Rabies vaccine, Human (NA) is a sterile, freeze-dried suspension of inactivated rabies virus prepared from the Wistar Rabies PM/WI 38-1503-3M strain, propagated in human diploid cells (HDCV). It is a purified, inactivated, cell-culture derived vaccine used for pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) against rabies. It induces active immunity by stimulating the production of virus-neutralizing antibodies (VNA) against the rabies virus glycoprotein.
Adult: Post-exposure (Previously Unvaccinated): 1.0 mL intramuscularly (IM) in the deltoid region on Days 0, 3, 7, 14, and 28 (Essen/5-dose IM regimen). The 4-dose IM regimen (Days 0, 3, 7, and 14) is also approved by WHO. Intradermal (ID) regimens (2-site or 8-site) require specific vaccine vials and trained personnel. Pre-exposure: 1.0 mL IM on Days 0, 7, and 21 or 28.
Note: For IM use: Administer 1.0 mL into the deltoid muscle (anterolateral thigh in infants). NEVER administer in the gluteal region due to risk of reduced immunogenicity. For ID use: Administer 0.1 mL per site, using a specific intradermal technique (e.g., 2-site ID regimen on Days 0, 3, 7, and 28). The vaccine must be reconstituted strictly as per manufacturer's instructions using the supplied diluent. Use immediately after reconstitution.
The vaccine contains inactivated rabies virus. Upon intramuscular or intradermal administration, the viral antigens are taken up by antigen-presenting cells (APCs) and presented to helper T cells (CD4+). This activates B lymphocytes specific to the rabies virus glycoprotein (G protein), leading to clonal expansion and differentiation into plasma cells that produce virus-neutralizing antibodies (VNA). These antibodies bind to the virus, preventing its attachment and entry into host neurons, thereby neutralizing the infection. The process also generates memory B and T cells for a rapid anamnestic response upon future exposure.
Pregnancy: Pregnancy is NOT a contraindication. Rabies is nearly 100% fatal. PEP or PrEP should be administered if indicated. Available data from registries show no evidence of fetal risk. WHO and NACO (India) recommend full PEP in pregnant women.
Driving: Vaccine may cause dizziness or fatigue. Caution advised when driving or operating machinery shortly after vaccination.
| Chloroquine, Mefloquine (Antimalarials) | May attenuate antibody response when vaccine given intradermally; use IM route for PrEP if on these drugs. | Moderate |
| Immunosuppressants (Corticosteroids, Chemotherapy, Biologicals) | May reduce immunogenicity and vaccine efficacy. For PEP, administer vaccine regardless, but do not delay. Consider checking VNA titers. | Major |
| Other Vaccines | Can generally be administered concurrently at different sites. No significant interaction. | Minor |
| Rabies Immunoglobulin (RIG) | Concurrent administration is standard for Category III exposures. RIG does not suppress active immunity from the vaccine but must be given at a different anatomical site and never in the same syringe. | None (Synergistic) |