Rabies Vaccination

What is the rabies vaccine?

The rabies vaccine protects against infection caused by the rabies virus, which can be present in both wild and domestic animals.

Rabies is passed on to humans through saliva, in the form of bites and scratches from infected animals, or through licks on broken skin and mucous membranes like the mouth. Most reported cases involve dog bites.

In Singapore, there have been no locally reported cases of rabies since 1953, but it remains a threat in many parts of the world.

Left untreated, rabies usually results in coma and death. Rabies is virtually fatal once symptoms appear. The best prevention method is getting vaccinated.

How the rabies vaccine works

The rabies vaccine stimulates the body’s immune system to produce antibodies against the rabies virus. It contains an inactivated virus, so rest assured that you will not get rabies from it.

The number of recommended doses will vary, depending on whether you are taking it pre-exposure or post-exposure, and whether you have previously received the vaccine.

The duration of protection varies based on the number of shots given, ranging anywhere from 6 months to 3 years.

Types of rabies vaccines

There are 2 types of rabies vaccines – nerve tissue and cell culture. Cell culture vaccines, which is what we offer at Parkway Shenton, are generally safer, more effective, and more affordable.

Why do you need the rabies vaccine?

The rabies vaccine may be taken as a preventive measure (pre-exposure) for those who are regularly in contact with wild or domestic animals, such as animal handlers and veterinarians, as well as those travelling to areas where rabies is common.

The rabies vaccine may also be taken post-exposure in order to prevent fatality from the virus.

When do you need the rabies vaccine?

If you have received the rabies vaccine as a preventive measure, rabies booster vaccines are recommended every 3 years.

However, most people only take the rabies vaccine after potential exposure (post-exposure). While there is no specific treatment for rabies, prompt vaccination after exposure, preferably within the same day, offers protection.

Any person who has been scratched or bitten by an animal should see a doctor immediately to receive the rabies shot on the same day and have the wound cleaned and dressed as soon as possible.

Post-exposure, a full course of rabies vaccination consists of 5 doses on days 0, 3, 7, 14 and 28. It is important to complete the full course for optimal protection. Not completing the full post-exposure prophylaxis (PEP) course, especially the initial doses within the crucial time frame, significantly increases the risk of rabies developing if the virus was indeed transmitted through the bite.

Who should not receive the rabies vaccine?

While the rabies vaccine is generally safe and effective, there are certain individuals who should be cautious or may not be suitable for vaccination, typically due to potential risks or complications.

Here are some categories of people who may need special considerations or to consult their doctor before receiving the rabies vaccine:

Individuals with a history of severe allergic reactions

Previous allergic reactions to rabies vaccine. If you have experienced a severe allergic reaction (anaphylaxis) to a previous dose of rabies vaccine, it's crucial to inform your doctor before considering further vaccination. They might suggest alternative options or carefully monitor you during and after administration.
Severe allergies to other vaccines or components. Those with severe allergies to egg protein, aluminium salts (adjuvants), or components of specific brands of the vaccine should discuss the risks and benefits with their doctor. Alternative formulations or other preventive measures might be recommended.

Individuals with weakened immune systems

Immunocompromised individuals. People with conditions like HIV/AIDS, severe immunodeficiency, or undergoing immunosuppressive therapy might have a reduced immune response to the vaccine. While vaccination is still recommended, its effectiveness may be suboptimal, and additional boosters or alternative preventive measures might be necessary.
Active infections. People with active infections, such as severe fever or acute illness, might experience delayed or reduced immune response to the vaccine. Postponing vaccination until recovery is preferable in most cases.

Pregnant or breastfeeding women

Pregnant women. While no harm has been observed in studies of rabies vaccine administered during pregnancy, most healthcare providers recommend postponing vaccination until after childbirth unless there's a clear and imminent risk of rabies exposure.
Breastfeeding women. Breastfeeding generally doesn't pose a problem after rabies vaccination, as the vaccine components are not excreted in breast milk. However, discussing concerns with your doctor is always advisable.

Other considerations

Age. While rabies vaccines are generally safe for all ages, some specific brands or formulations might have age restrictions or require different considerations for children or older adults. Consult your doctor for age-appropriate recommendations.
Neurological conditions. In rare cases, people with certain neurological conditions might experience side effects like Guillain-Barré syndrome after rabies vaccination. A thorough medical evaluation and discussion of the risks and benefits with your doctor are crucial in such cases.

How do you prepare for the rabies vaccine?

You should inform your doctor of the following during your pre-vaccination consultation:

If you have severe allergies
If you have a weakened immune system
If you have received the rabies vaccine in the past (so your doctor will know how many doses you need)
If you have had an allergic reaction after taking a vaccine
If you are currently taking or will be taking chloroquine or any related drugs

However, if you have been potentially exposed to the rabies virus, you should receive the vaccine regardless of the above.

What can you expect when getting the rabies vaccine?

The rabies vaccine is given in the arm for older children and adults. For young children and babies, it is given in the thigh.

What are the common side effects of the rabies vaccine?

It is common to experience some side effects after getting the rabies vaccine, which include localised effects at the injection site as well as other symptoms.

At the injection site:

Itching
Pain
Redness
Swelling
Thickening or hardening of the skin

Other symptoms:

Dizziness
Fever
Headache
Joint pain
Muscle aches or weakness
Nausea

After receiving the rabies vaccine, you should not receive any treatments that suppress the immune system, as this might affect the development of antibodies.

What are the serious side effects that require medical attention?

In rare cases, the rabies vaccine may trigger a severe allergic reaction or anaphylaxis. This is a medical emergency, and you should receive immediate medical attention if you experience: