Rabies vaccine shortage: advice for health professionals

Important advice on rabies vaccine shortage for health professionals

• This updates the news item of 13 December 2023

Rabies is a vaccine-preventable viral disease spread mostly by contact with saliva from any rabies-infected wild or domestic animal, via a bite, scratch, lick to an open wound or with the eyes, mouth or nose (mucous membranes).

Bats can also carry rabies, including in the United Kingdom (UK) [1].

In humans, rabies is almost always fatal, once symptoms develop [1, 2]. Rabies can be prevented by avoiding contact with animals and seeking prompt medical attention if in contact with saliva from a rabies-infected wild or domestic animal.

Rabies vaccine may sometimes be in short supply or temporarily unavailable.

Where pre-exposure rabies vaccine products are in short supply, health professionals may need to:

• prioritise vaccine doses and schedules for those at highest risk, such as travellers to endemic areas for extended periods, young children and those who intend to have animal contact such as vets or animal handlers.
• delay vaccination for a few days until vaccine is back in stock (there is no need to restart the course). Information on interrupted vaccination schedules is available.
• consider if the traveller can complete their course when abroad.
• the ISTM Global Travel Clinic Directory provides details of clinics at travel destinations, if courses need to be completed abroad.

Verorab^® has been given a licence in Great Britain as of 1 November 2023 [3]. However, this has not yet been launched in the market and further communication is expected from Sanofi Pasteur shortly.

Travellers who are at occupational risk and cannot complete their vaccine schedule should be advised to contact their Occupational Health department/employer so they can consider additional mitigation measures that might be needed.

All at risk travellers should be counselled about animal bite avoidance measures and what to do if they are bitten, scratched or licked, regardless of whether they have received pre-exposure vaccine before travel.

A practical guide to undertaking a risk assessment of potential rabies exposures and the correct use of post-exposure treatment (PET) is available [4].