The rabies vaccine is used to prevent rabies, says the U.S. CDC. There are several rabies vaccines available worldwide that are both safe and effective. They can be used to prevent rabies before and for a period of time after exposure to the rabies virus, commonly caused by a dog or a bat bite.
Unlike the conventional, inactivated rabies vaccine, live-attenuated viruses are genetically modified viruses that can replicate in an inoculated recipient without causing adverse effects while still eliciting robust and effective immune responses against rabies virus infection. Current US human vaccines are inactivated.
On June 2, 2022, the CDC published an update to Rabies Vaccine: What You Need to Know. And on June 24, 2021, Sharon Frey, M.D., FACP, FIDSA, with the CDC's Advisory Committee on Immunization Practices (ACIP), presented an Overview, Rabies immune globulin, PEP vaccine series, and Recommendations Framework for Rabies Pre-Exposure Prophylaxis.
The ACIP recommends a 2-dose [0, 7 days] intramuscular rabies vaccine series in immunocompetent persons <18 years of age for whom rabies vaccine pre-exposure prophylaxis (PrEP) is indicated. And the ACIP recommends an intramuscular booster dose of rabies vaccine, as an alternative to a titer check, for immunocompetent persons <18 years of age who have sustained an elevated risk for only recognized rabies exposures (i.e., those in risk category #3 of rabies PrEP recommendations table). The booster dose should be administered no sooner than day 21 but no later than three years after the 2-dose PrEP series.
In 2020, the BMJ Global Health published a Commentary: 'Vaccinating children in high-endemic rabies regions: what are we waiting for?
Available Rabies Vaccines
Chirorab, previously known as Rabipur, is an inactivated rabies virus of the strain Flury LEP. In addition, Chiron Behring Vaccines is re-launching Rabipur, a purified chick embryo cell (PCEC) vaccine.
Imovax Rabies is an inactivated vaccine made from an attenuated rabies virus. It is a sterile, stable, freeze-dried suspension of Rabies Vaccine Inactivated virus prepared from WISTAR Rabies PM/WI 38 1503-3M strain.
RabAvert is a vaccine that contains an inactivated rabies antigen. Bavarian Nordic's RabAvert vaccine is indicated for preexposure vaccination, primary and booster doses, and postexposure prophylaxis.
Rabivax-S is a lyophilized vaccine manufactured by Serum Institute of India Pvt. Ltd., containing inactivated purified rabies antigen.
Rabies Vaccine Candidates
ChAdOx2 RabG vaccine is based on the ChAdOx2 vector—a weakened version of a common cold virus (adenovirus) that has been genetically modified. Researchers from the University of Oxford have reported new findings from a Phase 1 clinical trial studying the immune response and safety of their newly-developed single-shot rabies vaccine, ChAdOx2 RabG—with promising results identified.
The CDC publishes Rabies Vaccination: Information for Healthcare Providers and Vaccines Recommended for Travel and Some Specific Groups. In addition, patient history, duration and progression of illness, and laboratory tests for other common etiologies of encephalitis will help determine if rabies should be on the differential diagnosis list for a patient, says the CDC.