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Demand for preexposure rabies vaccine remains unmet
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Physicians and public health authorities should continue to educate the public on appropriate precautionary measures to avoid rabies exposure while vaccine supplies for preexposure prophylaxis remain limited.
“A variety of health educational materials are available in each state health department, as well as at the national level, such as the Advisory Committee on Immunization Practices 2008 recommendations, websites such as the CDC and peer-reviewed literature sources, in addition to public health consultations ad hoc,” Charles E. Rupprecht, PhD, VMD, chief of the rabies program at the CDC, told Infectious Disease News.
CDC officials encourage physicians to inform patients of the following precautionary behaviors to help manage currently limited human rabies vaccine supplies:
- Vaccinating any animals, including pets and livestock, in close contact with humans.
- Avoiding stray and wild animals.
- Safely capturing or detaining biting animals and obtaining owner contact information.
Currently, the rabies human diploid cell vaccine (Imovax, Sanofi Pasteur) and the rabies vaccine for human use (RabAvert, Novartis) are available for postexposure prophylaxis use only, with limited preexposure prophylaxis supplies available for those in critical need on approval from state and federal public health authorities. Those at highest risk for rabies exposure, such as animal control officers, rabies laboratory workers, veterinary staff and wildlife workers, will continue to receive priority, according to a CDC health advisory.
Postexposure prophylaxis
Vaccine supply for postexposure prophylaxis has not been affected, according to Rupprecht. However, some restrictions are in place. Health care providers must now receive a code confirming approval from state health officials before ordering vaccine for postexposure prophylaxis directly from the manufacturer, because officials are not allocating supplies to traditional distributors.
Other options for postexposure treatment, such as the human rabies immune globulins HyperRAB S/D (Talecris Biotherapeutics) and Imogam Rabies-HT (Sanofi Pasteur) remain widely available for use in conjunction with postexposure vaccines, however some limitations exist. Human rabies immune globulins are not approved for use in patients who have been previously immunized with rabies human diploid cell vaccine or children, and may interfere with patient responses to measles-mumps-rubella live vaccines, according to the manufacturers.
“Supply is affected by increases in rabies cases, seasonal demands, regulatory review and production issues,” Rupprecht said.
Additional information ot the rabies vaccine supply is available online at www.cdc.gov/rabies. – by Nicole Blazek