Rabies vaccine
Rabies vaccine · IAP (PEP/PrEP)
| When to give | Any age. Post-exposure (PEP) after animal bite; pre-exposure (PrEP) for high-risk. |
|---|---|
| Dose | Cell-culture vaccine, ≥2.5 IU per dose. IM regimen: 1 mL (whole vial) per site. ID regimen: 0.1 mL per site. ThRabies (recombinant nanoparticle, >18 yr): 0.5 mL. |
| Route | Intramuscular or Intradermal |
| Site | Deltoid (adult) / anterolateral thigh (child) — NEVER gluteal |
| Schedule / interval | IAP-ACVIP 2025 PEP: 5-dose IM (NCDC/Thai Red Cross), days 0, 3, 7, 14, 28 + RIG/RMAb per bite category. Alternatives — WHO IM Essen: 0,3,7,14(±28); Zagreb 2-1-1: 0,7,21; ID Updated Thai (2-site): 0,3,7,28. PrEP: days 0,7,21/28. |
Catch-up schedule
PEP cannot be delayed — start immediately after Category II/III exposure regardless of age. For Category III, add rabies immunoglobulin (RIG) or rabies monoclonal antibody (RMAb).
Adverse events (AEFI)
Local pain/redness; mild fever, headache, myalgia. 100% seroprotective titres (>0.5 IU).
Brands available in India
Vaccines: Chirorab, Rabivax-S (Vero-cell), Vaxirab (Vero-cell), AbhayRab, IndiRab (Vero-cell), Berab (Vero-cell), ThRabies (recombinant). RIG — HRIG: Kamrab, Berirab (20 IU/kg, max 1,500 IU); ERIG: Equirab (40 IU/kg, max 3,000 IU); RMAb: Rabishield & Twinrab (3.33 & 40 IU/kg).
Special considerations
2025 UPDATE — IAP-ACVIP now aligns with NCDC on a 5-dose IM schedule (days 0,3,7,14,28) as a safety-first approach. NEVER give in the gluteal region. Category III bites need RIG/RMAb infiltrated into and around the wound(s); no need to give remaining RIG volume IM. Store 2–8°C.
See the full IAP-ACVIP 2025 immunisation schedule →
Sources
- IAP-ACVIP Recommended Immunization Schedule 2025 (Indian Pediatrics 2026)
- IAP Purple Book 2025, 5th edition