3 rabies shots and a false alarm

[edwardandtubs]

I was bitten by a cat and went ahead and had 3 rabies shots in the normal way. I've done my research and the standard advice from WHO and the CDC is that if the animal is healthy after 10 days you should discontinue administering the vaccine. Well, 17 days later the cat is fit as a fiddle so I'm all clear. However, having had 3 shots I was thinking why not go ahead and get a forth shot which would give me longer term immunity (scientists are uncertain about this but recent research suggests lifelong immunity, though you need the 2 extra shots if you get bitten). I believe if I don't get the forth shot and get bitten again, I would need to start the 4 or 5 shot treatment all over again. Any informed opinions on this?

Edited May 23, 2014 by edwardandtubs

[sanuk21]

For your suggested "lifelong immunity, though you need the 2 extra shots if you get bitten" depends on completion of either

of the pre and post vaccination regimes.

These both require the last shot to be given between 21 and 28 days after the start of the regime.

So if you haven't completed the course I believe you would have to start over if bitten again.

Personally I would consult my travel medicine specialist.

Sanuk

[edwardandtubs]

According to the CDC anyone who receives a full course of rabies vaccine, either the 0, 7, 28 schedule or the 0, 3, 7, 14 schedule, requires only 2 shots post exposure.

Sadly I don't have a travel medicine specialist. I'm not sure consulting one would lead to a definite answer as different countries have different guidelines. Thailand still considers 5 shots to be necessary post-exposure, whereas America considers 4 sufficient. The choice seems to be have one shot now and 2 shots if you get bitten again or have 4 shots if you get bitten again. That's following American rather than Thai guidelines. Or I suppose I could wait until day 28, which would mean I'd received a 0, 3, 7, 28 schedule.

Edited May 24, 2014 by edwardandtubs

[FBN]

If you had Immune globuline as part of the routine PEP (post exposure prophylaxis) you may not develop full immunity after the series you have had.

Immune globuline is "passive" immunity; antibodies prepared from immune serum which is meant to bind any virus particle immediately and prevent the virus from getting into a nerve. They last a few weeks only and, while they still circulating in your blood stream, they will also inhibit the formation of full immunity after the vaccine. Suggest wait 4-6 weeks and get the routine vaccination.

After this, you will not need to go through this series of shots again if bitten another time.

Alternatively, you can have a blood test done in about 6 weeks from now and determine your antibody status; if sufficient levels of IgG, you may not need vaccination.

Safest and less expensive option (recommended) is just to have the routine immunisation shots.

[umbanda]

I was bitten by a dog and I had to get the full program. The hospital said that after that, if happens again, will be just 2 shots. With so many soi dogs around, my advice for you is to take all the shots now. For peace of mind now...and for the future. Thailand is #2 in the world in rabies infections.... following India.,,and many travel companies advice to take the 2 preventive shot to Asia travelers.

[h90]

If you had Immune globuline as part of the routine PEP (post exposure prophylaxis) you may not develop full immunity after the series you have had.

Immune globuline is "passive" immunity; antibodies prepared from immune serum which is meant to bind any virus particle immediately and prevent the virus from getting into a nerve. They last a few weeks only and, while they still circulating in your blood stream, they will also inhibit the formation of full immunity after the vaccine. Suggest wait 4-6 weeks and get the routine vaccination.

After this, you will not need to go through this series of shots again if bitten another time.

Alternatively, you can have a blood test done in about 6 weeks from now and determine your antibody status; if sufficient levels of IgG, you may not need vaccination.

Safest and less expensive option (recommended) is just to have the routine immunisation shots.

Antibody status is always interesting.

For example I got decades ago vaccinated against ticks (is it meningitis?) in Europe and never got any refreshments. My antibodies are out of the scale. When I called in the lab they told me most probably I am immune for life. Either I reacted unusual strong, or I got bitten direct after vaccination and the infection worked as huge booster.

While I was several times vaccinated on Hepatitis B and have no antibodies at all.

[edwardandtubs]

I didn't have any immune globulin so just one more shot would be enough. It's true that soi dogs are everywhere but the rabies vaccine is also available everywhere so I wouldn't recommend everyone get the 3 pre-exposure shots. You're more likely to die of lightning strike than rabies in Thailand. I might as well do it on day 28 though as I only need one more.

[Thanyaburi Mac]

Our household dog nipped one of the neighbor kids, a little bit of blood. The wife took the kid off to the local Nong Suea District hospital to start the post-exposure shot series.

Just came back from shot #2, one more to go.

BTW, the dog has had his appropriate shots, just being cautious.

BTW II, baht 477 per shot. Cheap insurance.

Mac

[ClutchClark]

If you had Immune globuline as part of the routine PEP (post exposure prophylaxis) you may not develop full immunity after the series you have had.

Immune globuline is "passive" immunity; antibodies prepared from immune serum which is meant to bind any virus particle immediately and prevent the virus from getting into a nerve. They last a few weeks only and, while they still circulating in your blood stream, they will also inhibit the formation of full immunity after the vaccine. Suggest wait 4-6 weeks and get the routine vaccination.

After this, you will not need to go through this series of shots again if bitten another time.

Alternatively, you can have a blood test done in about 6 weeks from now and determine your antibody status; if sufficient levels of IgG, you may not need vaccination.

Safest and less expensive option (recommended) is just to have the routine immunisation shots.

This thread should now be closed because FBN responded with all the necessary and correct info for the OP and the future posts are going to just confuse the matter with misinformation and "I heard this" and "my friends girlfriends nephews cat...".

Please close the thread.

[ClutchClark]

I didn't have any immune globulin so just one more shot would be enough. It's true that soi dogs are everywhere but the rabies vaccine is also available everywhere so I wouldn't recommend everyone get the 3 pre-exposure shots. You're more likely to die of lightning strike than rabies in Thailand. I might as well do it on day 28 though as I only need one more.

Do NOT downplay the significance and frequency of this horrible and 100% death rate disease.

Your post is incorrect and a disservice to any poster not well educated on the matter and looking for advice.

Furthermore, ALWAYS get the immuno-globulin shot if the skin has been punctured.

ALWAYS.

[FBN]

To keep the integrity of information shared so far, it has been suggested that we lock this thread.