Latest Rabies Vaccination Guidelines 2025

① For people with normal immune function and fully vaccinated against rabies, if secondary or lower non-head and face exposure occurs again within 3 years, they only need to receive 2 booster doses and do not need to inject rabies immune globulin.； ② For scratch and bite exposures that meet the three conditions of "domestic pets + full vaccination with rabies vaccine + no history of contact with stray animals within six months", vaccination can be started first and the 10-day observation method can be strictly followed. During the observation period, if the animal is healthy, subsequent vaccinations can be terminated ； ③ For people who are allergic to the Vero cell vaccine, the adverse reaction rate of the newly approved human diploid cell freeze-dried vaccine in 2025 has dropped by 62% compared with the old version, and can be used as the first choice alternative.

Last week at a community vaccination station, I met a little girl who was in her second year of high school. She was stepped on by her Yingdun, who had been raising her for three years. She had two red marks on her ankle. She was crying and dragging her mother to get an immune globulin injection. Dr. Li, who was sitting in the clinic, stopped her for almost ten minutes before she could persuade her to stop. This is also the most common misunderstanding after the adjustment of this year’s guidelines: in the past, it was recommended to take egg whites whenever blood was seen, but now there is really no need to generalize. Ordinary people with normal immune function, as long as they are not exposed to Level 3 in nerve-dense areas such as the head, face, and perineum, and have been fully vaccinated within 3 years, the protein can be completely saved. Of course, this is not without controversy. Several senior disease control officials in our site still remain conservative. I feel that I cannot bear the responsibility if I encounter an individual case of immune failure, but last year’s national disease control system statistics showed that the probability of being infected with rabies virus for people who meet the above conditions has been as low as 0.17 per 100 million, which is lower than the probability of being hit by a car on the way to get an injection.

Speaking of this, I have to mention the 10-day observation method that has been the most controversial in the past two years. Now the industry is basically divided into two groups: Most doctors on the grassroots vaccination side feel that they cannot relax. After all, many pet owners cannot tell whether their pets have been vaccinated on time. There are also many people who picked up stray animals and were caught within two days of returning home. There is no way to observe them for 10 days. ； However, experts who do epidemiological statistics have been calling for liberalization. In 2024, the rabies vaccination rate of domestic dogs and cats in domestic cities and towns has reached 87.2%. If exposed under observation conditions, the really problematic animals will not survive for 5 days. The remaining 5 days are completely redundant observation periods. Last year, Jiangsu Province alone counted 120,000 unnecessary full vaccinations. The wasted medical resources were almost enough to fully immunize stray animals in the entire western province. This year's guide is a compromise: it does not clearly say that vaccination can be avoided directly, but it says that "observation can be carried out at the same time as vaccination, and follow-up injections will be terminated for animal health." This leaves everyone with a choice.

Oh, by the way, many people ask whether vaccination can be covered by medical insurance now. Starting from 2025, most coordinating districts across the country have included rabies vaccine in Class B medical insurance for reimbursement, especially for post-exposure vaccinations. The reimbursement rate can reach 70%, so you don’t have to worry about hundreds of dollars in expenses. There is also an unpopular question that is often asked: Should I spank someone if bitten by a hamster, guinea pig, or rabbit? This year’s guide clearly concluded that rodents and lagomorphs almost never carry rabies, unless they are wild individuals in epidemic areas. Domestic pets do not need to run around for injections. Last week, a young man was bitten by his own golden bear. He went to the emergency room and had to go to the emergency room. After a long time of persuasion, he left. He was still clutching an outdated post on Baidu that said “all warm-blooded animals carry rabies virus.” It made people laugh and cry.

Of course, not all situations can be relaxed. If you have AIDS, have been taking immunosuppressants for a long time, or are undergoing radiotherapy and chemotherapy, the three-year intensification period and the 10-day observation method mentioned above do not apply. Regardless of the exposure, it is recommended to be fully vaccinated and immune globulin. This is also controversial. Some clinicians feel that if you only take small doses of hormones and the degree of immunosuppression is very low, you can also follow the process of ordinary people. However, the guideline still leaves a hole: it is recommended for special groups to follow the doctor's advice and not to make blind judgments on your own.

Every time I tell people who come for consultation, if you are really scratched or bitten, your first reaction is not to run to the hospital. Find soap first and rub it with running water for 15 minutes. It is much more effective to get to the hospital half an hour earlier than you do. Last year, I met a girl whose face was scratched by a stray cat. She was rushed to the hospital for 20 minutes and then received injections according to the procedure. In the end, there was no scar or any problems. ； On the other hand, there was an uncle who was bitten on the leg by a neighbor's dog. He felt that the dog had been vaccinated anyway and the wound was not even washed. In the end, the wound became infected, inflamed and had a fever for three days. The pain he suffered was worse than ten injections.

In fact, after doing vaccination consultations for so many years, the biggest feeling is that people either take it too seriously or are too anxious. The core essence of guideline updates is to find a balance between risks and burdens. If you are really unsure, go to a nearby community vaccination site and ask. Don’t frighten yourself by blindly searching on Baidu, and don’t hold on to it. After all, rabies is really 100% fatal, but there is no need to spend thousands on protein for an almost zero risk. Oh, by the way, there is a small update this year: you don’t have to eat milk tea, coffee, or seafood during vaccination. As long as you are not allergic to these, you can eat them as you like. The old saying that “you can’t eat spicy food after vaccination” has long been overturned, so don’t irritate your mouth anymore.