Rabies post-exposure prophylaxis (PEP) vaccine , HRIX

Rabies post-exposure prophylaxis (PEP) involves several key steps:

1. Wound Care: Immediately clean the wound with soap and water for at least 15 minutes, then apply a virucidal agent like povidone-iodine or alcohol.
2. Human Rabies Immune Globulin (HRIG): Administer HRIG as soon as possible to neutralize the virus. The dose is typically 20 IU/kg body weight; half should be infiltrated around the wound, and the rest given intramuscularly at a site distant from the vaccine.
3. Vaccine Series: Give four doses of rabies vaccine (usually on days 0, 3, 7, and 14). The vaccine is administered intramuscularly in the deltoid muscle or thigh for young children.

PEP recommendations may vary based on previous vaccination status:

• Unvaccinated individuals require both HRIG and the full four-dose vaccine series.
• Previously vaccinated individuals only need two doses of the vaccine (on days 0 and 3), with no additional HRIG needed unless the wound is severe or the immune response is uncertain.

For immunocompromised patients, consult specific guidelines for adjusted dosing. If an animal that caused exposure cannot be observed, PEP should still be initiated due to the high risk of rabies.

(Source: CDC Rabies Post-exposure Prophylaxis Guidance)