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Table. Completing rabies post-exposure prophylaxis in Australia that started overseas

These scenarios assume the person had not received pre-exposure prophylaxis before the exposure. For more details, see Figure. Rabies post-exposure prophylaxis: terrestrial animal exposures or Figure. Rabies post-exposure prophylaxis: bat exposures.

Overseas scenario	Rabies vaccine schedule (with or without HRIG) in Australia
Person received nerve tissue–derived vaccine	Restart schedule, starting at day 0 Give HRIG immediately if indicated. If rabies vaccine was given within the previous 7 days, give HRIG in different limb to that which the vaccine was given.
Use of vaccine or RIG is unsure or unknown, or documentation is poor.	Restart schedule, starting at day 0 Assume that RIG has not been given. If HRIG is indicated, give immediately if still within 7 days (168 hours) of receiving 1st dose of vaccine (even if uncertain). Give HRIG in a different limb to the vaccine.
Person is immunocompromised, and vaccines were administered intradermally	Regardless of number of previous doses, give a 5-dose schedule intramuscularly. Check serology 2–4 weeks after final dose Give HRIG immediately if still within 7 days (168 hours) of receiving 1st intradermal dose of vaccine while overseas. Give HRIG in a different limb to the vaccine.
Scenario is well documented. Person received 2 vaccine doses given intradermally on day 0 (IPC/TRC regimens). RIG (equine or human) may or may not have been administered at same time as 1st dose of vaccine	Give a further dose intramuscularly on day 3, day 7 and day 14 If HRIG is indicated, give immediately if still within 7 days (168 hours) of receiving 1st dose of vaccine. Give HRIG in a different limb to the vaccine.
Scenario is well documented. Person received 2 vaccine doses given intradermally on each of day 0 and day 3 (IPC/TRC regimens). RIG (equine or human) may or may not have been administered at same time as 1st dose of vaccine	Give a further single dose intramuscularly on day 7 and another dose on day 14 If HRIG is indicated, give immediately if still within 7 days (168 hours) of receiving 1st dose of vaccine. Give HRIG in a different limb to the vaccine.
Scenario is well documented. Person received 2 vaccine doses given intradermally on each of day 0, day 3 and day 7 (IPC/TRC regimens). RIG (equine or human) may or may not have been administered at same time as 1st dose of vaccine	Give a further single dose intramuscularly on day 14
Scenario is well documented. Person received a vaccine dose given intramuscularly on each of day 0 and day 3 (Essen/modified Essen regimen). RIG (equine or human) may or may not have been administered at same time as 1st dose of vaccine	Give a further dose on day 7 and day 14 (modified Essen regimen). If the person is immunocompromised, give an additional dose on day 28 If HRIG is indicated, give immediately if still within 7 days (168 hours) of receiving 1st dose of vaccine. Give HRIG in a different limb to the vaccine.
Person received 2 vaccine doses given intramuscularly on day 0 (Zagreb regimen). RIG (equine or human) may or may not have been administered at same time as 1st dose of vaccine	Give a further dose on day 7 and day 21 (Zagreb regimen). If the person is immunocompromised, give an additional dose on day 28 If HRIG is indicated, give immediately if still within 7 days (168 hours) of receiving 1st dose of vaccine. Give HRIG in a different limb to the vaccine.
Footnotes: HRIG = human rabies immunoglobulin; IPC/TRC = Institut Pasteur du Cambodge/updated Thai Red Cross; PEP = post-exposure prophylaxis; RIG = rabies immunoglobulin

Page history

Last updated

9 October 2024

Last reviewed

9 October 2024

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