Rabies Vaccination Guidelines 2019

Rabies exposure is divided into three levels according to the risk of infection and corresponds to different treatment plans. The "ten-day observation method" can be applied to the scratches and bites of regularly vaccinated cats and dogs at home. The rabies vaccine is an inactivated vaccine with no absolute contraindications (pregnant women and young children can be safely vaccinated). Re-exposure within 3 years after full vaccination does not require re-vaccination. All conclusions are supported by large-scale clinical data. Do not believe in all kinds of folk remedies and rumors on the Internet.

I have been working in the vaccination position at a community health service center for almost 4 years. When the 2019 version of the regulations was implemented, I specially participated in a 3-day special training. In the past few years, I have seen too many people who either panicked so much that they cried when they got a white mark and wanted to take protein injections, or they were so worried that they were bitten by stray dogs and still refused to get the injection. I just used this guide to explain the issues that everyone is most concerned about.

Let me start with what everyone should do as soon as they encounter a scratch or bite - don't run to the hospital clutching the wound. First, find soapy water and running water, and wash the wound alternately for more than 15 minutes, while gently squeezing the surrounding blood. This step can wash away more than 90% of the virus attached to the surface of the wound. It is much more effective than getting to the hospital half an hour earlier to get vaccinated. At our post, we often encounter people running over covered in sweat, with dog hair still stained on their wounds without even wiping them. They say they are afraid of wasting time, but in fact they miss the most critical step.

As for whether you should get an injection, you don’t need to blindly compare it with online posts. You can tell by touching the wound: if you were just rubbed by a cat or dog, the skin you licked is intact, and there are no red marks, you don’t need to do anything, just go home and wash your hands. If there are red marks and no bleeding from scratching, or if the skin is broken but no blood is seen, it is enough to get a rabies vaccine. If bleeding has already occurred, or the bite location is in areas with particularly dense nerve distribution such as the head, face, neck, or fingers, in addition to the vaccine, immune globulin must be administered around the wound, which is equivalent to placing a layer of "interception net" directly at the entrance of the virus to destroy the virus that has not yet spread.

The "Ten-Day Observation Method" that everyone has been arguing about for many years has actually been officially included in the 2019 version of the specifications. However, there are indeed differences in industry recommendations under different scenarios. Let me tell you clearly: the rabies vaccination rate for stray animals in European and American countries can reach More than 80%, local veterinarians generally recommend that as long as the cats and dogs are domestic and have been vaccinated on time, they can be observed while receiving the first two doses of vaccine after being bitten. If the cat or dog does not show symptoms of rabies within 10 days, the remaining injections can be stopped without wasting pain. However, many grassroots doctors in China have directly advised everyone not to use this method. The core reason is that the vaccination rate for stray animals in many districts and counties in China is less than 10%. If you are bitten by a wild dog that suddenly appears on the roadside or a stray cat of unknown origin, there is really no need to bet on the one in 10,000 chance. It is safer to go through the entire process honestly. If your cat has been raised in a high-rise home since childhood and has been vaccinated against rabies on time every year and has never come into contact with stray animals outside, then you can definitely use the ten-day observation method. I was scratched by my cat last year and observed it while I was getting the first injection. It was alive and kicking for ten days, but I skipped the next two injections.

Many people have asked about the vaccination of special groups. The 2019 version of the regulations also clearly states that the rabies vaccine is an inactivated vaccine and will not have any impact on the development of fetuses and young children. There are no absolute vaccination contraindications. I once met an expectant mother who was 3 months pregnant and got a small scratch from her cat. Her parents-in-law stopped her from allowing the injection, saying it would cause teratogenesis. Finally, I turned over the original text of the 2019 version of the regulations to them, and asked the general practitioner on duty to explain it to them for a long time before agreeing to be vaccinated. Now her children are 2 years old. She said hello to me last time she came to get a flu shot. She said she was healthy and had no problems. Also, do you need to spank if you are bitten by small pets such as hamsters, rabbits, and chinchillas? The appendix of the regulations clearly states that rodents and lagomorphs rarely carry rabies virus and there is no need to spank them at all. A young man was bitten by his own golden bear and had to wait in line for 40 minutes to get to me. I told him that he did not need to spank, but he looked incredulous and said that there was everything said on the Internet. Finally, I showed him the original text of the regulations and he left with peace of mind.

If you have been vaccinated against rabies before and are bitten, there is no need to panic and re-vacculate the entire course: the 2019 version of the regulations is that if you are bitten within six months after the full course of rabies vaccination, as long as it is not a particularly serious penetrating injury or the head and face are exposed, you do not even need to get an injection; between half a year and a year, just two additional injections; between one and three years, three additional injections; and more than three years before you need to re-inject the entire course. I have seen many times people shout as soon as they enter the door, "I just had a shot last year and now I'm bitten again, please give me 5 shots." In fact, it is completely unnecessary. It hurts after spending money in vain.

In fact, rabies is not as scary as everyone thinks. After 2019, the incidence rate of rabies in my country has dropped to less than one in 100,000. As long as it is handled according to regulations, there is almost no risk of infection. Don’t scare yourself into injecting randomly, and don’t worry about bleeding and lingering on it. That’s enough.