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Rabies intradermal booster dose doubt
Hello Doctor,
Can anyone please clarify quantity for intradermal rabies vaccine? For day 0
Also for intradermal booster dose? For day 0
I am confused!! Please help.
Answers (22)
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I am Dr. Shamoon. Your confusion is very common, so let me set out the intradermal (ID) numbers plainly. For the intradermal route the dose is fixed at 0.1 ml per site, whichever cell-culture vaccine is used - the difference between schedules is only in how many sites you get on each day, never in the volume per site. For a fresh (previously unvaccinated) exposure, the schedule now recommended in India is the Updated Thai Red Cross / IPC 2-site regimen: on Day 0 you get 0.1 ml at TWO sites, one over each deltoid - that is 2 x 0.1 ml = 0.2 ml total on Day 0 - and the same 2 sites are repeated on Day 3 and Day 7 (the IPC variant stops there; the 4-visit variant adds Day 28). For a BOOSTER, that is a re-exposure in someone who has already completed a full pre-exposure or post-exposure course previously, the answer is different and much simpler: 0.1 ml at ONE site on Day 0 and 0.1 ml at ONE site on Day 3 only. No Day 7, no Day 28, and importantly no rabies immunoglobulin is needed for a properly vaccinated person, whatever the wound category. So the short version to remember: primary ID course = 2 sites x 0.1 ml on Day 0; ID booster = 1 site x 0.1 ml on Day 0. Two practical points that trip people up: the injection must raise a visible bleb of about 8 mm in the skin - if it goes subcutaneous the dose is wasted and must be repeated at an adjacent site immediately; and an opened vial reconstituted for ID use should be used within 6-8 hours, which is why ID is done in centres running batched sessions.
Next Steps
1) Decide which situation you are in before choosing the schedule: if this is your first ever rabies course, take 0.1 ml intradermally at 2 sites (one per deltoid) on Day 0, Day 3 and Day 7. If you have completed a full course any time in the past, you only need 0.1 ml at 1 site on Day 0 and 1 site on Day 3. 2) Carry your old vaccination card to the centre - the booster shortcut is only valid if the previous course was documented and complete. 3) Get it done at an anti-rabies clinic or a district hospital ARV centre that routinely runs the ID protocol, using an insulin/1 ml syringe with a fine needle; do not let a general pharmacy improvise the ID technique. 4) Watch the injection: a raised pale bleb must appear. If it does not, ask for the dose to be repeated at once at a nearby site. 5) Category III wounds (bleeding bite, licks on broken skin, mucous membrane contact) in a never-vaccinated person also need rabies immunoglobulin infiltrated into the wound on Day 0 - vaccine alone is not enough; a previously vaccinated person taking a booster does not need it. 6) Wash the wound with soap under running water for 15 minutes and apply povidone-iodine, and check that your tetanus cover is current. 7) Do not mix routes midway - if a dose was given intramuscularly, tell the next centre so the remaining schedule is planned correctly. If you would like me to look at your vaccination card and confirm exactly which schedule and which day you are on, you can book a consult with me on Practo, or see me at Synergy Multispeciality Hospital, Miraj.
Health Tips
Never delay the Day 0 dose while sorting out the schedule - rabies is nearly 100% fatal once symptoms start, and a day lost matters more than the route chosen. Also, do not accept the intradermal route if you are on long-term steroids, chemotherapy or are otherwise immunocompromised: such patients must get the full intramuscular schedule with immunoglobulin, and an antibody titre check afterwards.
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Kindly do connect and consult for better treatment
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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4 units on each deltoid thats 0:1ml
Next Steps
If schedule not followed then consult once
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Regimen 0 3 7 and 28 day intradermal route B/L
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1 ml
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Hey Rabies Intradermal dose is 0.5ml at day 0,7,14,21
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Day 0
0.1 ml intradermally into right and left deltoid muscle
Booster also0.1 ml intrademally into rt and Lt deltoid on day 0
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For Intradermal Dose It's 0.1 Ml Per Injection Site.Given In Two Site In The Deltoid Region.
Then Booster Dose Is Given On Day O and Day 3.For Booster Dose Generally It's Given On 1 site
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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Day 0,3 booster dose.
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For Post Exposure
Intradermal Dose is 0.1 ml on 2 site (Right and left deltoid) on Day 0,3,7,28
Intradermal Booster dose is 0.1 ml on 1 site on either deltoid region on Day 0,3
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First of all we must conclude whats the category of bite You have to decide whether to begin rabies vaccine course.
Its 0.1 cc two shots one in each arm intradermal . On day 0 3 7 28 . If you have given rabies vaccine recently day 0 3 would be enough .
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Mr. Rohan Gumber
General Physician
1 yrs exp
Sri Ganganagar
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Please consult
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Do connect and consult
Will help you
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
0.1 ml on left and right deltoid
Next Steps
Do consult
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Sachin Bhiwaji Sanap
General Practitioner
8 yrs exp
Hingoli
need more information
kindly consult
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Dr. Zahra Fathima Khan
General Physician
17 yrs exp
Delhi
Please elaborate on type of bite and area of bite I.e on which part of body did the animal bite and how extensive the bite is ?
Then will decide whether only rabies vaccine or Human rabies immunoglobulin is required.
Rabies vaccine IM is given as following schedule
0,3,7,14 ,28.
Next Steps
For further assistance and any doubts please consult on PRACTO
Health Tips
Wash the area throughly with soap and running water for 10 min and clean with an antiseptic ointment immediately.
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