Rabies Vaccination Guidelines 2024 Latest Edition

No need to indiscriminate vaccination if there is no exposure. There are no absolute contraindications for priority vaccination of inactivated vaccines for Level II and above exposures. The 10-day observation method can be used as a basis for vaccination adjustment but it can never replace the vaccination operation immediately after exposure. The protection period after full vaccination is at least half a year. Special groups can take pre-exposure prophylaxis in advance.

Last week, a friend came to me with his arms raised and said that he scratched a red mark on the neighbor’s orange cat downstairs. The cat had just been fully vaccinated last year and was wondering whether to go to the hospital. My direct suggestion is to get the first two injections first, and at the same time keep an eye on the orange cat's condition. If the cat is still alive and kicking and squatting downstairs asking for cans after 10 days, you don't need to take the next three injections. She later told me that the cat blocked her door every day, and in the end she only received two injections, but nothing happened.

Many people are confused by what the doctor calls "Level I and Level II exposure" when they come to disease control. In fact, you don't need to remember the professional terms at all. You can judge by yourself: if you touch a cat or dog, or if you are licked, there will be no red mark on the skin. Just rinse your hands clean and do not need to hit anything; if you are scratched or bitten, there will be a red mark. Even if there is no bleeding, or a small wound is licked and broken, it belongs to the category of vaccination; if you see blood, or the wound is in a nerve-intensive place such as the head, face, and neck, don’t hesitate. Not only do you need to get vaccinated, but you also need to get immune globulin around the wound, which is equivalent to putting a temporary protective shield on the body.

Regarding the 10-day observation method that everyone has been arguing about for many years, the 2024 version of the guideline is not one-size-fits-all, but gives two clinical suggestions at the same time: one group believes that as long as there is a risk of exposure, especially when encountering stray animals and the vaccination history cannot be confirmed, it is safest to complete the entire process directly, without waiting for observation to delay time; the other group believes that if the cats and dogs are clearly domesticated and have full and effective vaccination records, they can be observed while being vaccinated. If the animals do not become sick and die within 10 days, subsequent injections can be cancelled. Both statements are supported by clinical data. To put it bluntly, it depends on how much time and cost you are willing to spend to be "safe." If you are really unsure, just listen to the doctor who treated you. There is no need to argue with others online.

Many people ask if they should get vaccinated now that they have been bitten again after having been vaccinated before. The time points given in this guide are also very clear: if you have just completed the injection within half a year, you do not need to get another injection; between half a year and one year, you need 2 supplementary injections, between 1 and 3 years you need 3 injections, and if it is more than 3 years ago, you can just restart the entire injection. I met a young man two years ago who had been fully vaccinated three years ago. He was bitten by a wild dog and refused to take the vaccine because he felt that he had antibodies. After persuading him for a long time, he agreed to be vaccinated. There is really no need to take this risk. After all, the mortality rate of rabies is 100%. This money and time are cost-effective.

There are also several misunderstandings that have been circulating for many years. This guide has clearly refuted the rumors: The first is that "the vaccination must be within 24 hours to be effective." Then, can pregnant women, lactating women, and children be vaccinated? The 2024 version clearly states that there are no absolute contraindications for inactivated vaccines, and they will not cause teratogenicity or affect the development of the baby. Last year, I encountered a pregnant woman who was 5 months pregnant and was bitten by a dog. Her family stopped her from giving it a shot. I read the guide and showed it to them before agreeing. In the end, the baby was born healthy and had no problems. There is also the "taboo list" that makes many people miserable. What they cannot eat is spicy, seafood, and coffee. This time, it is stated directly. As long as you usually eat things that you are not allergic to, you can eat them. Previously, the taboos were mentioned because I was afraid that you would feel uncomfortable after eating them. It would be indistinguishable from the adverse reactions of the vaccine. It will not affect the effect of the vaccine at all. There is no need to wrong yourself for this matter.

If you often deal with animals, such as veterinarians, pet store employees, people who like to hike in the mountains, or those who have three or four cats and dogs at home, you can also take pre-exposure prophylaxis in advance, with a total of 3 injections. If you are exposed again later, you only need to make up 2 injections. There is no need to take immune globulin, which saves a lot of trouble. As for whether to choose inactivated or attenuated vaccines, the current mainstream in China is inactivated vaccines, which have low adverse reactions and high safety. Most people recommend this option; live attenuated vaccines are generally used in pastoral areas and are low-cost, but are not recommended for people with low immunity. Both are compliant. You can choose according to your own situation. The vaccination procedure can be the traditional 5-shot or 4-shot "2-1-1". There is no difference in the effect. If you find it troublesome to go to the hospital, choose the 4-shot vaccine and save yourself a trip.

I have been working in CDC for nearly 6 years, and I have seen too many people get into trouble because they were lucky enough not to get any injections, and I have also seen many people who were so panicked after being rubbed by a cat that they needed more than a dozen injections. There is really no need to go to extremes. To put it bluntly, the core logic of this guideline is just one sentence: Don’t gamble with your life, get vaccinated first if there is a risk, and adjust the rest according to the actual situation. If you are really unsure, ask the local disease control doctor, which is much more reliable than searching for messy information on the Internet.