Latest version of rabies vaccination guide

The current national unified vaccination standards in 2024 clearly distinguish three types of exposure levels corresponding to different treatment plans. The ten-day observation method approved by the WHO can be used in qualified scenarios. Non-exposure high-risk groups can choose pre-exposure immunization as needed. The rabies vaccine is an inactivated vaccine with no absolute contraindications. Pregnant women, infants and young children can be safely vaccinated.

I have been working at a community disease control and immunization post for almost 6 years, and I have met too many people who came in a panic with outdated information from Baidu. Some were bitten by hamsters and needed serum, some were scratched by a cat at home that had been vaccinated three times and needed 5 injections, and there were pregnant women who were licked by a dog and did not dare to get injections for half a month. Today I will explain the issues that everyone is most concerned about.

Last week, a young man was bitten on the calf by a stray dog. After the bite, he ran to the hospital for 20 minutes. When the wound was still bleeding, he didn't even wash it. In fact, among all post-exposure treatments, treating the wound as soon as possible has a higher priority than vaccination. Alternately wash the wound with running soapy water and clean water for more than 15 minutes, and then use iodophor for disinfection. This step can reduce the viral load by more than 90%. Many people rush to the hospital, but miss the most critical step.

Let me first let you know what the situation is and don’t panic at all: If you just petted the cat on the roadside and it licked the back of your intact hand, or your cat scratched you without even leaving a red mark, then you don’t even need to disinfect, let alone get an injection. This is a level I exposure and there is no risk of infection at all. Last month, I met a little girl who was bitten by her golden bear and cried for vaccination. In fact, rodents (hamsters, squirrels, chinchillas, etc.), lagomorphs, and cold-blooded animals (tortoises, snakes, etc.) hardly carry rabies virus. If you are bitten by these, you only need to disinfect them, and there is really no need to get a shot.

If it scratches you and there is a red mark but no bleeding, or a light bite without breaking the skin, then it is a level II exposure, and you can get a regular rabies vaccine instead of the extremely expensive immune globulin. If the wound is bloody, or you have a barb or broken skin on your hand, and you are licked by an animal, or even have its saliva splashed into your eyes or mouth, that is Level III exposure. In addition to vaccination, you must also infiltrate and inject immune globulin around the wound, especially if the wound is on the head, face, or neck. Don't save money on the ones you have. These places are close to the central nervous system, and the incubation period of the virus is short. Immunoglobulin directly replenishes your antibodies, just like sending you a batch of temporary weapons before the reinforcements arrive to help you carry it until the 7-14 whitening period when the vaccine itself produces antibodies. You have to spend it.

Speaking of this, some people must ask whether the ten-day observation method is reliable? Now the Internet is divided into two halves. Some people say that this is the gold standard for WHO certification, while others say that it is not suitable for China's national conditions. Let me say this objectively: First of all, this method is indeed clearly recognized by WHO and China Disease Control and Prevention, but there are strict prerequisites - the animal that injures people must be a domestic animal that you can find and observe continuously, and it has been vaccinated with at least two formal rabies vaccines. Then you can completely observe it while taking the first two vaccinations. Within 10 days, it will be alive and kicking, and subsequent injections will not be needed, which saves time and money. But if it’s a stray dog ​​or cat from nowhere running on the road, especially one that bites, drools, and staggers when seeing people, don’t bet on it and get fully vaccinated first. After all, if you are really infected, the mortality rate is 100%, and you can’t afford to bet on that probability with your own life.

The current vaccination program is also more flexible than before. It is not just the traditional 5-shot method (one shot each on days 0, 3, 7, 14, and 28). If you are in a hurry, you can choose the 2-1-1 procedure. One shot in each arm on day 0, and one shot in each arm on day 7 and 21. A total of 4 shots and 3 times will be enough. The effect is exactly the same as that of the 5-shot method. It is suitable for people who have to go on a business trip or go to school and have no time to run frequently.

Many people don’t know that you don’t need to get rabies vaccine only if you are bitten. If you often feed stray cats, or are a veterinarian, a pet store employee, or someone who often goes hiking in the wild, you can definitely get 3 shots of pre-exposure vaccine in advance. Even if you are really bitten by an unknown animal, you don’t need to take immune globulin. You only need to make up 2 shots of the vaccine, which is much more worry-free.

Finally, let’s talk about the most frequently asked misunderstanding: the rabies vaccine is an inactivated vaccine. There are no absolute contraindications to vaccination. Pregnant women, nursing mothers, babies, the elderly and even those with underlying diseases can get it as long as there is a risk of exposure. It will not have any impact on the body. Previously, an expectant mother who was 3 months pregnant was scratched by a cat. She was afraid that the injection would affect her child and she had to carry it for a week. In fact, it is completely unnecessary. If something goes wrong, the consequences will be unimaginable.

In fact, rabies is not as scary as everyone thinks. The current dog immunization rate in our country is increasing every year. There are very few rabies cases in cities. As long as you handle it according to the regulations, there will be basically no problems. Don't scare yourself, and don't be too careless. If you are really unsure, go directly to the community disease control near your home and ask. It is much more reliable than searching on Baidu to find out-of-date posts from ten years ago.