Rabies immunization for adults

General information
Rabies is a serious and usually fatal viral disease of the nervous system. It's transmitted by the bite of an infected animal. Although rare in the United States, veterinarians and people who handle animals are at an increased occupational risk due to their exposure to animals.
The rabies vaccine (Imovax, RabAvert) is made from an inactivated form of the virus. It's given to prevent disease before and after exposure to the virus.


Recommendations
The rabies vaccine is recommended for:
veterinarians and people who handle animals
people who explore caves for enjoyment (spelunkers) because of their risk of exposure to bats

Dose/booster
Pre-exposure vaccination involves three injections, with the second dose given seven days after the first and the third given 21 to 28 days after the first.
Postexposure vaccination involves one dose of rabies immune globulin and one dose of rabies vaccine given immediately, followed by four doses of the rabies vaccine on days three, seven, 14 and 28.

A booster vaccination is needed if potential exposure to rabies is frequent.


Side effects
Side effects are usually mild and include pain, redness and swelling at the injection site; headache; nausea; abdominal pain; muscle aches; and dizziness.
A serious allergic reaction after the vaccine is possible, but rare. If an allergic reaction to the vaccine occurs, the vaccine's ability to prevent a fatal disease may be jeopardized. The vaccine may be given with medication to prevent allergic reactions if vaccination is considered necessary.


Pregnancy-specific information
During pregnancy, the rabies vaccine is given to prevent disease before and after exposure to the virus. Use of the vaccine during pregnancy hasn't been studied, but it hasn't been reported to cause problems.