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Post-exposure rabies vaccine and human rabies immunoglobulin

Rabies vaccine and human rabies immunoglobulin post-exposure treatment for Australian bat lyssavirus and rabies exposures are NSW-funded additional free vaccines.

Doctors should contact their local Public Health Unit (PHU) on 1300 066 055 to notify potential exposures to rabies or Australian Bat Lyssavirus (ABLV) including overseas exposures.

PHU staff will arrange rabies vaccine and human rabies immunoglobulin (HRIG) to be provided at no cost to the patient from the NSW Vaccine Centre and give advice on administration schedule.

Post-exposure management pathways differ between terrestrial mammals and bat exposure.
The Australian Immunisation Handbook – Rabies and other lyssaviruses

Rabies and other lyssaviruses | The Australian Immunisation Handbook (health.gov.au)

Post-exposure prophylaxis for rabies virus and other lyssavirus exposures comprises:

  • prompt wound management
  • rabies vaccine
  • HRIG (human rabies immunoglobulin)

The appropriate combination of these components depends on a detailed risk assessment, including determining the:

  • type of exposure
  • animal source of the exposure
  • person’s immune status
  • person’s previous vaccination history.

Refer to the Australian Immunisation Handbook – Rabies and other lyssaviruses

The NSW Health Immunisation Programs website has a list of both Commonwealth and NSW-funded free vaccines, at:

https://www.health.nsw.gov.au/...

Pre-exposure prophylaxis to rabies virus and other lyssaviruses

Pre-exposure prophylaxis rabies vaccines are not funded.

All vaccine prescriptions should be dispensed and then stored in line with ‘Strive for 5’ cold chain management. Vaccines should not be dispensed to a patient with advice to store in a personal domestic fridge. Vaccines should be stored in a purpose-built vaccine fridge up until administration.

NSW Health Vaccine Storage and Cold Chain Management -

https://www.health.nsw.gov.au/...

Pre-exposure prophylaxis is recommended for people who work with bats, laboratory workers who work with live lyssaviruses and people who travel to rabies-enzootic areas.

Pre-exposure prophylaxis simplifies how a potential subsequent exposure to rabies virus or Australian bat lyssavirus is managed because:

  • the person needs fewer doses of rabies vaccine in the post-exposure phase
  • the person does not need rabies immunoglobulin unless they are severely immunocompromised

Rabies and other lyssaviruses | The Australian Immunisation Handbook (health.gov.au)

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