Week 3 – Question of the Week: Should preppers get the rabies vaccine?

Week 3:  2011-03-24 

{ Above image – rabid dog }

Today I’m asking our professionals to weigh in on the question:  should preppers get the rabies vaccine?

(see Rabies and The End of the World)

You, too, are welcome to post your responses and questions below. 

Check back soon and see what our panel of over 100 professionals has to say.

– Doc Cindy
Enhanced by Zemanta

About Cynthia J. Koelker, MD

CYNTHIA J KOELKER , MD is a board-certified family physician with over twenty years of clinical experience. A member of American Mensa, Dr. Koelker holds degrees in biology, humanities, medicine, and music from M.I.T., Case Western Reserve University School of Medicine, and the University of Akron. She served in the National Health Service Corps to finance her medical education.
This entry was posted in Acute diseases, Education, Medical archives, Question of the Week, Rabies, Vaccination and tagged , , , , , , , . Bookmark the permalink.

14 Responses to Week 3 – Question of the Week: Should preppers get the rabies vaccine?

  1. DrLee says:

    The following free websites can be helpful in getting educated regarding the treatment and identification of rabies. When resources are scarce, this information can be valuable.


    This online course is designed to educate healthcare providers and public health professionals about rabies, the approach used in evaluating patients for rabies virus exposure, and the administration of rabies postexposure prophylaxis (PEP) as recommended by the Advisory Committee on Immunization Practices (ACIP).


    The goal of all rabies prevention information, including this electronic algorithm, is to prevent human cases of rabies while avoiding the unnecessary administration of postexposure prophylaxis. We hope that this computerized flow chart enables local health department staff to become more efficient and self-directed when managing commonly encountered rabies exposure situations.


  2. Jeff J, MD says:

    Rabies vaccination makes sense. Whether you are bugging out across an endemic area, recreating in an endemic area, trapping, brain tanning, shooting strays, living in caves. It really doesn’t matter. In a TEOTWAKI situation, the spread of rabies is to be expected and vaccination is reasonable for me. For most, survival in a TEOTWAWKI situation will likely require travel to new areas and habitats, and the idea of endemic areas will likely lose some meaning due to spread and change in everything from hunting pressure and feral animal contact.I understand that many dogs and cats will die, but some estimate that there are over 300 million dogs in America right now? They mate how often and have how many in a litter? That’s a lot of hungry desperate dogs. Now, what about my kids, do I immunize them? (What if the real issue is zombies? What if a mutated rabies is the virus that leads to zombies?)

  3. DC, DVM says:

    DC, one of our veterinary colleagues, offers this:

    As the former Director of Veterinary Technical Services for the world’s largest animal rabies vaccine manufacturer, I have some firsthand experience with rabies virus.

    First, I am vaccinated and more importantly “immunized” against this disease…the difference being that I have my titers checked every 18-24 mos by the KSU Rabies lab.

    In my opinion, obtaining a rabies immunization is a risk:benefit decison. The old intraderm vaccine, when not administered properly, resulted in at least one human death from lack of protection that I’m aware of. Intramuscular administration is more straightforward and mounts a substantial immunity that simply needs to be monitored and then boostered when it reaches a level the individual feels is too low. I practice in a rabies edemic area (raccoons and foxes as vectors) so I keep my eye on my titer and my physician knows that if I say I need a booster, to simply order it for administration.

    Since treatment for rabies is at the very least problematical, I recommend to my colleagues who are prepping for TEOTWAWKI to have their MD order and administer it. Obviously you have to locate an MD who understand YOUR idea of risk management.

  4. pa4ortho says:

    There is a reason why stray dogs are chased away and sometimes poisoned in the developing world, unlike in the US where they are our best friend. Bites alone are bad enough, but almost everyone knows someone who has died from rabies in endemic areas due to lack of access to vaccine, due to cost. Middle income families have to chose between vaccination for a bitten child or not, when the cost amounts to 1-4 months of savings. So imagine you have been bitten or exposed to any preventable disease, no resources are available, now what’s your choice.

    Here where I live there is a community famous for vaccine avoidance. Even 50 miles away we are affected by the human petri dish that limits the effect of herd immunity in our region. Pertussis outbreaks are more common here. (Pertussis vaccine it not 100 % effective and relies on herd immunity to stop the spread and limits outbreaks.)

    Vaccine risk is low. Disease risk is up to you to evaluate.
    In a long term major disaster or in much of the developing world, I think the risk is high.

  5. from PF says:

    On the question of rabies vaccination, all I can offer is that in a post-disaster scenario, there are more likely to be packs of feral animals on the loose, whether dogs, raccoons, or what have you. Therefore, more vectors for rabies, and presumably more contact of rabies-positive animals with uninfected animals and humans.

    Since dogs are an important vector of rabies, it would seem prudent not only for humans to get vaccinated, but to assure that our pets are. According to a quick internet search I did, dogs, cats, and bats are the most common vectors, and I know that raccoons, skunks and rodents also carry the virus (from my days as a field biologist).

    Rabies vaccination is recommended for people in high-risk professions, i.e. animal control officer to name one example, and also residents of nations and/or regions with significant numbers of cases, as in some African and Asian nations.

    Another factor in deciding whether or not to get vaccinated, is the availability of post-exposure treatment where you are living and traveling. Given that prophylactic vaccination eliminates the need for rabies immune globulin and decreases the number of doses of vaccine needed if bitten, then one should get treated beforehand if traveling or living in an area where prompt, modern medical attention may not be available.

    Interesting to read of successful treatment using PEP or the Milwaukee protocol, “induced coma” combined with targeted drug and supportive care. Also looks like current practice is to treat using PEP those exposed to bats while sleeping, intoxicated or in a mentally-compromised state, as having been exposed, due to the fact that those bitten by bats often do not know they have been bitten.

    My late father was bitten by a dog which could not be identified or captured, in his small Georgia town in the 1930s, and thus got the whole rabies series of injections, in those days administered via direct injection into the stomach, over ten shots if memory serves. Ouch!

  6. Stan M. says:

    I think it would depend. How long is the vaccine good for?

    • Per the CDC’s Human Rabies Prevention — United States, 2008

      The persistence of immune response was assessed by measuring rabies virus neutralizing antibody titers, considered protective at >0.5 IU/mL.

      In brief here is their summary:

      “In summary, rabies virus neutralizing antibody titers >0.5 IU/mL were observed in all persons at 180 days and 96.8% at 365 days after initial vaccination (72), 94% of persons at 21 months after initial vaccination (63), and all persons tested at 26 months after primary vaccination (77).”

      They mention no studies beyond 26 months, and go on to say:

      “An important use of rabies pre-exposure prophylaxis is to prime the immune response to enable a rapid anamnestic response to postexposure booster vaccination and simplify the postexposure prophylaxis requirements for previously vaccinated persons.”

      At the current time, 1-2 booster doses are recommended for those with known exposure to rabies, just in case.

    • KF says:

      There are two regimens for the Rabies vaccine.
      Primary and Pre-exposure prophylaxis (for travelers going to 2nd and 3rd world countries).

      Then there is a Rabies Booster available too.
      Check out this info from the CDC regarding Rabies Vaccine
      Administration doses for adults and pediatrics.



  7. Wolf says:

    I had the rabies vaccine before I deployed to Iraq the first time. No side effects, and it gave me some reassurance. I viewed it as cheap insurance.

  8. David J DMD says:

    I don’t feel the cost and risk of the rabies vaccine are worth the benefit. Too many other areas to prepare, including other vaccines. In a serious event, many strays will be shot.

    • pa4ortho says:

      ……Shot and unless the possibly thousands of carcasses in a big Katrina-like disaster are disposed of properly, they can spread disease like rabies to other hungry animals. Yes, water, food, shelter, are important, but so is security. One aspect of security is medical preparedness. I would not place rabies vaccine as a first priority item, but would get it if it was available. I think we all agree that, like all purchases, it needs to be prioritized.

  9. Wh2thdr says:

    Sammy the WonderPug says that he will need more kibbles before he shares his vaccine.

  10. pa4ortho says:

    Get vaccination and stay up-to-date or risk an ugly death. (period)

    I have had to scramble to find vaccine in Bangladesh after a monkey bite once… A dang monkey!

    In a disaster don’t interact with unknown animals. (another period) You don’t know where it has been. Perhaps it just left its dead owner who died of a contagious pathogen and you just pet the dog. That cat was just feeding on a body 20 min ago. The dog just ate human poop. With limited resources, bites and scratches can be lethal. Recognise the threat and keep them away or shoot them. Because best efforts are not perfect, the raccoon, fox, skunk, that is in your trap may have rabies. The bat in the cave you hide in or under the bridge may infect you while you sleep. By the time you have symptoms it’s too late. Get vaccinated, or not, your call, but I get your stuff when you are dead.

  11. KF says:

    So, the event has occurred, we have been bitten. What do we do with the animal? What do we do for the person who has been bitten? The usual process is to safely try to contain the animal or, if you’re in the hinter boonies, kill it and preserve it’s head. Call the animal control, give them the head and file a report. You’ve earned a free ticket to the county health clinic and have your wound washed, update your Tetanus vaccine and begin the prophylaxis series of Rabies injections.

    Only, now there is NO animal control available to call for help or a health department to notify. Here’s a source from a rural Canadian Health Services, which has given permission to copy and post this article in it’s entirety.

    Recognizing a Rabid Animal

    Animals do not all behave the same way when they have rabies. The signs described below are characteristic, but a rabid animal may not exhibit all of them, or to the same degree. The disease may take different forms, “furious” or “dumb” rabies, or a combination of the two.

    Furious rabies

    In the early stages, the animal changes its disposition or behaviour (a friendly animal may become shy and hide in a corner, a shy animal may become snappy, uncertain or unusually friendly, and a wild animal may become abnormally tame). It may bite indiscriminately – its chain, other animals, people, its owner, itself, etc. Its voice may become hoarse.

    In the later stages, the animal may become unusually restless and excitable. It may startle easily, run aimlessly, become watchful and exhibit a puzzled or apprehensive look. It might change its eating habits, and finally develop gradual paralysis in the throat (drooling profusely) and hindlegs. Eventually, it dies.

    Dumb rabies

    Vicious and aggressive signs are less noticeable, but otherwise the course of the disease is similar. Rabies may invade the nervous system faster in this form. Paralysis usually starts in the throat, causing difficulty in swallowing. The animal rapidly loses weight, becomes paralyzed and dies.

    If you know or suspect that an animal has rabies, keep humans and other animals away from the suspect animal. Keep track of the animal’s location. Only an experienced or trained trapper or animal control officer should attempt to capture the animal

    If the suspect animal has had contact with pet or livestock, contact: The Canadian Food Inspection Agency at (519) 332-3031 (formerly Agriculture Canada).

    If it becomes necessary to destroy the animal, or if the suspect animal is already dead, use gloves and shovels to handle the carcass. Contain the carcass in a double garbage bag. Do not damage the head if the animal has had contact with humans, pets or livestock so that rabies tests can be done. Otherwise, dispose of the carcass by burial or incineration.

    If the suspect animal has had contact with a human, immediately wash the affected area with soap and water, contact your doctor, and notify the health unit as soon as possible.


    * * *

    In the event of an apocalyptic TEOTWAWKI scenario occurring, it is only prudent to consider the reality of fact that not only will humans be mass exiting the cities. The pets of those who have fled to the countryside in search of water and food sources, will be left behind to fend for themselves, unless they have a planned prepositioned retreat to go to that is stocked to meet their needs.

    If you have pets, or livestock and are preparing, don’t forget to get their vaccines and meds up to date, now. Stock up on their required supplies as well. Food, water, Rx medications, wormers, flea and tick preps, first aid kit, and a reputable book on veterinary medicine with treatments and diagnoses.

    Foraging and hunting will become much more prevalent and thus, so will human exposure to non-medicated and unvaccinated animals and wild rabid epidemics will become the norm again in short order.

    While the rabies vaccination series is costly, and the series is not without it’s side effects, it still makes common sense to include it in your medical prophylaxis of vaccines if you are planning to tend to your own animals, or plan to take to the forest for food or shelter.

Leave a Reply

Your email address will not be published. Required fields are marked *