Rabipur inactivated rabies virus vaccine.
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Rabipur vaccine is Rabies vaccine used from humans after dog bite to prevent deadly rabies disease. This vaccine is produced by GSK Pharmaceuticals. Rabies is deadly disease and it is spread from animals to humans when infected animals bite humans. There is no cure for this disease. Death is almost certain when someone suffers from the rabies disease. Rabies vaccination is the only thing that can prevent Rabies disease. The animal can be asymptomatic at the time of the bite but may be carrying virus in the saliva. It can also spread the virus by scratch also.
This vaccine containsinactivated rabies virus (strain flury LEP) potency > 2.5 IU, host system primary chicken fibroblast cell cultures. Other ingredients include TRIS-aminomethan, sodium chloride, EDTA, potassium L glutamate, polygeline, saccharose water for injections.
In which form Rabipur vaccine is available?
The vaccine is available in form of freeze dried powder and sterile water for injection. The sterile water for injection is available in separate vial. The packet includes sterile disposable syringe for injection and a sterile needle. The powder freeze dried is available in separate vial. It is packed in opaque box to protect it from light.
How is Rabipur vaccine stored?
Rabipur vaccine is stored at temperature range 2 – 8 degree Celsius as recommended by manufacturer. The temperature range is maintained at all stages of transport and storage using cold chain. The temperature range should be strictly maintained. If frozen accidentally should not be used.
How to reconstitute Rabipur vaccine?
Sterile water available with the freeze dried powder is first mixed with freeze dried powder. It is agitated gently for some time. Then the constituents are mixed evenly. When the mixture is made even and looks transparent should be sucked back in to the syringe. The reconstituted mixture should be used as soon as possible after reconstitution to retain the potency of the vaccine.
How is Rabipur vaccine given?
Rabipur vaccine is given by injection. In small children it is given on thigh anterolateral aspect. In adolescents and adult it can be given in the deltoid muscle. The injection can be given by intradermal route. Intradermal route needs less dose and efficacy almost similar to intramuscular route. All the safety injection precautions are to be taken while injection. The disposables are discarded as per the biomedical waste management protocols. The expired vaccine should not be used and discarded as per biomedical waste management protocol to protect the environment.
What is schedule for Rabipur vaccine?
For post exposure prophylaxis following schedule is recommended for the injection. The need of Rabieshield vaccine together depends upon the category of bite wound.
|Category||Type of contact||Type of exposure||Recommended post exposure prophylaxis|
|I||Touching or feeding of animalsLicks on intact skin||None||None if reliable case history is available.|
|II||Nibbling on uncovered skinMinor scratches or abrasion without bleeding||Minor||Wound management and antirabies vaccine.|
|II||Single or multiple trans-dermal bites or scratches, licks on brocken skinContamination of the mucous membrane with saliva.||Severe||Wound management + Antirabies immunoglobulin + Antirabies vaccine|
- For intradermal route, four doses should be administered 2 injections of 0.1 ml at 2 different sites as per the updated thai red cross regimen (2-2-2-0-2) as given above.
- In those previously immunized by complete vaccination schedule (pre or post exposure prophylaxis) 2 doses of 1ml given by intramuscular route or 2 doses of 0.1 ml by intradermal route on day 0 and 3 are recommended.
- In cases of category 3 exposures and of category 2 exposure in immunodeficient patients, human rabies immunoglobulin or equine rabies immunoglobulin should be given with Rabivax S vaccine.
- If rabies immunoglobulin is not available at the time of first vaccination, it must be administered no later than 7 days after the first vaccination since later administered would result in interference with immune response of the vaccine
|Route||Dose||Number of doses||Schedule|
|Intramuscular||1 ml||5||Day 0, 3, 7, 14 and 28|
|Intradermal||0.1 ml+0.1 ml||4||Day 0, 3, 7 and 28|
For Pre exposure prophylaxis following schedule is used for the injection.
- Periodic booster injections are recommended as an extra precaution only for people whose occupation puts them at continual or frequent risk of exposure.
- For people who are potentially at risk of laboratory exposure to high concentrations of live rabies virus, antibody testing should be done every 6 monthly.
- Those professional who are not continual risk of exposure through their activities, should have serological monitoring every 2 years. Vaccine induced immunity persists in most cases for years, a booster should be administered if rabies virus neutralizing antibody titres fall to < 0.5 IU/ml.
|Route||Dose||Number of doses||Schedule|
|Intramuscular||1 ml||3||Day 0,7, 21 or 28|
|Intradermal||0.1 ml||3||Day 0,7, and 21 or 28|
What are side effects of Rabipur vaccine?
Rabipur vaccine prevents deadly rabies disease. Compared to disease in which death is certain with no cure the side effects of vaccine are mild and minimal.
- Injection site pain and swelling.
- Abdominal pain.
Like all other vaccines this may cause the anaphylaxis reaction and should be given at facility where necessary drugs and skilled personnel to manage the anaphylaxis is available. The anaphylaxis is very rare side effect to occur after vaccination like all other vaccinations.
Considering the life threatening nature of the rabies disease it is beneficial to use this vaccine in pregnancy and lactating mothers where the exposure is for sure happened or suspected.