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Hi Doctor, My Kids Aged 5 And 3 Were Bitten

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Posted on Thu, 11 Feb 2021
Question: Hi Doctor, My kids aged 5 and 3 were bitten by dogs 48 hours ago. Yesterday, they received their first dose of anti rabies vaccine. However, the nurse administered the vaccine on the side of thigh, I think it is called lateral aspect of thigh instead of anterolateral aspect of thigh. Now, is the site of injection okay? Will the anti rabies vaccine work and start producing antibody to fight the rabies virus? Also, is the lateral aspect of thigh (side of thigh) a muscle? They didn't get fever after receiving the vaccine. Is it okay or does it mean that body hasn't absorbed the vaccine? I am very worried and scared. Please suggest. I am also attaching an image that shows the site of injection on my 5 years old son. Plaster is on the site of injection. Do let me know if you don't receive the image.
doctor
Answered by Dr. Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
Dont worry,thigh is good sight for antirabies vacc

Detailed Answer:
Hi

I have gone through the query and do understand your concern.
I won't get worried as thigh is an ideal sight for any vaccination in children including anti rabies vaccine.
Thigh has good muscle mass and unlike gluteal area fat content is very less so there is good immunogenic response following vaccination.
Antetolateral or more lateral site is acceptable. Fever following rabies vaccination is not common and it absence does not suggest that vaccine is not working.
I am sure that the concerned doctor must have assessed about the need of immunoglobulin based on site and severity of bite.
I am not able to find any attached image but I assure you that as per your description there is nothing to worry regarding the site of vaccination.
In case of any doubt please feel free to ask.
Thanks and regards


Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Pradeep Kumar Jain (53 minutes later)
Hi Doctor, I have sent the photo of the site of injection for my son to YYYY@YYYY and also wrote your name on it. Plaster is pasted at the site of injection 💉. It would be kind of you if you can check it and let me know if the site of 💉 is correct. The same site has been used for my 3 years old daughter.
doctor
Answered by Dr. Dr. Pradeep Kumar Jain (1 hour later)
Brief Answer:
Please attach the image to my mail id

Detailed Answer:
Hi
My mail id is YYYY@YYYY
thanks
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Pradeep Kumar Jain (1 hour later)
Just sent the image to your Gmail account. Please check and let me if the injection site is correct. Also, is that part where the jjection is given a part of thigh muscle? And is it called lateral aspect of thigh? I am very worried. So, kindly help me.
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Follow up: Dr. Dr. Pradeep Kumar Jain (7 hours later)
Hello doctor, Could you kindly check your email and clarify my doubts. I am very scared and worried.
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Follow up: Dr. Dr. Pradeep Kumar Jain (12 hours later)
Hi Doctor, Could you please reply to my query! I have sent the image to your Gmail.
doctor
Answered by Dr. Dr. Pradeep Kumar Jain (2 hours later)
Brief Answer:
Sorry ma'am, The message was in spam folder

Detailed Answer:
Hi Ma'am
I am really very sorry for delayed reply. I rechecked the mail and your attachment was in spam.
I have seen the image and there is no need to worry. The vaccine site is lateral aspect of thigh and the muscle is Vastas lateralis. Vastas lateralis extends from lateral to anterolateral aspect and this is the muscle where vaccines are given.
The only difference between lateral and anterolateral aspect of vastas lateralis is that the muscle is bulkier in anterolateral aspect so chances of swelling, hematoma are comparatively less. This does not have any effect in immunogenicity.

So there is no need to worry at all.
I hope this helps.
please feel free to ask if you have any doubt.
Thanks and regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Pradeep Kumar Jain (32 hours later)
Hi Doctor, Thank you for the reply. Today, was my kids date for 2nd fise if anti rabies vaccine and they took it. I told the nurse to give injection at the anterolateral aspect of thigh and she gave it. I have sent the image to your Gmail account. Please check and let me know if the site of injection is correct. Also, none of my kids got fever. Does it mean that vaccine isn't working or its fine?
doctor
Answered by Dr. Dr. Pradeep Kumar Jain (4 hours later)
Brief Answer:
This is the correct site ma'am

Detailed Answer:
Hi
I have seen the image and this is the correct site of vaccination. Slightly anterior is also acceptable.

The main reason for choosing an anterolateral site particularly in small children is the presence of good muscle mass and lack of substantial fat.

The absence of fever does not indicate that vaccine efficacy or immunogenicity is not good. In fact, fever is uncommon following rabies vaccination.

Thanks and regards

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Dr. Pradeep Kumar Jain

Pediatrician, Cardiology

Practicing since :2006

Answered : 2073 Questions

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Hi Doctor, My Kids Aged 5 And 3 Were Bitten

Brief Answer: Dont worry,thigh is good sight for antirabies vacc Detailed Answer: Hi I have gone through the query and do understand your concern. I won't get worried as thigh is an ideal sight for any vaccination in children including anti rabies vaccine. Thigh has good muscle mass and unlike gluteal area fat content is very less so there is good immunogenic response following vaccination. Antetolateral or more lateral site is acceptable. Fever following rabies vaccination is not common and it absence does not suggest that vaccine is not working. I am sure that the concerned doctor must have assessed about the need of immunoglobulin based on site and severity of bite. I am not able to find any attached image but I assure you that as per your description there is nothing to worry regarding the site of vaccination. In case of any doubt please feel free to ask. Thanks and regards