Time is of the essence if a rabies exposure is expected. Treatment involves four shots of the rabies vaccine and one shot of a drug called human rabies immunoglobulin (HRIG). HRIG contains immune antibodies that immediately inactivate and control the rabies virus until the vaccine can begin to work.
HRIG is only given to people who have not been previously vaccinated for rabies. It is injected directly into the wound. Any leftover would be injected into a muscle far away from where the vaccine shots are delivered. (Injecting HRIG too close to the vaccination site may interfere with the immune response.)
There are two HRIG preparations approved for this purpose:
- Imogam Rabies-HT (human rabies immune globulin)
- HyperRab TM S/D (human rabies immune globulin)
Treatment should be started without delay after exposure. The first shot of HRIG and the rabies vaccine is given immediately; three additional vaccine injections are given three, seven, and 14 days later.
The side effects are generally mild and may include injection site pain and mild fever.