Graphic illustration of a healthcare professional with syringe and patient in an exam room

Reach for RabAvert^® (rabies vaccine) to protect against rabies

RabAvert has been used for more than 35 years to protect humans from rabies infections.¹ Your doctor will assess whether vaccination is appropriate for you.²

What RabAvert is used for

RabAvert (rabies vaccine) is for pre-exposure vaccination in both primary series and booster dose, and for post-exposure prophylaxis against rabies, in all age groups.²

What is RabAvert?

A rabies vaccine for humans:

Administered via intramuscular injection; the upper arm is the preferred site for adults and the thigh is the preferred site for small children and infants²
One of two rabies vaccine options included in human rabies prevention guidelines from the Centers for Disease Control and Prevention (CDC)³; meets the standards of the World Health Organization (WHO)⁴

RabAvert dosing schedules

Prevention

Pre-exposure prophylaxis (PrEP)^2,3,5

If you are considered to be at high risk of exposure to rabies, RabAvert may be given as a preventative immunization. This is known as PrEP or pre-exposure prophylaxis.

PrEP rabies
vaccine schedule

3 intramuscular injections

According to the FDA-approved prescribing information, RabAvert is administered intramuscularly in 3 doses on Day 0, Day 7, and Day 21 or 28.²

*Please note that current CDC/ACIP dosing recommendations (2022) differ from those in the prescribing information, no longer calling for a third dose in the primary series.⁸

Periodic testing for antibodies after people have received rabies vaccination is sometimes recommended to ensure ongoing protection against infection, especially if you have frequent or continuous contact with potentially rabid animals, or to the live rabies virus itself. A rabies immunity level (or titer) test indicates the strength of someone’s immune response against rabies virus infection. A routine test that checks your titer can be performed to determine whether vaccine booster doses are needed to enhance the immune response.³

Pre-exposure vaccination does not eliminate the need for additional treatment after a known rabies exposure.²

Pre-exposure vaccination with RabAvert should be delayed if you are ill or recovering from an illness, or if you test positive for an infectious disease but may not yet have symptoms.

Exposure

Post-exposure prophylaxis (PEP)

If you might have been exposed to rabies (for example, from a bite from a potentially rabid bat), RabAvert may be given to prevent rabies from developing. This is known as PEP or post-exposure prophylaxis.^2,3,5

Not every animal bite/scratch is a risk for rabies. To help avoid unnecessary vaccination, your healthcare provider will carefully assess your situation and consider factors such as the animal species involved, the circumstances of the bite or other exposure, the immunization status of the animal, and the presence of rabies in the region.

PEP rabies vaccine schedule

PEP, if it is necessary, should begin as soon as possible after exposure and consists of^3,5:

Extensive washing and local treatment of any wound as soon as possible after exposure

Administration of human rabies immune globulin (HRIG) if you have not previously received rabies immunization

A course of rabies vaccinations

Not previously vaccinated

If you have not previously received rabies immunization

According to the FDA-approved prescribing information, the HRIG injection is followed by a series of 5 individual injections of RabAvert® (1.0 mL each) given intramuscularly on days 0, 3, 7, 14, and 28.⁷

*Please note that current CDC/ACIP dosing recommendations differ, calling for a fifth dose on Day 28 only for patients who are immunocompromised.⁶

Previously vaccinated

If you have previously received rabies immunization

HRIG should not be administered to previously vaccinated patients. You should receive 2 doses of RabAvert – one on Day 0 and another on Day 3.^2,5,6

Adverse reactions

In very rare cases, individuals who were vaccinated with RabAvert developed, close in time, serious conditions, including severe allergic reactions, meningitis, neuroparalytic events such as encephalitis, transient paralysis, Guillain-Barré syndrome, myelitis, retrobulbar neuritis, and multiple sclerosis.
In clinical trials with RabAvert, the most common adverse reactions were injection-site reactions (injection-site redness, localized hardening of the skin, and pain); flu-like symptoms (weakness, fatigue, fever, headache, muscle pain, and feeling unwell); joint pain; dizziness; enlarged lymph nodes; nausea; and rash.

To report SUSPECTED ADVERSE REACTIONS, contact Bavarian Nordic at 1-844-4BAVARIAN or the US Department of Health and Human Services by either visiting www.vaers.hhs.gov/reportevent.html or calling 1-800-822-7967.

If you are concerned about any side effects you may experience, please contact your healthcare provider for advice.

More information about RabAvert is available from Bavarian-Nordic at medical.information_us@bavarian-nordic.com.

References

Giesen A, et al. Expert Rev Vaccines. 2015;14(3):351-367. doi:10.1586/14760584.2015.1011134 https://www.tandfonline.com/doi/full/10.1586/14760584.2015.1011134
RabAvert. Prescribing information. BN; 2018. Accessed April 14, 2021. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=84b7a672-eeb1-4527-84ac-68196b156be2
Centers for Disease Control and Prevention. Human Rabies Prevention—United States, 2008. Morbidity and Mortality Weekly Report; 2008. Accessed April 14, 2021. https://www.cdc.gov/mmwr/PDF/rr/rr5703.pdf
Medscape. What are the CDC and WHO recommendations for rabies vaccination? Accessed April 30, 2021. https://www.medscape.com/answers/220967-99473/what-are-the-cdc-and-who-recommendations-for-rabies-vaccination
World Health Organization. Rabies. Accessed April 15, 2021. https://www.who.int/en/news-room/fact-sheets/detail/rabies
Rupprecht CE, et al. MMWR Morb Mortal Wkly Rep. 2010;59(RR02);1-9. Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm. Accessed October 2023.
RabAvert® Prescribing Information. Available at: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=84b7a672-eeb1- 4527-84ac-68196b156be2. Accessed October 2023.
Use of a Modified Preexposure Prophylaxis Vaccination Schedule to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices — United States, 2022. Available at:https://www.cdc.gov/mmwr/volumes/71/wr/pdfs/mm7118a2-H.pdf. Accessed November 2023.

Important Safety Information

People with a history of severe allergic reaction (e.g., anaphylaxis) to RabAvert or any of its ingredients should not receive RabAvert…

Indication

RabAvert is a vaccine approved for all age groups to help prevent rabies infection both before and after a suspected exposure.

…for protection before a potential exposure (PrEP) to the rabies virus. They should receive a different rabies vaccine if a suitable product is available. However, because rabies is almost always fatal if left untreated, the protection provided with RabAvert after a potential exposure (PEP) to the rabies virus outweighs the risks associated with a severe allergic reaction.

The ingredients of RabAvert, which could in rare cases, cause allergic reactions in some people, include egg and chicken proteins, processed bovine (cow) gelatin and trace amounts of neomycin, chlortetracycline, and amphotericin B. Let your healthcare professional know if you have had any issues, including allergic reactions, with any of these ingredients or with vaccines in general.
Severe, potentially life-threatening allergic reaction, swelling of the brain and spinal cord; loss of movement or sensation due to nerve damage, such as inflammation of the brain or temporary loss of movement; Guillain-Barré Syndrome; inflammation of spinal cord; inflamed nerves of the eye; and multiple sclerosis have in very rare cases been reported.
RabAvert should be injected into muscle only. RabAvert injected into a vein may cause a reaction throughout the body, including shock.
Fainting can occur when injectable vaccines are used, including RabAvert. Your healthcare provider should put procedures in place to avoid falling injury and to restore blood flow to the brain after fainting.
Patients with a weakened immune system due to illness or the use of certain medications or treatments (such as radiation therapy, antimalarials, and corticosteroids) may have issues developing immunity. If such a patient is receiving RabAvert, then the healthcare professional may measure immune response through blood testing. Vaccination with RabAvert for protection before a potential exposure (PrEP) to the rabies virus should be delayed in anyone who is sick or recovering from an illness.
RabAvert contains albumin which is a protein found in human blood that carries an extremely remote risk for transmission of viral diseases, including Creutzfeldt-Jakob disease (CJD), a rare brain disorder. No cases of transmission of viral diseases or CJD have ever been identified for albumin.
Persons who have not been previously vaccinated against rabies will receive Human Rabies Immune Globulin (HRIG). HRIG should not be administered to persons who have been previously vaccinated as it may counteract the effect of the rabies vaccine. Let your healthcare provider know if you were previously vaccinated for rabies as you may not need HRIG.
Only use RabAvert while pregnant or breastfeeding if clearly needed. RabAvert was not studied in pregnant or lactating women so it is not known if RabAvert can cause any harm to the fetus, have any effect on ability to get pregnant, or whether it is passed through breast milk to infants (but many drugs are excreted in human milk).
There is no information on how RabAvert works when given at the same time as other vaccines.
The most common side effects in clinical trials were reactions at the injection site, such as reddening, hardening, and pain; flu-like symptoms, such as lack of energy, tiredness, fever, headache, muscle pain, and feeling of discomfort; joint pain; dizziness; swelling of lymph nodes; upset stomach; and rash.
Vaccination before a potential exposure (PrEP) to the rabies virus does not remove the need for additional therapy after a suspected or known rabies exposure.
Seek the advice of a healthcare professional to help assess your specific level of risk if you are traveling to areas of high risk of rabies exposure; in frequent contact with the rabies virus or rabid animals, such as on the job; and/or are active outdoors and could encounter animals with rabies in the wild.
If you are exposed to a potentially rabid animal, seek medical attention right away before you have symptoms. Once symptoms are present, the rabies infection has spread through the body and survival is unlikely.

Uses for RabAvert