Latest Rabies Vaccination Guidelines 2023

In the rabies vaccination guidelines updated by the National Bureau of Disease Control and Prevention in 2023, there are three adjustments that are most relevant to ordinary people - secondary exposures that leave red marks without bleeding when bitten by cats and dogs no longer need to use thousands of immune globulin; in the past For people who have been fully vaccinated against rabies within six months, if they are exposed again and there is no serious bite on the head or face, they basically do not need to re-vacculate; if they are scratched and bitten by rodents and lagomorphs such as hamsters, rabbits, and chinchillas, unless there are very special circumstances, there is no need to vaccinate at all. If you happen to meet these situations, you can rest assured after seeing this. We will talk about the remaining details slowly.

Last week, I accompanied a friend to a community vaccination site to treat cat scratch wounds. I met a little girl who had just entered college. She was scratched by her own stuffed doll and had a half-centimeter-long red mark. There was no bleeding. I had read an old version of popular science and said that I need to take immune globulin, which costs more than 1,000 even if she is light. I became red-eyed on the spot. According to the new guidelines, she was a typical secondary exposure. She was only in her early 300s after taking 5 shots of the vaccine, so nothing happened. But to be honest, there are indeed many grassroots vaccination sites still using the old implementation standards. Level 2 exposures will also recommend taking egg whites. This is not meant to deceive people. After all, the grassroots are afraid of taking responsibility. If the position of your scratch and bite is in a nerve-intensive place such as the face or neck, it is okay to voluntarily take the vaccine if you feel uneasy. The guidelines also leave room for independent choice, so you don’t have to worry about right or wrong.

Some people may ask, how do I know what situation I am in? Let’s take a few common scenarios and you’ll understand: if you touch a stray cat on the road, and it doesn’t scratch or bite or leave any marks, that’s called level one exposure, and it doesn’t even require disinfection; if it bites a shallow tooth mark, scratches a red mark, and doesn’t bleed after being squeezed for a long time, it’s level two just mentioned, and you just need to be vaccinated according to the procedure; if the wound bleeds, Even if you bite a deep hole, or the wound is in a nerve-rich location such as the head, face, neck, or fingers, you need to add immunoglobulin. To put it bluntly, immunoglobulin is to directly inject ready-made antibodies around the wound to block the path for the virus to travel to the nerves. If you are not at that risk level, there is really no need to spend this money.

Speaking of this, I have to mention the ten-day observation method that everyone has been arguing about for several years. Many people have said before that "the ten-day observation method is foreign and not suitable for China's national conditions where there are many stray animals." In fact, the new guidelines have clearly stated: If the dog or cat that bites you is a domesticated cat or dog that has been vaccinated against rabies for two consecutive years as required, you can take the first dose of vaccine while observing the animal's condition. If it is alive and kicking without getting sick within 10 days, you don't need to take the remaining shots. This is a plan recognized by the WHO and our national disease control, so there is really no need to worry. Of course, if the dog that bites you is a stray cat or dog that cannot find its owner, and you cannot observe it for 10 days, it is safer to follow the procedures and complete the treatment. After all, once rabies occurs, the mortality rate is 100%, so there is no need to bet on that probability. When I was a volunteer for disease control in the past two years, I encountered a case where a young man was bitten by a stray dog ​​and thought it was fine, but did not get an injection, and finally became ill. This is a pity.

There are a few misunderstandings that people ask a lot about: Some people say that pregnant women, children, and lactating women cannot get rabies vaccines? Don’t believe it, this is an inactivated vaccine, which is completely safe for special groups of people. The guide clearly states that there are no contraindications for vaccination. It really means don’t delay because of this. Also, should you hit someone if you get bitten? Unless the person biting you is definitely a confirmed rabid patient, don't use it at all. Don't get the shot in vain. Not to mention if you are bitten by a snake, you need to take snake venom serum, which has nothing to do with the half cent of rabies vaccine.

As for the vaccination procedures, the two commonly used ones are actually equally effective: one is the familiar 5-injection method, with one injection each on days 0, 3, 7, 14, and 28; the other is the "2-1-1" procedure, one injection in each arm on day 0, and one injection each on days 7 and 21. The total number of injections is two fewer trips. You can choose according to your own time, and you don't need to listen to anyone to say which one is more effective. They are all proven. If you have been fully vaccinated before, you don’t need to re-vacculate every time: if you are exposed within half a year, you don’t need to make up for it. From half a year to a year, you need to make up for 2 shots. From 1 to 3 years, you need to make up for 3 shots. After more than 3 years, you need to re-vacculate the whole course.

Finally, a little practical tip for everyone: If you are really scratched or bitten, don’t rush to take a taxi to the hospital first. First, wash the wound with soap and running water for 15 minutes, and then apply iodophor for disinfection. This step can wash away more than 90% of the virus. It is much more effective than arriving at the hospital ten minutes earlier. When you arrive at the vaccination site, don't just say "I was bitten by a dog and need to be vaccinated." Take the initiative to tell the doctor whether the animal is domesticated or stray, whether it has been vaccinated, and whether you have been vaccinated against rabies before. The more complete the information, the more suitable the plan given by the doctor will be for you, and you will spend less money and less unnecessary injections.