Rabies vaccination guide in 2020

First determine the treatment plan according to the exposure level, and give priority to using the same brand of vaccine to complete the full course of vaccination. There are no vaccination contraindications for pregnant women, infants and other special groups. After standardized treatment, the incidence rate is almost 0.

I have been rotating in the community prevention and protection department for more than half a year in 2020. I have encountered at least hundreds of people who rushed over because they were bitten by cats and dogs. Most of the first words they said when they entered the door were "Doctor, can I have rabies?" In fact, most of the cases are not as serious as everyone thinks. You don’t need to memorize professional terms by rote, you can make a preliminary judgment by yourself: if you only scratch the red mark, break the skin without bleeding, it is a second-level exposure, go home and wash the wound with running soapy water for 15 minutes, and then get the vaccine. There is no need to get immune globulin; if the injury If you see blood in the mouth, are bitten by stray animals of unknown origin, or have wounds on the head, face, neck, or fingers where nerve distribution is particularly dense, even if you are exposed to Level 3, in addition to conventional vaccines, you must also administer immune globulin around the wound to block the virus locally to avoid spreading.

Speaking of which, we cannot avoid the most controversial "ten-day observation method". The guidelines in different regions do differ: many countries in Europe and the United States, because of their high immune coverage of domestic animals, will recommend that if a domestic animal that is regularly vaccinated injures a person, you can observe the status of the animal while receiving the first two doses of vaccine. After 10 days, the animal If there is no illness or death, subsequent vaccinations can be stopped; however, domestic disease control considerations at the time were that the vaccination rate of stray animals in our country was less than 3%, and the risk was too uncertain. It was also recommended that everyone complete the full vaccination process according to the process and not stop the injection without authorization - after all, the mortality rate of rabies once it develops is 100%, and there is really no need to gamble on this risk. At that time, I met a young man who was bitten by a stray dog ​​downstairs. He thought the dog looked very energetic and didn't take it seriously. A week later, he heard that the dog had died, and he was so anxious that he came over all night to get a patch. Although he was fine in the end, it was not okay to scare him half to death.

There are two special circumstances in 2020 that did not exist in previous years, and many people asked about them at the time. One is the epidemic lockdown. Many communities are not allowed to go out. If they are bitten, they cannot get vaccinated immediately. At that time, the CDC issued a supplementary notice: in principle, the first injection should be vaccinated within 24 hours. If it is impossible to get out of the lockdown, the vaccination 1-2 days later will still be effective. Subsequent injections can be postponed accordingly, and there is no need to start the whole process all over again. There was also an announcement about the recall of individual batches of vaccines at the beginning of the year. At that time, many people were panicking, fearing that they would get faulty vaccines. In fact, the recalls were only a few batches that had not passed inspection. Vaccines from regular community health service centers and CDCs are fully traceable. You can check the batch information by scanning the electronic supervision code on the box, so there is no need to panic.

As for the side effects that people ask about most, they are really not as evil as those posted on the Internet. Most people only experience a little redness and swelling at the injection site, a little fatigue, and a low fever, which is similar to the reaction to a regular flu vaccine. It will disappear after drinking more water and resting for two days. I met a young man who went to play basketball all afternoon after getting the second injection. His fever reached 38.7 in the evening. He called me almost crying and asked if he had been infected. I told him not to run around and lay down at home to drink warm water. He recovered after sleeping for one night. The probability of a truly severe allergy is less than one in 100,000, which is lower than the probability of picking up ten bucks when you go out.

There is also the rumor that "pregnant women and children cannot receive rabies vaccine" that has been circulated for many years. In 2020, there was clear evidence-based medical evidence to disprove it: the rabies vaccine is an inactivated vaccine, which will not affect the fetus through the placenta, nor will it affect the development of infants and young children. At that time, I treated an expectant mother who was 2 months pregnant, and her hand was bitten by her own Teddy. She struggled for three days to come. After the full vaccination, the baby was healthy and had no problems. If you have just received a full course of vaccination within the past six months, you do not need to get vaccinated again if you are bitten again. Two supplementary injections will be given every six months to one year, three supplementary injections will be given between 1 and 3 years, and the full course will only be required after 3 years.

To be honest, my biggest feeling during the six months of my rotation was that most people’s fear of rabies came from fragmented information on the Internet. They either ignored it or were overly panicked. If you are really unsure, just go to the nearby prevention and security department and ask. It is much more effective than posting "rabies precursors" posts for half an hour. As long as we follow the regulations, this disease is actually far away from us.