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Intradermal use (ID): the recommended dose is 0.1 mL of reconstituted vaccine per injection site.
Pre-exposure prophylaxis: For pre-exposure immunisation, immunocompetent individuals can be vaccinated according to one of the vaccination schedules presented in table 1 and according to official recommendations. (See Table 1.)
Click on icon to see table/diagram/imageBooster doses are determined based on the risk of exposure and on serological tests in accordance with official recommendations.
VERORAB can be administered as a booster injection after primary vaccination with a cell culture rabies vaccine (a rabies vaccine prepared in VERO cells or prepared in human diploid cells (HDCV)).
Post-exposure prophylaxis: Post-exposure prophylaxis includes local non-specific treatment of the wound, vaccination and, where appropriate, passive immunization with rabies immunoglobulins.
Post-exposure prophylaxis should be initiated as soon as possible after suspected exposure to rabies. In all cases, proper wound care (careful washing of all bites and scratches with soap or detergent and copious amounts of water and/or virucidal agents) must be performed immediately or as soon as possible after exposure. It must be performed before administration of vaccine or rabies immunoglobulins, when they are indicated. Post-exposure prophylaxis should be adjusted to the exposure category, the condition of the animal (see Table 3) and the vaccination status of the patient, in accordance with official recommendations (see Table 2, WHO recommendations).
Post-exposure prophylaxis should be performed as soon as possible after exposure under medical supervision and only at a rabies centre.
If necessary, post-exposure prophylaxis can be supplemented by tetanus prophylaxis and antibiotic therapy to prevent the development of infections other than rabies. (See Tables 2 and 3.)
Click on icon to see table/diagram/image
Click on icon to see table/diagram/imagePost-exposure prophylaxis of non-immunised subjects: Non-immunised subjects may be vaccinated according to one of the vaccination regimens by intramuscular use (IM) or by intradermal use (ID) presented in Table 4.
In all cases, refer to the local official recommendations. (See Table 4.)
Click on icon to see table/diagram/imageWhatever the regimen used, vaccination must not be discontinued unless the contact animal is declared free from rabies after veterinary supervision (see Table 3).
Rabies immunoglobulins should be administered concomitantly with the vaccine, in case of category III exposure (WHO classification, see Table 2). If possible, the vaccine should be administered contralaterally to the immunoglobulin administration sites.
Refer to the Summary of Characteristics of the rabies immunoglobulins used.
Post-exposure prophylaxis for already immunised subjects: In accordance with official recommendations, this applies to subjects who have already received pre exposure prophylaxis or post-exposure prophylaxis or who discontinued post-exposure prophylaxis after receiving at least two doses of vaccine prepared in cell culture.
Subjects who have already been immunised must receive 1 dose of vaccine (0.5 mL intramuscularly or 0.1 mL intradermally) on D0 and 1 dose on D3.
Alternatively, 4 intradermal injections of 0.1 mL may be administered in 4 separate sites on D0.
Rabies immunoglobulins are not indicated in this case.
Immunocompromised subjects: Pre-exposure prophylaxis: In immunocompromised subjects, antibodies conventional three-dose regimens should be used (see table 1) and blood tests for neutralising antibodies should be performed 2 to 4 weeks following the last dose of the vaccine to assess the possible need for an additional dose of the vaccine.
Post-exposure prophylaxis: In immunocompromised subjects, a complete vaccine regimen should be administered (see table 4). Rabies immunoglobulins should be administered concomitantly with the vaccine in the event of any category II or III exposure (see table 2).
Paediatric population: Children should receive the same dose as adults (0.5 mL intramuscularly or 0.1 mL intradermally).
Method of administration: Intramuscular use (IM): The vaccine is administered via the intramuscular route, in the anterolateral region of the thigh muscle in infants and young children and in the deltoid muscle in older children and adults.
Intradermal use (ID): The vaccine should ideally be ad ministered in the upper arm or the forearm.
Do not inject in the buttocks region.
Do not inject via the intravascular route.
Precautions to be taken before handling or administering the medicinal product.
For instructions on reconstitution of the medicinal product before administration, see Special precautions for disposal and other handling under Cautions for Usage.
