Australians travelling overseas who are exposed to a potentially rabid animal (including bats from any country) may receive post-exposure prophylaxis using cell culture–derived vaccines and schedules that are not used in Australia.

If the person received an older nerve tissue–derived rabies vaccine, do not regard these doses as valid. This is a very rare circumstance. See Table. Completing post-exposure prophylaxis in Australia that started overseas.

If a person received either a chick embryo–derived or a cell culture–derived vaccine overseas, they are recommended to continue the standard post-exposure prophylaxis regimen in Australia with either human diploid cell vaccine or purified chick embryo cell vaccine. See Interchangeability of rabies vaccines.

Table. Rabies vaccines available globally, and compatibility with vaccines registered in Australia
Rabies vaccine Vaccine information Compatible
Human diploid cell vaccine (HDCV)

Imovax, Sanofi Pasteur SA

Kanghua Rabies, Chengdu Kanghua Biological Products China

Yes
Purified chick embryo cell vaccine (PCECV)

RabAvert, GSK

Vaxirab-N, Cadila Healthcare India

Yes
Purified Vero cell vaccine (PVCV)

Rabivax, Serum Institute India

SPEEDA, Chengda Bio China

Verorab, Sanofi Pasteur

Abhayrab, Human Biologicals Institute India

Indirab, Bharat Biotech India

Yes
Purified duck embryo vaccine (PDEV)

Lyssavac, Cadila Healthcare India

Vaxirab, Cadila Healthcare India

Yes
Primary Syrian hamster kidney cell vaccine (PHKCV) Local producers in China Yes
Baby hamster kidney cell vaccine (BHKV) Kokav, Russia Yes
Suckling mouse brain vaccine (SMBV) Used in South America No
Nervous tissue vaccine (sheep, goat) Used in Asia, Ethiopia and Argentina No

Intramuscular dosing schedules for post-exposure rabies vaccination that are approved by the World Health Organization include:

  • Zagreb regimen — 2 doses on day 0, doses on days 7 and 21 (annotated as 2-0-1-0-1)
  • Essen regimen — doses given on days 0, 3, 7, 14, and 28 or 30 (annotated as 1-1-1-1-1)
  • modified Essen regimen — doses given on days 0, 3, 7 and 14 (annotated as 1-1-1-1-0)

Intradermal dosing regimens for post-exposure rabies vaccination that are approved by the World Health Organization include:

  • Institut Pasteur du Cambodge (IPC) regimen — 2 doses on days 0, 3 and 7 (annotated as 2 2 2 0 0)
  • updated Thai Red Cross (TRC) regimen — 2 doses on days 0, 3, 7 and 28 (annotated as 2 2 2 0 2)

A person is recommended to receive HRIG (human rabies immunoglobulin) in Australia if:

If the person in Australia had their 1st post-exposure prophylaxis dose more than 7 days ago, they should not receive HRIG. However, they should still complete the appropriate number of remaining rabies vaccine doses. 

For these and other scenarios, Table. Completing rabies post-exposure prophylaxis in Australia that started overseas outlines the most common post-exposure prophylaxis regimens that may be started overseas and the recommended schedule to complete post-exposure prophylaxis in Australia.

Advise travellers that, if they start post-exposure prophylaxis while overseas, they must request a post-exposure prophylaxis certificate from the vaccination centre, and obtain or record the following information (preferably in English):

  • the contact details for the clinic attended (telephone and email address)
  • the batch and source of RIG (rabies immunoglobulin) used (some countries may use ERIG rather than HRIG)
  • the volume of RIG administered
  • the type of cell culture vaccine used
  • the vaccine batch number
  • the number of vials used
  • the route of vaccine administration 
  • the date and time of administration of RIG and/or vaccine 

These details help inform decisions about how to complete post-exposure prophylaxis when the traveller returns home.

Page history

Last updated: 
27 September 2021
Last reviewed: 
27 September 2021

Definitions

PCECV
purified chick embryo cell vaccine (rabies)
HRIG
human rabies immunoglobulin
RIG
rabies immunoglobulin