5.5.1. What is the difference between pre- and post-exposure prophylaxis?

-  Pre-exposure Prophylaxis (PrEP) consists of a course of rabies vaccination given prior to an exposure and does not include rabies immunoglobulin (RIG). It is recommended for those at very high risk of being exposed (for example people working in a rabies vaccine manufacturing facility or in a rabies diagnostic laboratory) and veterinarians. It is also recommended for those living in or traveling to remote regions of the world where rabies is highly endemic or currently epidemic, where prompt access to healthcare difficult.

- Post-exposure Prophylaxis (PEP) is given after an exposure or suspected exposure to rabies has occurred. It includes local treatment of the wound, administration of a course of rabies vaccination and (dependent on the category of exposure and your individual health status) RIG may need to be administered.

- A person that has received either complete PrEP or complete PEP previously and is subsequently exposed to rabies does not need to receive RIG, but should receive a booster series of rabies vaccine. If the patient had received a full course of PEP within the last three months, only local wound treatment is required; neither vaccine nor RIG is needed. All incomplete vaccinations must be ignored and the exposure must be managed appropriately (full PEP).

See section 5.5.5 for details of the visits required for PrEP, PEP and booster vaccination.

PrEP = Pre exposure prophylaxis
PEP = Post-exposure prophylaxis
RIG = Rabies immunoglobulin
IM = Intramuscular
ID = Intradermal




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Version 4 - last updated May 2017