Rabies Vaccine

Syllabus: General Studies Paper 3

The death of a 12-year-old girl in Kerala from rabies, despite having multiple inoculations of the vaccine.

How does a rabies vaccine work?

• Rabies is a disease that is caused by a family of viruses called the lyssaviruses and found in a range of mammals. 
• The virus targets the central nervous system and is nearly 100% fatal to the host animal if it succeeds in infecting it. 
• Though many animals from cats to crocodiles can be transmitters of the virus, it is most likely to spread to people from the bite of an infected dog or a cat as they are the most common pets. 

How is the vaccine made?

• The vaccine is made up of an inactivated virus that is expected to induce the body into producing antibodies that can neutralise the live virus in case of infection. 
• There are also test vaccines that involve genetically modified viruses.
• There is no single-shot rabies vaccine or one that offers permanent immunity. 
• Administering a vaccine, even after being bitten by a rabid animal, is effective because the virus is slow-moving and it can be several weeks before the disease manifests into a fatal encephalitis.
• A shot of rabies immunoglobulin (rabies-antibodies against the virus derived either from people or horses) followed by a four-week course of anti-rabies vaccine, is nearly guaranteed to prevent rabies.
• There are mainly two ways of administering the rabies vaccine – firstly, post-exposure prophylaxis (PEP) which is given to persons who have been exposed via a bite to an animal suspected to be infected. The vaccines are administered either into the muscles, or into the skin.
• Secondly, Pre-Exposure Prophylaxis (PrEP) which is given ahead of time to persons who have a high risk of being infected, such as veterinarians.
• The advantage of a PrEP is that if bitten, one doesn’t need an immunoglobulin injection, and two subsequent shots of the vaccine will suffice for full protection, unlike the four-course prescription in the case of PEP.
• However, the WHO doesn’t recommend PrEP as a general preventive.

Are rabies vaccines easily available in India?

• According to the Health Ministry, there are at least six rabies vaccines approved for India. 
• They all contain inactivated virus made of duck, chicken or human cell cultures and are marked as safe, efficacious and with long immunity. 
• Rabies vaccines are available for free in government dispensaries though vaccines administered in a private clinic can cost up to ₹500 per dose. 

Vaccines for Animals

• Given that rabies treatment requires multiple shots of vaccine as well as immunoglobin, sticking to the schedule is challenging.
• Governments of countries where rabies is endemic have frequently set targets to eliminate the disease India has committed to do so by 2030. 
• Vaccinating animals too doesn’t guarantee lifelong immunity from the disease. Because dogs are deemed responsible for 99% of all rabies infections in people, the government in its 2021 plan, called the ‘National Action for Plan — Rabies Elimination’, aims to vaccinate at least 70% of all dogs in a defined geographical area annually for three consecutive years. 

Concerns

• Hospitals running out of vaccines
• Knowledge about vaccines and treatment is still inadequate in India.
• No centralised database of vaccine availability is maintained.
• Requirement of multiple shots of vaccine as well as immunoglobin makes sticking to the schedule challenging.