Medications

There are 2 types of rabies vaccine injections.

• Injection of the human rabies immune globulin (HRIG) for immediate protection is based on exact weight. This is not a situation where more is better. Therefore, you should not overestimate your weight. If the exact weight is not known, you will be weighed at the hospital.
  
  
  • Once the dose is determined, as much as possible is injected into and around the bite site. If the entire volume does not fit into the tissue in that area (for example, the tip of the finger), then the remaining volume will be injected into some other site in your body, such as the arm, leg, or buttocks. The doctor may use numbing medicine to decrease the pain associated with injection of HRIG into the tissues at the bite site.
    
    
  • If you have been previously immunized adequately against rabies, then the HRIG is not needed. You would need only the vaccine described next.

• Injection of the vaccine will begin during this initial visit to the emergency department and will proceed on a schedule over the next 28 days, with a total of 5 small injections.
  
  
  • There are 3 different types of rabies vaccines licensed for use in the United States (human diploid cell [HDCV], rabies vaccine absorbed [RVA], and purified chick embryo cell culture vaccine [PCEC]). If given properly and on schedule, any of these 3 types will protect you against rabies.
    
    
    • The dose for each is 1 cc, or milliliter, delivered into the muscle. This vaccine must be delivered into the deltoid, or shoulder muscle, in adults or older children. The front, outside aspect of the thigh muscle is acceptable in younger children. It must never be injected into the buttocks. Injection into the proper site ensures absorption. It must be administered in a site different from the remainder of the immune globulin that is not injected into the bite site.
      
      
    • If you have never been vaccinated against rabies, then vaccine shots will be given on the day of the visit (day zero), and again on days 3, 7, 14, and 28. If you have already been adequately immunized against rabies, a series of 2 booster vaccine injections will be given on day zero and again on day 3 only. This is sufficient to stimulate your body's immune system, or memory, and provide protection against rabies.