A patient receives rabies vaccines either for pre-exposure prophylaxis (PrEP) or Post-exposure (PEP)
Pre-exposure prophylaxis (PrEP)
Pre-exposure prophylasis (PrEP) prevents rabies before exposure (e.g., travelling to a high-risk area, or an occupational risk). PrEP involves a series of injections given on specific days before potential exposure.
Post-exposure (PEP)
Post-exposure prophylaxis (PEP) is provided after a potential exposure, such as a bite or scratch from an infected animal. PEP involves prompt wound care (at A&E rather than General practice), risk assessment, and a specific course of vaccines and, in some cases, rabies immunoglobulin (antibodies), depending on the animal, location, and type of exposure.
Process map for assessing patient and obtaining vaccines
Based on UKHSA guidance the below outlines the contractual obligations for General Practice when providing services to registered patients.
Accessing Vaccines under PEP, Administration and Follow ups
UKHSA Rabies and Immunoglobulin Service (RIgS). RIgS telephone number: 0330 128 1020. (open 7 days per week from 09:30 to 17:00).
Vaccines are usually dispatched within 24hrs to the person supporting the assessment with UKHSA.
Clinicians who originally treat/assess the patient and contact UKHSA will be responsible for completing the vaccination process (i.e., A&E or General Practice).
Practice staff to be aware of and have systems in place to adhere to strict cold chain requirements upon receipt of vaccine. Requests for immunoglobulin/vaccine made Monday to Friday will be ordered through Movianto for delivery to a named responsible clinician and will arrive the next working day before 2pm. However, there may occasionally be specific urgent situations where immunoglobulin/vaccine is needed sooner than this, and in these circumstances UKHSA can issue through a more rapid delivery.
Any follow up bloods required will be interpreted by UKHSA.
An appropriatly trained clinican can administer the vaccine, no additional training is required for the rabies vaccines, all injections are intermuscular.
Rabies and Immunoglobulin Service (RIgS)
RIgS operates 7 days per week. Their routine hours are 09:30 to 17:00. After this time, the emergency out of hours service is only able to deal with calls about potential human cases of botulism or diphtheria, or the highest risk rabies exposures who have not already received one post-exposure dose of rabies vaccine (these are exposures to the head or neck, or to an animal that is confirmed to have rabies).
- RIgS telephone number:
- 0330 128 1020
The whole process outlined in this resource should be used alongside the UKHSA Guidelines on managing rabies post-exposure. Rabies post-exposure treatment: management guidelines – GOV.UK : always refer to the website for the most up to date information