HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Rabies

default
Posted on Mon, 28 Aug 2017
Question: I recived rabies post exposure treatment for an incident where my dog got a hold a of an animal an I had to pull it out of his mouth.

1. on day 0 I received the vaccine and the HRIG unfortunately they made a mistake and put it in the same muscle the left deltoid. This error was not caught until after my second shot on day 3 also in the left deltoid.

On day 4 the doc decided to start my shots over. However he put them in the quadriceps muscle right above the knee because it was a different muscel than the HRIG was put in (the HRIG was put in both delts and the outside of the thigh.

My next shot was also in the quad above the knee, my third shot was in the right dekt because the doctor said they can move back to the delt because it has been long enough since the HRIG was given. My 4th shot on the new series will be tomorrow in the deltoid muscle. So I have had 6 shots in total: Day 0 left delt (same place as HRIG) day 3 left delt, then error was caught and started over. Day 0 (or 4) left quad right above the knee. Day 3 (or 7) left quad right above the knee. Day 7 (or 10) right delt and tomorrow will be day 14 (or 17) right delt

my questions are

1. are my first 2 shots invalid, I figure the first one for sure is but is the second one?

2. are shots in the quad muscle ok, the doc said they were

3. Is it ok to move back to the delt for the rest of the shots?

4. I will have gotten six shots in total is that a problem?

5. Should I get the extra shot at 28 days just in case because they messed up, tm is supposed to be my last shot.

6. AM I contagious to any one in the family, can I kiss my wife and kids.

7. will this protect me from rabies now and long term, this messed up schedule
doctor
Answered by Dr. Dr. Monika Dede (3 hours later)
Brief Answer:
Please see the detailed answer below.

Detailed Answer:
Hello,
Thank you for writing in HealthcareMagic.

You should know that it is recommended that the full dose of HRIG should be infiltrated around any wound and any remaining volume should be administered IM at an anatomical site distant from vaccine administration because neutralization of rabies vaccine may occur if HRIG and rabies vaccine is administered into the same injection.

1. The 2 shot in the left deltoid is not invalid.

2. Yes, the rabies vaccine could be applied in quadriceps muscle (anterolateral area of the thigh).
3. Yes, it is normal to apply the rest of vaccination in the deltoid.

4. Usually, is recommended to get 4- 5 doses of rabies vaccine but I think it is not a problem to get 6 doses since those vaccines contain inactivated rabies virus.

5. I think the last dose in 28 days is not necessary because usually the 5th dose on day 28 may be recommended for immune compromised persons.

6. After applying of HRIG and anti-rabies vaccination you are not contagious and can kiss your wife and children because contact with someone who is receiving rabies vaccination does not constitute rabies exposure and does not require post exposure prophylaxis.

7.After this post exposure application you should know that if you are exposed to rabies again, you should receive only two IM doses of vaccine, one immediately and one three days later and it is not necessary to apply HRIG.

I hope my answer helps you.
Regards.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Dr. Monika Dede (4 hours later)
The problem was they spread the HRIG all over because the wound was on my little finger.

Then they put the HRIG and the vaccine in the same muscle left deltoid, that's why the started over.

So my second shot in the left delt 3 days after the HRIG was put in the same delt was good because three days had past?

Since the started over on day 4 (vaccine only) you don't see any problems with it?
doctor
Answered by Dr. Dr. Monika Dede (11 hours later)
Brief Answer:
Please see the detailed answer below.

Detailed Answer:
Hello,
Thank you writing back.

Yes applying the second shot in the same place , 3 days after HRIG it is not a problem. It is a problem when you apply them in the same time.

Since you did HRIG on Day 0 you have antibodies to fight the virus at present and it's not a problem that a late vaccination has started.

I hope my answer helps you.
Regards.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Dr. Monika Dede

Infectious Diseases Specialist

Practicing since :2003

Answered : 1005 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Rabies

Brief Answer: Please see the detailed answer below. Detailed Answer: Hello, Thank you for writing in HealthcareMagic. You should know that it is recommended that the full dose of HRIG should be infiltrated around any wound and any remaining volume should be administered IM at an anatomical site distant from vaccine administration because neutralization of rabies vaccine may occur if HRIG and rabies vaccine is administered into the same injection. 1. The 2 shot in the left deltoid is not invalid. 2. Yes, the rabies vaccine could be applied in quadriceps muscle (anterolateral area of the thigh). 3. Yes, it is normal to apply the rest of vaccination in the deltoid. 4. Usually, is recommended to get 4- 5 doses of rabies vaccine but I think it is not a problem to get 6 doses since those vaccines contain inactivated rabies virus. 5. I think the last dose in 28 days is not necessary because usually the 5th dose on day 28 may be recommended for immune compromised persons. 6. After applying of HRIG and anti-rabies vaccination you are not contagious and can kiss your wife and children because contact with someone who is receiving rabies vaccination does not constitute rabies exposure and does not require post exposure prophylaxis. 7.After this post exposure application you should know that if you are exposed to rabies again, you should receive only two IM doses of vaccine, one immediately and one three days later and it is not necessary to apply HRIG. I hope my answer helps you. Regards.