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Graphic illustration of a park ranger who has been scratched on the arm by a raccoon near a ranger station

Rabies is 100% vaccine-preventable, if you act quickly.1

The Centers for Disease Control and Prevention (CDC) says to talk with a healthcare or public health professional immediately if you have been in contact with any wildlife or unfamiliar animals, particularly if you have been bitten or scratched.2

Once you have been exposed to rabies, it can take anywhere from 5 days to 2 years for symptoms to appear, depending on the type of rabies you were exposed to and where your wound is located.3 The face and hands have many nerve endings, and bites or scratches there tend to spread the virus quicker.4

It is important to seek medical attention immediately for a potential rabies exposure, before symptoms appear. Once symptoms are present, the virus has spread into your central nervous system and it is too late. Untreated rabies is almost always fatal, but is 100% vaccine-preventable.5

Potentially exposed to rabies? Here’s what to do.2

Graphic illustration of washing a wounded hand with soap and water next to the number

Immediately wash any wound for at least 15 minutes using soap and water. This can help reduce rabies virus infection by eliminating or inactivating rabies virus particles that may have entered the wound.

Graphic illustration depicting a rabies virus and HRIG biologic next to the number

Seek the help of a medical professional and share all relevant information about your potential exposure. When evaluating the need for anti-rabies treatment, your provider will likely consider a number of things. You may be asked for information about the species and behavior of the animal you had contact with along with the circumstances and type of potential exposure you had (bite or non-bite).

Graphic illustration of a calendar and syringe representing a vaccine schedule next to the number

Depending on the circumstances of your potential exposure, you may need to receive anti-rabies treatment. If it is necessary, and you have not been previously vaccinated, then treatment will begin with a dose of special antibodies called human rabies immune globulin (HRIG). This should be injected as close to the wound as possible, immediately providing antibodies to neutralize the virus at the site of exposure.6

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 28.9

Please note that the CDC/ACIP recommendations differ, calling for a fifth dose on Day 28 only for patients who are immunocompromised.8

Graphic of a calendar page representing the rabies incubation period

Treatment after a potential exposure is different if you received pre-exposure vaccination4,7

Receiving rabies vaccination before you are exposed does not eliminate the need for additional treatment if you are bitten. But it can offer a level of protection, particularly against unrecognized exposures. Pre-exposure vaccination primes your immune response so treatment after exposure can be effective more quickly. It also reduces the number of post-exposure vaccine doses (2 doses instead of 4-5 doses) and simplifies treatment because no HRIG is needed.

Remember, 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 taken hold and it’s too late.

Learn more about post-exposure vaccination
References
  1. Centers for Disease Control and Prevention. How can you prevent rabies in people? Accessed April 14, 2021. https://www.cdc.gov/rabies/prevention/people.html
  2. Centers for Disease Control and Prevention. When to seek care. Accessed April 14, 2021. https://www.cdc.gov/rabies/exposure/index.html
  3. 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
  4. WHO Expert Consultation on Rabies: Third Report. WHO Technical Report Series; 2018. Accessed April 14, 2021. https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf?ua=1
  5. Pieracci EG, et al. MMWR Morb Mortal Wkly Rep. 2019;78(23):524-528. doi:10.15585/mmwr.mm6823e1 https://www.cdc.gov/mmwr/volumes/68/wr/mm6823e1.htm
  6. Briggs DJ. The Immunological Basis for Immunization Series. Module 17: Rabies. World Health Organization; 2011. Accessed April 14, 2021. https://apps.who.int/iris/bitstream/handle/10665/44517/9789241501088_eng.pdf
  7. World Health Organization. Wkly Epidemiol Rec. 2018;93(16):201-220. https://reliefweb.int/sites/reliefweb.int/files/resources/WER9316.pdf
  8. 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.
  9. RabAvert® Prescribing Information. Available at: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=84b7a672-eeb1-527-84ac-68196b156be2. Accessed October 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

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

Patients should always ask their healthcare professionals for medical advice about the appropriate use of vaccines and adverse events. 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.

Please see full Prescribing Information