Vaxirab N vaccine ( Rabies vaccine, human IP)

Contents of Vaxirab N

Vaxirab N is a Rabies vaccine used for humans after dog bite to prevent deadly rabies disease. This vaccine is produced by Zydus.

Rabies is a 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 contains purified Rabies antigen (Rabies virus Pitman-Moore strain 3218-VERO adapted and grown on vero cells, inactivated using beta-propiolactone and sterile water for injection.

In which form Vaxirab N vaccine (Human IP) 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 pre filled syringe. The powder freeze dried is available in separate vial. It is packed in opaque box to protect it from light.

How is Vaxirab N vaccine (Human IP) stored?

Vaxirab N 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 Vaxirab N vaccine (Human IP)?

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 it should be sucked back into the syringe. The reconstituted mixture should be used as soon as possible after reconstitution to retain the potency of the vaccine.

How is Vaxirab N vaccine (Human IP) given?

Vairab N vaccine (Human IP) 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 Vaxirab N vaccine (Human IP)?

For post exposure prophylaxis, give injection in the following schedule. The need of the Rabieshield vaccine together depends upon the category of bite wound.

CategoryType of contactType of exposureRecommended post exposure prophylaxis
ITouching or feeding of animalsLicks on intact skinNoneNone if reliable case history is available.
IINibbling on uncovered skinMinor scratches or abrasion without bleedingMinorWound management and antirabies vaccine.
IISingle or multiple trans-dermal bites or scratches, licks on broken skin Contamination of the mucous membrane with saliva.SevereWound management + Antirabies immunoglobulin + Antirabies vaccine
Category of dogbite

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 Vaxirab N 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

RouteDoseNumber of dosesSchedule
Intramuscular1 ml5Day 0, 3, 7, 14 and 28
Intradermal0.1 ml+0.1 ml4Day 0, 3, 7 and 28
Post exposure prophylaxis animal bite

For Pre exposure prophylaxis following schedule is used for the injection.

Periodic booster injectios 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 months.

Those professionals 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.

RouteDoseNumber of dosesSchedule
Intramuscular0.5 ml5Day 0, 3, 7, 14 and 28
Intradermal0.1 ml+0.1 ml4Day 0, 3, 7 and 28
Pre exposure prophylaxis

What are side effects of Vaxirab N vaccine?

Vaxirab N vaccine prevents deadly rabies disease. The side effects are usually milder and usually self resolving and can be managed at home.

  • Fever.
  • Injection site pain.
  • Irritability.
  • Headache.
  • Asthenia.
  • Shivering.
  • Dizziness.
  • Myalgia.
  • Nausea.
  • Abdominal pain.
  • Arthralgia.

Like every other vaccine anaphylaxis allergic reaction can occur after this vaccine though extremely rare it should be managed swiftly. The necessary skilled personnel, drugs and equipment should be available at the time of the vaccination.

What are warnings and precautions while taking the Vaxirab N vaccine?

Corticosteroids, chloroquine and other immunosuppressive treatments can interfere with the immune response of vaccine and lead to failure of the vaccination.

Immunoglobulins must be administered at a different site from that of the vaccine.

The recommended dose of the immunoglobulin should not be exceeded nor should repeated doses of the same be administered once the vaccination course has been started since a higher dose could interfere with the immune response to rabies vaccine.

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