Rabies vaccine purified vero call rabies vaccine Give me dosage and route of administration and schedule for this particular dose.
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purified vero cell rabies vaccine PVRV dosage route schedule pre-exposure post-exposure
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Now I have comprehensive data. Here is the complete answer:
Purified Vero Cell Rabies Vaccine (PVRV) - Verorab
What Is It?
PVRV is an inactivated rabies vaccine grown on Vero cells (kidney cells of the African green monkey). It contains no preservatives, must be stored at +2°C to +8°C, and after reconstitution must be used within 6-8 hours. Each intramuscular dose must contain ≥2.5 IU of rabies antigen per the WHO potency standard.
Dose volume: 0.5 mL per IM dose | 0.1 mL per ID dose
A. PRE-EXPOSURE PROPHYLAXIS (PrEP)
Who needs it: Lab workers handling rabies virus, veterinarians, animal handlers, forestry workers, travellers to endemic areas, children in high-risk rural areas.
Route & Schedule Options
| Route | Schedule | Doses |
|---|---|---|
| Intramuscular (IM) - deltoid | Days 0, 7, 21 or 28 | 3 doses × 0.5 mL |
| Intradermal (ID) - deltoid or thigh | Days 0, 7, 21 or 28 | 3 doses × 0.1 mL (1 site/day) |
| IM - 2-visit schedule | Days 0 and 7 | 2 doses × 0.5 mL |
| ID - 2-visit schedule | Days 0 and 7 | 2 × 0.1 mL at 2 different sites on each day (4 injections total) |
Note on 2-visit schedules: Do NOT use in immunocompromised patients. The 2-visit ID schedule should not be used in adults >50 years due to reduced seroconversion rates.
Booster Doses (PrEP)
- Routine boosters not required for travellers who completed the primary series.
- People at continual/frequent occupational risk - serological monitoring every 6 months (lab workers) or every 2 years (veterinarians, etc.).
- A booster is given only if rabies virus neutralizing antibody (RVNA) titre falls to <0.5 IU/mL.
B. POST-EXPOSURE PROPHYLAXIS (PEP)
First, always perform immediate wound care: thorough flushing with soap and water for at least 15 minutes, then apply virucidal agents (70% alcohol, tincture of iodine, or 0.01% aqueous iodine/povidone-iodine). Do not suture wounds immediately.
WHO Exposure Categories
| Category | Type of Contact | Action |
|---|---|---|
| I | Touching/feeding animal, licks on intact skin | None required |
| II | Nibbling of uncovered skin, minor scratches without bleeding | Vaccine + wound care |
| III | Transdermal bites/scratches with bleeding, licks on broken skin, mucous membrane contact, bat contact | Vaccine + RIG + wound care |
Intramuscular PEP Regimens
Site: Deltoid muscle in adults; anterolateral thigh in children <2 years. Never use the gluteal site (associated with vaccine failures).
1. Essen Regimen (5-dose) - Standard
| Day | Dose |
|---|---|
| 0 | 1 IM dose (0.5 mL) |
| 3 | 1 IM dose (0.5 mL) |
| 7 | 1 IM dose (0.5 mL) |
| 14 | 1 IM dose (0.5 mL) |
| 28 | 1 IM dose (0.5 mL) |
2. Zagreb Regimen / Abbreviated 4-dose (2-1-1) - for healthy, immunocompetent patients
| Day | Dose |
|---|---|
| 0 | 2 IM doses - 1 in each deltoid simultaneously |
| 7 | 1 IM dose |
| 21 | 1 IM dose |
3. 4-dose Regimen (simplified, for healthy immunocompetent patients with good wound care + RIG)
| Day | Dose |
|---|---|
| 0 | 1 IM dose |
| 3 | 1 IM dose |
| 7 | 1 IM dose |
| 14 | 1 IM dose |
Intradermal PEP Regimen
Dose per ID site: 0.1 mL (one-fifth of the IM dose). Must produce a visible, palpable bleb in the skin.
2-site ID Regimen (2-2-2-0-2)
| Day | Sites | Dose per site |
|---|---|---|
| 0 | 2 sites (both deltoids/thighs) | 0.1 mL each |
| 3 | 2 sites | 0.1 mL each |
| 7 | 2 sites | 0.1 mL each |
| 14 | - | (skipped) |
| 28 | 2 sites | 0.1 mL each |
If accidentally given subcutaneously or IM instead of ID, repeat that dose intradermally.
PEP for Previously Vaccinated Individuals
If a person has documented previous complete PrEP or PEP with a cell-culture vaccine:
- 2 doses only - IM or ID on days 0 and 3
- No RIG required
- Alternative: single-visit 4-site ID regimen (4 × 0.1 mL at 4 sites on day 0)
Rabies Immunoglobulin (RIG) - Required for Category III (never-vaccinated)
| Type | Dose |
|---|---|
| Human RIG (HRIG) | 20 IU/kg body weight |
| Equine RIG (ERIG) / F(ab')2 | 40 IU/kg body weight |
- Give as much as anatomically possible infiltrated directly into the wound.
- Remaining RIG: inject IM at a site distant from the vaccine site.
- Never give RIG and vaccine at the same site or with the same syringe.
- RIG is valid only up to day 7 after first vaccine dose; after that it is not indicated.
Special Populations
| Population | Recommendation |
|---|---|
| Immunocompromised / HIV | Full 5-dose IM Essen regimen + full RIG; check RVNA titre 2-4 weeks post-vaccination |
| Pregnancy | Not a contraindication; treat as normal |
| Children <2 years | Same dose and schedule; use anterolateral thigh |
| On chloroquine | Use IM route only (chloroquine reduces ID immune response) |
Adverse Effects
- Local: erythema, pain, swelling at injection site (35-45% with ID booster)
- Systemic: transient fever, headache, dizziness, GI symptoms (5-15%)
Sources:
- Park's Textbook of Preventive and Social Medicine, pp. 324-326
- Harrison's Principles of Internal Medicine 22E (2025), pp. 1697-1698
- Sanofi Verorab Prescribing Information (South Africa/New Zealand)
- ATAGI recommendation for PVRV (Verorab) - December 2023
- WHO Guide for Rabies Pre and Post Exposure Prophylaxis in Humans (2014)
abhayrab rabies injection dosage and Route and Schedule
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Abhayrab rabies vaccine dosage route schedule pre-exposure post-exposure Indian Immunologicals
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Abhayrab dosage route schedule pre-exposure post-exposure intradermal intramuscular
I now have complete product-specific data directly from the official SmPC of Abhayrab and Abhayrab-PF. Here is the full answer:
Abhayrab Rabies Vaccine - Dosage, Route & Schedule
Manufacturer: Human Biologicals Institute (a division of Indian Immunologicals Limited)
Type: Purified Vero Cell Rabies Vaccine (PVRV) - Inactivated
Two formulations:
- Abhayrab - contains thiomersal as preservative; available in 0.5 mL or 1.0 mL packs. Can be given IM or ID.
- Abhayrab-PF (Preservative-Free) - reconstituted with 0.5 mL diluent only; IM route only.
Storage: +2°C to +8°C. After reconstitution, use immediately or within 6 hours.
Never give by intravascular route.
Injection Site
- Adults: Deltoid muscle (deep IM) or deltoid area (ID)
- Children: Anterolateral aspect of the thigh
- Never inject into the gluteal region
A. PRE-EXPOSURE PROPHYLAXIS (PrEP)
For people at risk: lab workers, veterinarians, animal handlers, wildlife/forest workers, slaughterhouse staff, travellers to endemic areas.
Abhayrab (with preservative) - IM or ID
| Route | Dose | Schedule |
|---|---|---|
| Intramuscular (IM) | 0.5 mL or 1.0 mL (as per pack) | Days 0, 7 and 21 or 28 |
| Intradermal (ID) | 0.1 mL at 1 site (deltoid) | Days 0, 7 and 21 or 28 |
Abhayrab-PF (preservative-free) - IM only
| Route | Dose | Schedule |
|---|---|---|
| Intramuscular (IM) only | 0.5 mL | Days 0, 7 and 21 or 28 |
100% of subjects achieved protective RVNA titre ≥0.5 IU/mL by day 28.
Booster Doses (PrEP)
- Only for people at continual or frequent occupational risk
- Give a booster (0.5 mL/1.0 mL IM, or 0.1 mL ID) whenever RVNA titre falls below 0.5 IU/mL
- Routine boosters are not required for travellers
B. POST-EXPOSURE PROPHYLAXIS (PEP)
Wound Care First (before any injection)
Wash wound thoroughly with soap and water for at least 15 minutes; apply virucidal agents (iodine/70% alcohol).
WHO Exposure Categories
| Category | Exposure Type | Action Required |
|---|---|---|
| I | Touching/feeding animal, licks on intact skin | No vaccination needed |
| II | Minor scratch/abrasion without bleeding, nibbling of skin | Vaccine + wound care |
| III | Transdermal bites/scratches with bleeding, licks on broken skin, mucous membrane exposure, bat contact | Vaccine + RIG + wound care |
A. Unimmunized / Incompletely Immunized Individuals
Abhayrab - IM Route (Essen Regimen)
| Day | Dose | Route |
|---|---|---|
| 0 | 0.5 mL or 1.0 mL | Deep IM - deltoid |
| 3 | 0.5 mL or 1.0 mL | Deep IM - deltoid |
| 7 | 0.5 mL or 1.0 mL | Deep IM - deltoid |
| 14 | 0.5 mL or 1.0 mL | Deep IM - deltoid |
| 28 | 0.5 mL or 1.0 mL | Deep IM - deltoid |
Total: 5 doses
Abhayrab - ID Route (Updated Thai Red Cross Regimen) (not available with PF formulation)
| Day | Dose | Sites | Route |
|---|---|---|---|
| 0 | 0.1 mL × 2 | Left + Right deltoid | Intradermal |
| 3 | 0.1 mL × 2 | Left + Right deltoid | Intradermal |
| 7 | 0.1 mL × 2 | Left + Right deltoid | Intradermal |
| 28 | 0.1 mL × 2 | Left + Right deltoid | Intradermal |
Total: 8 ID injections (4 visits)
(Day 14 is skipped in this regimen)
B. Previously Fully Immunized Individuals
For patients with documented complete prior PrEP or PEP course:
Abhayrab (IM)
| Day | Dose | Route |
|---|---|---|
| 0 | 0.5 mL or 1.0 mL | Deep IM |
| 3 | 0.5 mL or 1.0 mL | Deep IM |
Total: 2 doses only. No RIG required.
Abhayrab (ID)
| Day | Dose | Route |
|---|---|---|
| 0 | 0.1 mL at 1 site | Intradermal |
| 3 | 0.1 mL at 1 site | Intradermal |
Total: 2 ID injections. No RIG required.
Rabies Immunoglobulin (RIG) - for Category III bites
| Type | Dose |
|---|---|
| Human RIG (HRIG) | 20 IU/kg body weight |
| Equine RIG (ERIG) | 40 IU/kg body weight |
- Infiltrate as much as possible directly into the wound
- Remaining RIG: give IM at a site distant from the vaccine
- Must be given at first visit, never after day 7 from first vaccine dose
- Immunocompromised patients: RIG is required even for Category II bites
Special Populations
| Population | Recommendation |
|---|---|
| Immunocompromised | IM route only (not ID); full 5-dose Essen regimen; RIG for Category II and III |
| Children | Same dose and schedule; use anterolateral thigh |
| Pregnancy | No contraindication for PEP; treat normally |
| Febrile illness / chronic progressive illness | Contraindicated for PrEP only; PEP has no contraindications |
| Hypersensitivity to vaccine components | Contraindicated for PrEP; no contraindication for PEP (rabies is fatal) |
Adverse Effects
- Local: Redness (38.4%), itching (20.5%), pain (1%) at injection site
- Systemic: Fever (1.4%) - all mild and transient
Source: Abhayrab and Abhayrab-PF Summary of Product Characteristics, Human Biologicals Institute, Indian Immunologicals Limited; National Guidelines on Rabies Prophylaxis, MoHFW India
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