Rabies vaccination: benefits and side effects

Rabies is a life-threatening disease of the central nervous system that is fatal if it breaks out. The disease is triggered by the rabies virus, which is contained in the saliva of infected animals. In this article you will find out whether a preventive rabies vaccination makes sense for you and how you should behave in an emergency.

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In our latitudes, rabies mainly occurs in wild forest animals such as foxes. They can transmit the disease to other animals or humans through bites. However, the spread of the rabies virus could be contained considerably through the consistent rabies vaccination of domestic animals and the use of vaccine baits in European forests and risk areas. You can find out how to treat an animal bite in our guide to first aid .

In contrast to wild rabies, which is prevalent in Europe, so-called pet rabies is widespread, especially in Asian and African countries. Especially in the tropics and subtropical areas, every animal must be considered suspect of rabies. However, it is primarily stray dogs that pose a potential risk of human rabies infection in these areas.

Rabid animals become trusting and aggressive at the same time, which can be dangerous, especially when they come into contact with children. They cannot yet assess the danger posed by the affected animals and may want to pet animals that appear tame. But even adults who do not consciously approach an animal can be attacked by a rabid animal.

How can you get infected with rabies?

Rabies is mainly transmitted by the saliva of infected animals getting into the body. This can happen, for example, through animal bites. Even if a rabid animal only scratches the skin with its teeth and the wound does not bleed, rabies infection can occur. The virus can also enter the body by licking injured skin. Saliva on undamaged skin is not dangerous at first, but if it is rubbed into the mucous membrane of the eyes, it is highly contagious.

Another possible source of infection are vaccination baits laid out in the forest. These are round, brown discs about three to four centimeters in size, which are provided with an active vaccine. This means that touching the bait with broken skin can also trigger rabies.

If you suspect you may be infected with rabies, you should seek medical help immediately. The wound should also be cleaned thoroughly with soapy water and then rinsed with clear water. Disinfection with an alcoholic agent or an iodine tincture is also necessary so that the wound does not become inflamed.

What is the benefit of the rabies vaccination?

In the event of an infection with the rabies virus and in the event of a subsequent outbreak of the disease, the virus spreads via the nerve tracts and thus reaches the spinal cord and brain. There it multiplies and spreads further in the body. As the disease progresses, general symptoms such as headaches and nausea appear. A first typical sign of rabies is severe difficulty in swallowing. Later, the rapid multiplication of the virus usually leads to meningitis and finally to spasms of the whole body, which lead to respiratory paralysis. Death usually occurs from cardiovascular failure.

Once rabies has broken out, there is currently no medical treatment that could halt the progression of the disease. A rabies vaccination before the onset of the disease is therefore the only reliable protection.

How does the rabies vaccination work?

When it comes to rabies vaccination, a distinction must be made between prophylactic vaccination, which is intended to prevent disease, and vaccination after exposure to rabies, i.e. after a bite, scratch or other contact with sources of infection. For both vaccinations, however, no time intervals to other vaccinations have to be observed and they are possible for children and adults of all ages. Both methods use an inactivated vaccine that only contains parts of the rabies virus that can no longer trigger the disease.

The preventive rabies vaccination

A preventive vaccination against rabies is intended to protect certain risk groups from becoming infected with the virus. Vaccination is therefore recommended for anyone who comes into frequent contact with animals that may be ill. These include veterinarians, hunters, foresters and animal keepers. But a preventive rabies vaccination can also be useful for people in whose environment bats often appear. In addition, laboratory personnel who handle rabies viruses should consider vaccination.

Another indication for prophylactic vaccination is for people who want to travel to a country with a high rate of rabies. However, this applies primarily to a long-term stay in a risk area. Short vacation trips, especially package trips in hotels, are usually no reason for a prophylactic vaccination.

If the preventive rabies vaccination is used, the vaccinated person will be given three doses of the vaccine.

  • There should be a week between the first and the second injection, and two or three weeks between the second and the third partial vaccination.
  • Two weeks after administration of the last vaccination dose, reliable vaccination protection is usually available.
  • A booster vaccination is scheduled after about a year.

If the immunization is carried out completely, the vaccination protection lasts about two to five years. Anyone who is exposed to a permanent risk of infection should have their antibody levels checked regularly, about once a year, and refreshed if necessary.

Vaccination if rabies is suspected

Immediate vaccination is essential after an injury from a wild animal or other animal suspected of having rabies. Even if there is a mere suspicion of an infection or an apparently harmless scratch, a rabies vaccination should be arranged immediately in order to prevent the virus from multiplying and thus the outbreak of the disease. The infected person is given an active and a passive vaccination at the same time.

The active rabies vaccine contains antigens that are intended to stimulate the immune system to produce antibodies against the pathogen itself. With the passive rabies vaccination, suitable antibodies are injected directly, which intercept the virus before it spreads.

While the passive vaccination is carried out once directly after the infection, the active vaccination is carried out in six stages.

  • The first rabies vaccination is given immediately after infection. At the same time, an antibiotic is usually prescribed to prevent the inflammation of the wound. In addition, it is checked whether there is sufficient tetanus protection and this is refreshed if necessary.
  • The second partial vaccination is carried out three days later.
  • The third partial vaccination follows four days later, i.e. on day 7 after the injury.
  • The fourth vaccine dose is given 14 days after the first vaccination.
  • After another two weeks, about 30 days after the presumed infection, the affected person is vaccinated for the penultimate time.
  • 90 days after the first vaccination, the immunization against rabies is completed with the sixth vaccination dose.

If a prophylactic vaccination was already in place prior to infection with the rabies virus, this should be refreshed immediately.

Who should not get the rabies vaccine?

Prophylactic rabies vaccination should be dispensed with, at least temporarily, in certain cases:

  • If the person to be vaccinated has acute infections with a feverish course, the vaccination should be postponed until the person is completely healthy again.
  • If there is a known allergy to an ingredient in the vaccine, another vaccine should be used if possible. The same applies if severe reactions such as seizures, fainting or shortness of breath occurred with a previous vaccination.
  • In pregnant women, the risks and benefits of vaccination should be carefully weighed against each other, since the exact effects on the unborn child are not known.

Important: All these restrictions only apply to preventive rabies vaccination. After being bitten or otherwise injured by a suspect animal, vaccination is the only way to prevent the infection from becoming fatal. If an individual is suspected of having allergic shock from the vaccine, appropriate precautions should be taken in that event.

Possible side effects of the rabies vaccination

As with any vaccination, after immunization with the rabies vaccine, there may be a slight reaction at the injection site. Redness, swelling, and tenderness, as well as temporary sensory disturbances, such as tingling near the injection site, are common. Gastrointestinal complaints, fever and fatigue can also occur as a result of the rabies vaccination.

If the vaccination is boosted frequently, reactions such as a rash or brief joint problems may occur.

Especially in developing countries, outdated, unsafe vaccines are often used, which can lead to severe neurological diseases, among other things. Particular caution is therefore required when vaccinating abroad. It is advisable to ask a trustworthy doctor at the relevant embassy before a necessary vaccination.

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