Pre-Exposure Rabies Immunization

Yesterday morning I got my first of three pre-exposure immunization shots for Rabies. This is required of veterinary schools before attending. ISU gave the option of getting them on your own and showing proof of immunization prior to July 30th or to sign up for a rabies clinic that will be held on campus in the Fall- and take you on your good word for going that route. I opted to get them ahead of time as it worked out cheaper that way ($789 through ISU or approximately $600 my way).

In order to get it done on my own I had to have a doctor's appointment and request it be ordered. The order was then sent to our local community health establishment where I would receive it from them. I also had to pay in full upfront before the center could order it in. This whole process was rather interesting since I live in a fairly small town ( <15,000), people aren't accustomed to dealing with the vaccine. My doctor wasn't even entirely sure which of the two available vaccines to order for me. There are two types of rabies vaccines that are licensed for pre-exposure in the US; both are equally safe and produce an antibody response against the rabies virus. The available vaccines are as follows: Human Diploid Cell Vaccine (HDCV), and Purified Chick Embryo Cell vaccine (PCEC). I ended up with the HDCV, called "Imovax"

The process of getting the immunization takes about a month. You get your first shot whenever (Day 0) but then the second shot has to be exactly 7 days after the first, and the third (and final) shot is given sometime during 21-28 days after the first (although some places say either ON day 21 or 28). Each shot contains a killed rabies virus vaccine; the link to Imovax above will go into detail about how the virus was killed, harvested, and so forth if you are interested in learning more about it. I am getting it rather late in the summer, but by the time I got it ordered and it had arrived I was going to be out of town on vacation for over a week so I couldn't get the first shot until after I had returned thanks to the timing of the series. [I was at a lovely cabin/vacation home "Wearing Waters" in northern Minnesota at the end of the Gunflint Trail and at the edge of the Boundary Waters- pictures will probably follow in a later post]

The vaccine itself is very pretty. It is mixed immediately before administering it, and turns a bright shade of fuchsia. Despite hearing all of the horror stories of the old vaccination (which was given in the abdomen and was very unpleasant to put it mildly) the present-day one is given intramuscularly in the upper arm. And surprisingly, I didn't feel any tingling or other discomfort when it was actually being given! Just a little prick and that was all. I was relieved that it was actually the most comfortable vaccination I have ever received! However, I have noticed some yucky side-effects: queasiness, achy, flu-like symptoms. But that's pretty common and to be expected.

And just to be clear- getting pre-exposure immunization does not mean that you are fully protected against rabies. Getting Pre-EP immunized means that you will need fewer doses if exposed: 2 doses versus 4 doses + antirabies serum.

Not entirely sure what the rabies virus is or what harm it causes? Rabies is a viral disease of mammals that attacks the nervous system, it is considered fatal even with pre- or post-ep immunization. One website I referenced put it best:

THE FIRST LEVEL OF PREVENTION IS TO AVOID RABIES EXPOSURE.
Pre-exposure vaccination is the second level of prevention.

And pretty much the third level, or more appropriately- Your Last Chance -is the post-ep treatment. Once a person begins to exhibit signs of the disease (it can take weeks to years, but generally 1-3 months for symptoms to surface), survival is rare. To date less than 10 documented cases of human survival from clinical rabies have been reported and only two have not had a history of pre- or postexposure prophylaxis. Moral of the story? DON'T GET BIT!
For more detail on the virus it self- go here or for more information on the disease- go here.

Rabies has always fascinated me, and it has quite a history of being misunderstood- for example, the myth that it causes hydrophobia (fear of water) is false, but this belief came in to being because those infected reach a point when they can no longer drink/swallow. I made a History Channel-esque documentary on it with a friend of mine when we were taking our course in Diseases in History. I wish I could load it up since it was actually quite humorous (yet factual!)- but it's rather long and I don't have the original file for it... It is very interesting to research if you ever feel compelled to do so, but I realize not everyone is as nerdy as I am!

1 down, 2 to go!!!