Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Rabies vaccination guidelines for travellers visiting high-risk areas:
- Travellers to rabies-enzootic areas should be offered pre-exposure rabies immunization, especially if they are staying for more than 1 month, unlikely to have access to prompt and safe medical care after exposure, engaging in activities that increase risk of animal bites (e.g., cycling, running), or working closely with animals (e.g., veterinarians, zoologists) NICE CKS,NICE CKS.
- The primary pre-exposure vaccination schedule consists of three doses given at days 0, 7, and 28; the third dose can be given from day 21 if time is limited before travel NICE CKS,NICE CKS.
- If there is insufficient time to complete the standard schedule, an accelerated course of three doses on days 0, 3, and 7 may be administered NICE CKS,NICE CKS.
- A booster dose should be considered one year after the primary course if the traveller will again visit a high-risk area, especially for those who received the accelerated schedule NICE CKS,NICE CKS.
- Pre-exposure rabies vaccination is contraindicated in individuals with a confirmed anaphylactic reaction to a previous dose or any vaccine component, and vaccination should be postponed in those with severe febrile illness; minor illness without fever is not a contraindication NICE CKS,NICE CKS.
- Rabies vaccine may be given to pregnant or breastfeeding women when the risk of exposure is high and access to post-exposure prophylaxis is limited, with no evidence of harm from inactivated vaccines NICE CKS,NICE CKS.
- Travellers who receive pre-exposure vaccination should be advised that if bitten or scratched by any animal abroad, they must wash the wound thoroughly with soap and water and seek immediate medical attention; if this is not possible abroad, they should seek medical care promptly upon return to the UK NICE CKS,NICE CKS.