Stay Awesome
Rabies (my personal favourite vaccine)
Find most of the information you need in these resources
Always refer to your local signed PGD's in practice, and remember the Green Book takes priority over the SPmC - and sometimes WHO takes priority over the Green Book! They don't always say the same!
Keeping up to date: Things to know in practice currently:
31st July 2026: Be aware that falsified rabies vaccine is circulating through unauthorised sources in Philippines
21st July 2026: Rabies Post Exposure Guidance updated: Advisory notices have been raised by the Philippines FDA regarding the distribution of falsified rabies vaccines in the Philippines. The falsified vaccines were relabelled as Speeda and Vaxirab-N vaccines. The UKHSA is undertaking a review of the records of individuals who have received rabies vaccine as part of their PEP course in the Philippines, and is in the process of contacting GPs if their patients are recommended to receive additional vaccines to complete their PEP. Anyone with concerns about a patient who may have received falsified rabies vaccine in the Philippines can contact RIgS for further advice.
2nd July 2026: The extremely sad case of the 11 year old boy who died of rabies in Canada when he woke up to a bat on his face, has featured a lot in the news lately. The incident happened in 2004 but the full case report has just been published in a journal recently which is why it is getting a lot of news attention.
19th June 2026: Rabies post exposure risk assessment form and calendar updated to V7. Note the phone number change.
10th April 2026: Rabies advice from NaTHNaC amidst the shortage... one of the recommendations is to consider an alternative licensed regime (I.E. 0,7d). A sensible approach from an immunity perspective. Lots of evidence for two dose schedules - but remember to check out the blog I wrote (linked below) before considering it as a 'standard' approach in times of plentiful supplies.
16th March 2026: Scientists turn mosquitoes ‘into a vaccination tool’ to immunise bats against rabies
13th March 2026: Vaccinating bats could be good for people. But how do you vaccinate a bat?
1st March 2026: Stray dogs in Egypt have been vaccinated in an anti-rabies campaign. So far, 13,000 dogs have been vaccinated since January.
27th Feb 2026: Two-dose or not two-dose? That is the question. I wrote a quick rabies-related blog this evening and I'm dedicating it to lovely Fiona who was on my course today and raised this interesting topic.
8th Dec 2025: US Man Dies From Rabies After Receiving Infected Kidney. So sad that the thing that saved his life then went on to kill him.
3rd Nov 2025: Falsified rabies vaccine is circulating through unauthorised sources in India. What a thing to falsify!!! WHY??? The public health agencies in the four nations of the UK are conducting a look-back exercise to identify any travellers who reported receiving rabies vaccine following an animal bite in India from November 2023 onwards, to determine whether further rabies vaccination may be recommended. In England, Wales and Northern Ireland, the traveller's GP will be informed by public health agencies if additional vaccination is recommended. In Scotland any identified traveller will be referred to local assessment pathways for further assessment and management. Travellers who received pre-exposure rabies vaccine in India during this period should contact their GP or travel clinic for advice on whether more vaccine is required. Travellers in Scotland should call NHS24 on 111 or their local GP.
19th October 2025: Plantation worker dies of rabies in Bintulu, fifth fatal case in Sarawak in 2025
3rd Oct 2025: Rabies Cases in Bali Reach 49,000 in 2025, 12 Deaths
28th September 2025: HAPPY WORLD RABIES DAY! And why is it world rabies day? 28th September also marks the anniversary of Louis Pasteur's death, the French chemist and microbiologist, who developed the first rabies vaccine. RIP Louis and thank you for starting us off on the journey to development of the fabulous rabies vaccines!
4th September 2025: Rabies post exposure risk assessment form and calendar updated with new immunoglobulin batch number, vial volume and expiry date.
14th August 2025: Update to this page: Guidance, Rabies and Immunoglobulin Service (RIgS). Did you know? In 2024 there were 4,743 calls related to rabies prophylaxis or post-exposure treatment.
22nd July 2025: Oh no! My favourite post-exposure patient has died. RIP Ozzy. (at least it wasn't rabies that got him). Did Ozzy Osbourne really bite the head off a live bat?
Rabies fears rise in Indonesia’s Bali as tourist hotspots declared ‘red zones’
17th July 2025: Really useful blog: Understanding the risks and management of rabies exposure for UK travellers
27th June 2025: Interim recommendations for the use of human rabies immunoglobulin were issued. These recommendations supersede guidance on the use of rabies immunoglobulin within the UKHSA guidelines on managing rabies post-exposure treatment. The current guidance on use of rabies vaccine for post-exposure treatment remain the same. It seems the recent UK death has prompted a bit of a surge in inquiries for PET so the RIG will have to be managed tightly.
23rd June 2025: MORE rabies in BBC news.... Rare rabies-like virus found in island bat on the on the Isle of Wight.
18th June 2025: So sad, and so avoidable. A Yorkshire lady has died of rabies after a holiday in Morocco and an unfortunate and seemingly benign run in with a puppy. This NaTHNaC factsheet comes at a good time: Worldwide rabies risk reminder
4th June 2025: Note the contact number has changed for the rabies immunoglobulin service.
3rd Feb 2025: Rabies post-exposure risk management forms updated - added information on Zimbabwean rabies vaccine alert. See the related NaTHNaC advice here.
22nd Jan 2025: The Medicines Control Authority of Zimbabwe announced that falsified rabies vaccine is circulating through unauthorised sources in Zimbabwe. They report this falsified product poses a significant threat to public health due to the possibility of lack of efficacy, harmful components and the risk of treatment failure in preventing rabies, a fatal disease.
1st Jan 2025: With effect from 1st January 2025, the responsibility for the marketing and distribution of Rabipur transitions from Valneva to Bavarian Nordic, in partnership with Polar Speed Distribution. I wonder if this means there may be some shortages of rabies vaccines ahead as often is the case when transitions are happening...
AUGUST 2024: Worth looking at this advice about rabipur reconstitution before ordering in the supplies THAT ARE NOW AVAILABLE TO ORDER AGAIN!! Yay!
(Do check out the product alert though)
Note that both Rabipur and Verorab SPC's include provision for two dose primary schedules (0, 7d).
Cautionary tales
Man succumbs to dog bite after failing to get vaccination in south-central Vietnam. The man did not get vaccination against rabies after being bitten by a strange dog
27-Year-Old Man Dies Of Rabies After Stray Dog And Cat Bites In Kalyan; Delayed Vaccine Blamed
Another very sad (and likely preventable) death: Canadian child dies from rabies after bat found in bedroom.
Another death 2 months after a bat contact in Minnesota at the end of September: Minnesota reports rare human death from rabies.
Another cautionary tale here of a man who died (also in Vietnam) after failing to be vaccinated.
Don't forget about BATS which this article shared by the BGTHA highlights nicely. Campers beware!
Woman in Delhi NCR dies of rabies, within days after drinking milk from infected cow.
After Michigan patient dies of rabies from a transplanted kidney, donor's other recipients get preventive shots
Dad dies after being bitten by bat as he tried to free it from his home
Canadian boy, 11, dies of rabies after waking to bat on his face
Could my job have saved my life? My experience as a post-exposure rabies case.
Watch an interview here about the sad case above.
Other useful links and further reading:
Animal bites - some gruesome pics - beware!
This was a revealing observational study published in TMAID in 2024, which really makes one think about the importance of rabies advice. It's a good read: Rabies knowledge gaps and risk behaviour in Dutch travellers: An observational cohort study
This free webinar from the ISTM is a good watch Rabies in Travelers: Deadly but Preventable and this is available on the ISTM YouTube channel (9th October 2024)
Very enlightening survey concluding that awareness and perception of rabies risk, and lack of consistent HCP discussion of the need for rabies PrEP may be major barriers to uptake of the vaccine for patients who are eligible to receive it.
Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand. Conclusions: Over half of the international travellers in this study delayed initiating rabies vaccine or immunoglobulin after potential rabid animal exposure. Some even DECLINED IT. As rabies is a fatal yet preventable disease, this review underscores the urgent need to raise awareness about the importance of prompt post-exposure management. Strengthening traveller education and advocating for pre-exposure immunisation are critical strategies to mitigate risks and improve outcomes.
Podcast episode: Unravelling Rabies
Delayed and incomplete rabies post-exposure prophylaxis among international travelers: A seven-year retrospective study at an emergency center in eastern Thailand, In this study, a large proportion of international travelers had delayed or incomplete PEP for rabies. The patient's age and wound characteristics and the animal type were key factors that influenced PEP adherence. These findings highlight the need for targeted interventions to improve adherence to rabies PEP among international travelers in regions where rabies is endemic.
Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand. If you are short of time to read, the take home message is that most travellers only thought about rabies after an animal had a nibble—nearly 60% had serious exposures before seeking help.
Delays in treatment were common, with many missing that all-important window for immunoglobulin. And despite the risks, barely 1 in 10 got the jab before they flew—so let’s shout louder about PrEP before people pack their bags!
Real-world experiences and challenges in rabies postexposure prophylaxis
Comment on Beyond the guidelines: real-world challenges in rabies post-exposure prophylaxis
Bits and bobs to casually drop into conversation
Did you know....
Ozzy Osborne received post-exposure rabies vaccines after biting the head off a dead bat during a live gig (just to ruin his street cred - he actually thought it was plastic and was horrified to learn it was real as soon as he tasted blood! eek)
It's NOT just spread by dogs!
It's NOT just spread by rabid-looking animals
It's ALWAYS fatal - one of the most deadly diseases we have
Vaccines are pretty much 100% effective!! What a great investment for health
"Not so cute and fluffy now" A webinar with some information about rabies and post exposure treatment. May 2024
