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Q. How often do I need to get a rabies booster for my daughter?

Answered by
Dr. Shilpa Reddy Diggireddy
and medically reviewed by Dr. Sneha Kannan
This is a premium question & answer published on Feb 08, 2021

Hi doctor,

Two days back, I fed a stray cat by pouring a glass of milk into the cat's bowl. I am not sure if the glass touched the cat's bowl or some droplets spilled on the glass. My daughter precisely, after an hour, picked the glass from the table and put it in her mouth. What are the possibilities of rabies transmission if the cat is rabid?

Does she require a booster dose now? It is exactly five months since she received her four doses of rabies vaccine. I forced my pediatrician for a booster, and she refused saying, that it may have side effects and boosters are recommended after a year. Is she right?

Will a child have enough immunity after a second non-bite exposure within five months? I got a second opinion from three pediatricians, of which two refused, and one said there might be a negligible chance of rabies transmission, so I am confused. Am I putting my daughter at risk? I have sleepless nights thinking about it. My daughter is 18.5 months old, and she got a post prophylaxis dose when she was 14.5 months old.

It has been ten days since the incident happened.

#

Hi,

Welcome to icliniq.com.

The possibility of acquiring rabies by the incident you described is very unlikely. And since it has been ten days already and if there was contamination, then your daughter would have shown some symptoms by now. So I would suggest you to be calm and get her vaccination done according to the schedule given to you and no need of any prophylactic intervention now.

Please feel free to contact for any further queries.

Hi doctor,

Thank you for replying. She got four doses of the anti-rabies vaccine. Even if there was an exposure this time, would not the previous immunization help?

#

Hi,

Welcome back to icliniq.com.

Yes, it would protect her if there were any chance of getting infected.

So I assure you again not to worry.

Thank you doctor,

Is my pediatrician right when she says no booster is required within a year of post prophylaxis treatment with four doses. The previous vaccines were also for a non-bite exposure, which was unlikely, but she agreed to a rabies vaccine since I was panicking.

Thanks in advance for putting up with my questions.

#

Hi,

Welcome back to icliniq.com.

Yes, she is right since your daughter will have the antibodies developed due to the vaccine given. Be calm. Your daughter will be fine. I advise you to be careful from now onwards since these incidents seem to repeat themselves and cause you to panic.

Hi doctor,

If I wish to get her booster vaccines, would there be any serious side effects?

She had her routine 18-month vaccines DPT, IPV, and Hib booster a few days back. If I get her a booster rabies vaccine tomorrow, will there be any side effects as the interval between the immunization vaccine is less?

#

Hi,

Welcome back to icliniq.com.

Every vaccine has its side effects, which are not very frequent. But if your daughter has not had any side effects for an earlier vaccine with rabies, it is unlikely that she will have now. Side effects due to the booster doses being so close to each other are also highly unlikely.

Thank you doctor,

Today I went to another pediatrician, and she, too, ruled out the need for boosters. Is there any reason why doctors are advising against boosters? Is it just another vaccine like hepatitis or other routine vaccines, despite me asking her multiple times for my sanity's sake. She refused. Is there any ingredient in the vaccine that is harmful to kids?

From the bit of research I did online. WHO recommends two booster vaccines for second exposure irrespective of the time of the past immunization. I am sorry for asking you repeated questions, and I know I need a psychiatrist first, but I do not seem to get the information from the doctors I visited so far (I have visited three different pediatricians), and they think that the previous immunization was itself unnecessary. Is not the incubation period in babies less? She would have shown some signs of infection if at all transmission had occurred. The last time when I forced my pediatrician for post prophylaxis vaccine, she agreed without much effort. This time she does not pay heed at all. Are boosters not recommended for babies?

#

Hi,

Welcome back to icliniq.com.

As I have already assured you that vaccines leave antibodies in our body when they are given, that is the reason booster doses are administered after a certain period of time like months or years. That is the reason boosters are not given frequently. As you have mentioned that babies incubation period will be less but this is not true for all diseases. In your case your baby would have shown signs of infection if she was infected. So my advice is to stop visiting other doctors because everyone will tell you the same.

Hello doctor,

As you know my history, I wanted to ask your opinion about a scenario. As you know, my daughter had four doses of the anti-rabies vaccine for eight months. Before five months, I got her a booster vaccine. The day before yesterday, I noticed a mysterious scratch on my daughter's leg. I was with her the whole day, and my mother says she is 99 % sure that it was due to some sharp toy. But me being a paranoid person thinking what if it is a stray animal's scratch. My mother has a habit of feeding stray animals and keeps a bowl of food outside my home. So I am just concerned if by any chance, the cat had scratched my baby while my mother was feeding. I pinged the pediatrician, and she just replied that you could not get rabies vaccine frequently, and I believe that it was because I keep asking her for an anti-rabies vaccine every other month, and she thinks I am over reacting. Am I putting my baby at risk by listening to her? Should I go ahead and get a vaccine shot. I am afraid as I read few reports of adverse reactions due to rabies overdose in animals. I am in a dilemma and cannot get this rabies thing out of my mind.

I have three questions.

1. Will the booster vaccine given before five weeks protect her if it was an animal scratch? Should I go again for a vaccine? The possibility of exposure is less than one percent, but just for my sanity, I wanted to get her another vaccine.

2. I am just paranoid, thinking, what if the vaccine's cold chain broke and she was not protected from the vaccine? During both the first prophylactic dose and a booster dose, she got a fever that lasted for a day. Does the fever confirm that her body responded to the vaccine, which implied that the cold chain did not break and her antibody titers would have raised?

3. How can I make sure my daughter has continued protection against rabies? By giving a booster every six months? When veterinarians get a booster dose every six months, do they again get two booster doses after a known exposure as WHO recommends? In that case, people who work closely with animals get boosters after every exposure in addition to bi-annual boosters? I tried to see for Rabies titer test (RFFIT), but that is not available in Chennai. Can we trust the ELISA test?

#

Hi,

Welcome back to icliniq.com.

Question 1: the booster dose will protect her after five weeks also. Another dose is not required.

Question 2: cold chain breaking is a very rare thing because utmost precaution is taken. Fever is not an indicator for rising immune titers.

Question 3: booster every six months will give your daughter complete protection.

Please see that only known exposure requires immediate doses. I hope this clears all your queries.

Please feel free to contact me for any further queries. Thank you.


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