Verorab Inactivated rabies virus vaccine developed on Vero cell culture.
Verorab is Rabies vaccine used from humans after dog bite to prevent deadly rabies disease. This vaccine is produced by Sanofi Pasteur. 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.
Rabies virus, WISTAR Rabies PM/WI38 1503-3M strain (inactivated) > 2.5 IU It is produced in vero cells.
Powder: maltose, 20% human albumin solution, Basal Medium Eagle (mixture of mineral salts, vitamins, dextrose and amino-acids including L-Phenylalanine), water for injections.
In which form Verorab 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 to store Verorab vaccine (Human IP)?
Store Verorab at temperature range 2 – 8 degree Celsius as recommended by manufacturer.
Maintain the temperature range at all stages of transport and storage using cold chain. Strictly maintain temperature range. Discard if frozen accidentally
How to reconstitute Verorab 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 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 Verorab vaccine (Human IP) given?
Give Verorab vaccine (Human IP) by injection.
In small children, give it on thigh anterolateral aspect.
In adolescents and adult, give it in the deltoid muscle.
Intradermal route needs less dose and efficacy almost similar to intramuscular route.
Follow all the safety injection precautions while injection.
Discard the disposables per the biomedical waste management protocols.
Do not use expired vaccine and discard it as per biomedical waste management protocol to protect the environment.
What is schedule for Verorab vaccine (Human IP)?
For post exposure prophylaxis, give injection in following schedule. 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, Administe 4 doses, 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), give 2 doses of 0.5 ml by intramuscular route or 2 doses of 0.1 ml by intradermal route on day 0 and 3.
- 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 Verorab vaccine.
- Do not administer immunoglobulin 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||0.5 ml||5||Day 0, 3, 7, 14 and 28|
|Intradermal||0.1 ml+0.1 ml||4||Day 0, 3, 7 and 28|
Give pre exposure prophylaxis for:
- Give Periodic booster injections 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 professionals who are not continual risk of exposure through their activities, should have serological monitoring every 2 years.
- Administer a booster, if rabies virus neutralizing antibody titres fall to < 0.5 IU/ml.
|Route||Dose||Number of doses||Schedule|
|Intramuscular||0.5 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 Verorab vaccine?
Verorab vaccine prevents deadly rabies disease. The side effects are usually milder and usually self resolving and can be managed at home.
- Injection site pain.
- Abdominal pain.
- Like every other vaccine anaphylaxis allergic reaction can occur after this vaccine though extremely rare I should be managed swiftly. The necessary skilled personnel, drugs and equipment should be available at the time of the vaccination.
What are warning and precaution while taking Verorab vaccine?
- Corticosteroids, chloroquine and other immunosuppressive treatments can interfere with the immune response of vaccine and lead to failure of the vaccination.
- Administer immunoglobulins at different site than that from vaccine.
- Do not exceed recommended dose of immunoglobulin.
- Do not administer repeated doses of the immunoglobulins once the vaccination course has been started.
- Higher dose of immunoglobulin could interfere with the immune response to rabies vaccine.
- The person who is hypersensitive to neomycin may get anaphylaxis reaction with this vaccine though it contains very small amount of neomycin. The vaccine should be given with precaution in such person as rabies is deadlier.