Post-Exposure Prophylaxis for Previously Vaccinated Rabies Patients

Rationale for Treatment

The Centers for Disease Control and Prevention recommends that previously vaccinated individuals who have been exposed to rabies receive a modified post-exposure prophylaxis regimen, consisting of 2 doses of rabies vaccine administered on days 0 and 3, without rabies immune globulin 1
Previously vaccinated individuals require a modified post-exposure prophylaxis regimen, which includes only two intramuscular doses of rabies vaccine, administered on days 0 and 3 1, 2

Previously vaccinated individuals develop a rapid anamnestic immune response upon re-exposure, with studies showing that persons who received primary vaccination maintained adequate antibody titers at 1 year post-vaccination 3
All persons tested at day 365 post-booster dose had rabies virus neutralizing antibody titers >0.5 IU/mL, which is considered protective 3

Immediate and thorough washing of all bite wounds and scratches with soap and water for about 15 minutes is an essential component of rabies prevention, as recommended by the Centers for Disease Control and Prevention 2

Post-exposure prophylaxis should be initiated as soon as possible after exposure to maximize effectiveness, according to the Centers for Disease Control and Prevention 4

For immunosuppressed patients, the standard recommendation for post-exposure prophylaxis comprises a full 5-dose vaccination regimen with RIG, as recommended by the American College of Emergency Physicians 5