What Are The Possible Repercussions Of Taking Rabies And HRIG Vaccines Same Day?

Posted on Thu, 12 May 2016

Thu, 12 May 2016 Answered on

Thu, 23 Jun 2016 Last reviewed on

Question : I was given vaccin for Rabies on Monday in Cairo Egypt. Today (Wednesday), after searching almost all over the city and around 48h later sort of, I was given HRIG. However the HRIG was given at the same anatomical site as the first vaccin (while I read so that this should not be done). Also the HRIG dose was too low, the doctor gave me 5ml while I at least should have had 10ml. What should I do know and how bad is it that the HRIG and first vaccin were given at the same site?

Answered by Dr. Ivo Ditah (1 hour later)

Brief Answer:
Take the process all over again!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this mix up. I will suggest you allow a one month interval and start this process of vaccination all over. However, I will like to know why you were receiving both HRIG and the vaccine at the same time. Were you beaten by a dog? Exposed to Rabies? As this might change the approach. Keep me posted.

I hope this helps. I wish you well. Feel free to ask for more information and clarifications if need be.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (23 minutes later)

Thank you for your answer.

I was scratched by a stray cat, a bleeding wound, and this contact was the reason why I started the process of vaccination. I dont think the cat has some form of Rabies but because it is a stray cat and in Egypt I don't want to take any risk.

I have read somewhere that HRIG can be given in the same anatomical site after 48hours when the first vaccin was given? Is this correct?

And what are the risks of all these mix-ups?

Thanks and Best in any case.

Answered by Dr. Ivo Ditah (57 minutes later)

Brief Answer:
NO risk but for the fact that the vaccin might not work fully!

Detailed Answer:
Hi,

There is no risk to health. My only concern is that the vaccin might not work as projective because the antibodies can right away neutralise the virologic particles responsible for initiating a response.

Why HRIG can be administered in such a way, it is preferable to use different sites.

I wish you well.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (7 hours later)

So it doesn't matter that it was 48 hours after the first injection of vaccine?
And what should I do now? Just finish the vaccination course or start all over immediately? For me it is pretty hard to find a right doctor here in Egypt who understands English or even heard of HRIG so now I am a bit confused what to do.

Answered by Dr. Ivo Ditah (7 hours later)

Brief Answer:
To me, start all over and complete the vaccination series!

Detailed Answer:
Hi and thanks for this follow up.

As for me, start the vaccination all over from zero and get the three doses as recommended on Day 1, Day 7 and day 21/28. It is better to be aggressive at vaccinating that being approximative.

I wish you well and keep me posted.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (6 hours later)

Thank you for your answer.
I am not completely sure if I know what you mean.

You mean start over as in 0 3 7 14 28 right?!
That was the schedule that was presented to me the first time.

And no HRIG anymore?!

Answered by Dr. Ivo Ditah (13 hours later)

Brief Answer:
HRIG will no longer be of major help now. Embark on vaccination rather!

Detailed Answer:
Hi,

I recommend vaccination only at this time. The schedule is day1, day7 and day21 0r day 28 for full vaccination.

I wish you well and hope this addresses your query.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (22 hours later)

But I thought the 1-7-21-28 was for the pre-vaccination and the 0-3-7-14-28 for after an incident with an animal as in this case maybe??

Answered by Dr. Ivo Ditah (13 minutes later)

Brief Answer:
Right now, am proposing prevention ONLY!

Detailed Answer:
HI,

The above plan is purely for vaccination. I have put aside the exposure you mentioned. It’s been a good number of days and I will rather follow the vaccination. Three vaccines are needed and not 4. it is either 21 or 28 and not both.

I wish you well.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar