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CDC reduces pre-exposure rabies vaccine doses to 2 shots

Reviewing pre-exposure rabies vaccine dose information I stumbled across the fact that the CDC has now reduced the number of jabs required from 3 to 2. When I checked last autumn it was still 3. (Note that the post-bite exposure series is different.)

The rabies vaccine is expensive in the US, I have an explanation of benefits right in front of me showing that last fall at a US urgent care facility the charge was $516 for one dose. So not having to get a third shot could be a real money saver for those considering the vaccine.

Adding that I priced out the vaccine per dose in 2 other countries, just in case that works out for anyone:

India: $6 (the vaccine is made here)
Israel: $32

Posted by
32508 posts

do many people get the rabies shots before travel? I'd never heard of that before.

Posted by
4495 posts

I don't think many people get the vaccine for travel as a prophylactic, but some do. I have certainly been freaked out by the packs of feral snarling dogs in some countries I have visited, esp India and Indonesia. The cost is high or the recommendation would be more common.

India has over 20,000 deaths from rabies/year.

https://www.who.int/activities/improving-data-on-rabies/rabies-epidemiology-and-burden

Also at least in the US the post-exposure series (without the prophylactic series having been finished first) is very expensive, at an urgent care facility:
vaccine: $550 x 4 = $2200
immune globulin 1 dose about $7000
So with doctor and facility fees over $10,000, and then double that cost if administered in an emergency room. Worth knowing in advance one's insurance coverage urgent care vs hospital emergency room, the difference can be thousands of dollars out of pocket.

Posted by
17628 posts

do many people get the rabies shots before travel? I'd never heard of
that before.

NIgel, I think it has something to do with the cueing to get on airlines..

Posted by
4495 posts

I had to have the three dose version

I am only guessing, but I think the number of recommended doses was revised downward, so there was never a need for the third dose. Sorry for the fever and vomiting, I hope it didn't happen every time. I see that fever or vomiting happens to 8% of the people, but it does give pause to getting the series on vacation, say while vacationing in Israel for an upcoming trip to Nepal, if it ruins vacation days. 2 previous vaccines, Shingles (Shingrix) and Moderna covid put me in bed and out for the day.

Posted by
1274 posts

I’m newly returned from Botswana and as our previous rabies protection had run out we decided to have fresh anti rabies injections, three of them, before we left. It was expensive and while they were administered by the NHS, we had to pay privately for them. Not sure how much exactly they were because we also opted to update our Yellow Fever protection and Hepatitis as well. We might have got away without rabies and Yellow Fever injections as it turned out, but we figured it was sensible to take a ‘belt and braces’ approach.

Ian