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Q. I had the preexposure
rabies vaccine series when I was in Vet School. When will I need a booster
vaccination?
A. It varies with the type of
work you are doing. According to the Centers for Disease Control and Prevention
(CDC):
1. If you are a veterinarian working in an area of low rabies enzooticity
(such as Louisiana), you do not need booster vaccinations unless you know or
suspect you have actually been exposed to rabies.
2. If your veterinary work is in an area where rabies is highly enzootic
(e.g., areas where there are a lot of cases of raccoon or coyote rabies), you
should be serologically tested to make sure you have an adequate antibody titer,
or have a booster vaccination, every 2 years.
3. If you work in a rabies research lab or where you are directly and
routinely exposed to the virus, you should be serologically tested every 6
months and boosted when results indicate an inadequate antibody titer.
Q. What is considered to be
an adequate antibody titer?
A. The minimum acceptable
antibody level is complete virus neutralization at a 1:5 serum dilution by the
rapid fluorescent focus inhibition test (RFFIT).
Q. How do I get my titer
checked?
A. Contact the
Rabies
Laboratory/RFFIT, Mosier Hall, 1800 Denison Avenue, Kansas State
University, Manhattan, KS 66506-5600; 785-532–4483. Currently, they charge $25
for this test.
Q. If I've just completed the
series, should I have my titer checked to make sure the vaccine worked?
A. Because the antibody
response after the recommended 3-dose preexposure prophylaxis vaccine regimens
has been satisfactory in most people, you do not need to be tested unless you
know or suspect you are immunosuppressed. Immunosuppressed persons who are
at risk of rabies exposure should have their antibody titers checked 2–4 weeks
after completing the vaccine series.
Q. What happens if I am
exposed to rabies at some point and don’t have any idea what my titer is?
A. It doesn’t
really matter. If you are ever exposed to rabies after having previously
received a full preexposure vaccine series, the recommendations are for you to
take two intramuscular doses (1.0 ml each) of vaccine, one given immediately and
one 3 days later. Treatment with human rabies immune globulin (HRIG) is
unnecessary and should not be given; an anamnestic antibody response will
follow the administration of a booster, regardless of the prebooster antibody
titer.
If you have any other questions,
please feel free to call 225-578-9663 (office hours M-F 8-5 CST).
"Human Rabies Prevention—United States, 1999;
Recommendations of the Advisory Committee on Immunization Practices (ACIP)" is
available from the CDC.
Click here to download a pdf file.
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