The Kerala Government Medical Officers’ Association (KGMOA) has called on the state government to implement a universal pre-exposure rabies vaccination programme, particularly focusing on children and other vulnerable groups. The appeal comes amid growing concerns over rabies-related deaths in the state, which remain a pressing public health issue.
Despite Kerala’s notable strides in combating rabies through mass dog vaccination drives, awareness campaigns, and improved access to post-exposure prophylaxis (PEP), KGMOA emphasized that a shift toward prevention is urgently needed. This statement was released shortly after the death of seven-year-old Niya Faisal, who died from rabies even after being vaccinated.
Rabies is almost always fatal once symptoms manifest. Globally, the disease claims around 59,000 lives annually, with India accounting for 18,000 to 20,000 of those cases. Children are particularly vulnerable, making up nearly 40% of the victims. In Kerala, 20 to 25 people still die from rabies each year.
The association highlighted the World Health Organization’s (WHO) recommendation of a simple three-dose intradermal vaccine schedule (administered on days 0, 7, and 21 or 28) to protect against rabies before exposure. This method offers long-lasting immunity and reduces the need for costly and limited rabies immunoglobulin if a vaccinated individual is bitten they would only need two booster shots.
KGMOA pointed out that this strategy is especially important for severe bites, such as those on the face or hands, and can offer protection in rare cases where PEP fails. Since 1980, there have been 122 global deaths from rabies even after complete PEP treatment incidents that can undermine public confidence in the healthcare system.
The association stressed the need to start this vaccination programme with children, who often do not report bites or fail to clean wounds properly. If a state-wide rollout is not immediately possible, they suggest beginning in high-risk areas and expanding gradually.
A task force should be formed to manage the phased rollout beginning with children in high-risk or underserved areas and later including groups like doctors, veterinarians, animal handlers, and sanitation workers. KGMOA also called for the integration of this pre-exposure vaccination (PrEP) initiative into current rabies control strategies and requested central government support to include PrEP in India’s national immunisation programme for rabies-endemic zones.
Kerala, known for its public health achievements, could once again set an example for the rest of the country by launching this preventive initiative, aligning with the global goal of eliminating rabies deaths by 2030.
The association’s proposal comes on the heels of three tragic child deaths in the state seven-year-old Niya Faisal from Kollam, six-year-old Ziya Faris, and a 13-year-old from Pullad despite them receiving the recommended vaccine doses.
Understanding the Rabies Vaccine: What You Need to Know
The rabies vaccine is designed to protect people from rabies, a rare but deadly infection that attacks the brain and nervous system. It is almost always fatal once symptoms begin and is typically transmitted through bites or scratches from infected animals, especially dogs. Rabies is prevalent in parts of Asia, Africa, and the Americas, but in the UK, it’s only found in a small number of wild bats.
Who Should Get Vaccinated?
The rabies vaccine is not routinely included in this vaccination schedule. It’s recommended only for people at increased risk of exposure, such as:
- Travelers to areas where rabies is common
- Workers exposed to animals (e.g., vets, animal handlers)
- Individuals already exposed to rabies
Who Should Avoid the Vaccine?
Most people, including babies, children, pregnant or breastfeeding women, and those with weakened immune systems, can safely receive the rabies vaccine. However, it should not be administered to individuals who’ve had a severe allergic reaction to a previous dose or an ingredient in the vaccine. Some vaccines may contain egg protein or antibiotics like neomycin, streptomycin, or polymyxin B.
Timing and Dosing
The vaccine is given as an injection, typically in 3 doses over 28 days. In urgent cases, it can be completed over 21 or even 7 days.
Booster Shots
Most travelers don’t need boosters. However, a single booster may be recommended if traveling to a high-risk area more than a year after initial vaccination. Those with ongoing exposure risk at work might require a booster after one year and additional boosters every few years.
How Effective Is It?
About 95% of people who receive all three doses develop protection against rabies. The protection typically lasts for one to two years, with boosters needed for ongoing protection in high-risk groups.
Side Effects
Common, mild side effects include:
- Pain or swelling at the injection site
- Fever
- Headache
- Nausea
- Itchy rash (hives)
Severe allergic reactions are extremely rare.
Important Note: Even if you’ve been vaccinated, you should seek immediate medical attention if you suspect you’ve been exposed to rabies.
