injected intramuscularly or intradermally on days 0 and 3, if you've had an initial series.

 

pep-prophylaxis-guideline-15-12-2014.pdf (who.int)

[Lorry]

56 minutes ago, LosLobo said:

WHO stipulates "one dose to be injected intramuscularly or intradermally on days 0 and 3, if you've had an initial series.

 

pep-prophylaxis-guideline-15-12-2014.pdf (who.int)

Correct.

This hasn't changed in the 2018 update (I posted the link in my last post)

 

So as of 2018, WHO basically recommends:

- 2 shots if you previously were vaccinated

- 4 shots if you aren't vaccinated yet

Edited February 1, 2023 by Lorry