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Image for article titled The Difference Between Post- and Pre-Exposure Rabies Vaccines (and When You Need Them)

Photo: Kevin Dietsch (Getty Images)

If you’ve been following the news lately, you may have heard about the Capitol Hill fox that bit a total of nine people, including a Congressman and a reporter. As amusing as the fox sightings have been, the story took a more serious turn in recent days, as the fox was captured and discovered to have rabies.

When I was in high school, I had to get the post-exposure rabies series after a cat-bite. I’d stopped to help a kitten that had been struck by a car, only for the kitten to bite me and escape, which meant I had no way of knowing if she was carrying rabies or not.

Although receiving the post-exposure shots felt like overkill—especially since this meant going to the local emergency room on a Friday night, where I received two injections (one in each butt cheek). These initial shots were then followed by three more, administered one at a time, over the course of the next two weeks.

As inconvenient as those shots were, the post-exposure rabies series is an effective treatment that, if administered right away, is almost 100% effective. Here’s what to know about the risk of rabies and why you might need to get vaccinated against it.

What you need to know about rabies 

If left untreated, rabies has a 99.9% fatality rate. This is not a virus you want to fuck with, as it will attack your central nervous system, destroying it in the process. An estimated 59,000 people die from rabies every year, mostly in countries where there aren’t widespread rabies vaccinations for dogs, and the post-exposure rabies vaccine isn’t readily available.

People typically catch rabies from being bitten or scratched by an infected animal, with bites from bats or unvaccinated dogs being some of the most common ways to contract it. In the U.S., deaths from rabies are very low, with last year’s total of five deaths being the highest on record in a decade.

There are very few survivors of an active rabies infection, with the only treatment available being to induce a coma, during which a patient is treated with antivirals. Even this treatment, which was introduced a few decades ago, is only partially successful, with death still being the most likely outcome.

However, if a person who has been exposed to rabies receives the post-exposure rabies vaccination series right away, it is almost 100% effective.

What the post-exposure rabies series is like 

In the past, the post-exposure rabies series required a shot in the stomach. Happily, that is no longer the case, with the first two shots being administered in the buttocks, and the remaining shots being given in the arm.

The first two shots, which are either given on the day of exposure or as close to it as possible, are a dose of the rabies vaccine, along with a dose of human rabies immunoglobulin. The immunoglobulin offers short-term assistance for fighting off any possible virus in your system, while the vaccine prompts your immune system to start developing antibodies against the rabies virus.

After the first two shots, there are an additional three doses of the vaccine, given on days 3, 7 and 14.

Why you might need to get the pre-exposure rabies vaccine 

The rabies vaccine is expensive, which is why most people will only get one after a potential exposure. However, people working in a high-risk setting may need a pre-exposure vaccine series. Potential high-risk professions include veterinarians or wildlife control specialists.

The CDC also recommends considering the pre-exposure vaccine series if you are traveling to a remote area where medical care is hard to obtain, or if you will be spending more than a month in an area with a high rate of dog rabies.

The pre-exposure vaccine series is a total of three shots administered over the course of a month. These initial shots may be followed by booster doses, with the timing and frequency of boosters depending on their exposure risk.

  



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