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Can HRIG And Vaccination Shots Be Taken Together Same Day?
Question: Context: scratched by a cat on the street in Cairo Egypt. It resulted in a small but bleeding wound.
I was not vaccinated against Rabies before going to Egypt.
Day 0: Vaccin 1 in upper right arm
Day 2: HRIG was administered in just one injection (5ml where it at least should have been 10ml) around 48hours after Vaccin 1. This HRIG was also given in upper right arm.
Day 3: Will go for Vaccin 2
So HRIG was given in the same anatomical side 48 hours after vaccin 1. The dose of HRIG was too low.
What should I do, just finish the vaccination course, how bad is it that it was given in the same anatomical site and does it make a difference that there was an 48 hours interval??
I was not vaccinated against Rabies before going to Egypt.
Day 0: Vaccin 1 in upper right arm
Day 2: HRIG was administered in just one injection (5ml where it at least should have been 10ml) around 48hours after Vaccin 1. This HRIG was also given in upper right arm.
Day 3: Will go for Vaccin 2
So HRIG was given in the same anatomical side 48 hours after vaccin 1. The dose of HRIG was too low.
What should I do, just finish the vaccination course, how bad is it that it was given in the same anatomical site and does it make a difference that there was an 48 hours interval??
Brief Answer:
they may interact...
Detailed Answer:
Hello,
first of all, a cat scratch is not considered a suspicious injury. Cleansing the wound with soap and water is the most effective first measure. It's too late for that though.
HRIG should be administered right away and infiltration of the wound site with immunoglobulin is recommended for better results. HRIG and vaccine should not be injected on the same site for at least 7 days. If more than 7 days have passed then it's considered more safe. Otherwise the two formulations may interact and reduce the effectiveness of the vaccine.
Based on the above, I would suggest repeating the dosage as soon as possible and proceed like if the first dose of the vaccine was never done...
With current data four doses are required (0,3,7 and 14 days after the incident). If the cat is available for observation its health and is healthy otherwise then 10 days of observation are enough to make sure that it had no rabies and the vaccination may stop.
I hope it helps!
Kind Regards!
they may interact...
Detailed Answer:
Hello,
first of all, a cat scratch is not considered a suspicious injury. Cleansing the wound with soap and water is the most effective first measure. It's too late for that though.
HRIG should be administered right away and infiltration of the wound site with immunoglobulin is recommended for better results. HRIG and vaccine should not be injected on the same site for at least 7 days. If more than 7 days have passed then it's considered more safe. Otherwise the two formulations may interact and reduce the effectiveness of the vaccine.
Based on the above, I would suggest repeating the dosage as soon as possible and proceed like if the first dose of the vaccine was never done...
With current data four doses are required (0,3,7 and 14 days after the incident). If the cat is available for observation its health and is healthy otherwise then 10 days of observation are enough to make sure that it had no rabies and the vaccination may stop.
I hope it helps!
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you for your answer.
I did cleanse the wound actually with water and soap afterwards (don't know if done in a correct manner but nonetheless I did it and put a Betadine Bandage around it).
I think I found the cat again although I am not completely sure.
So if I understand you correctly I have to go back to the hospital, ask for another dose of HRIG, and start again with the vaccin.
Day 0 (Today) In this case 5ml HRIG (or 10ml??) in wound and leftover in upper right arm.
Day 0 (Today) Vaccin in upper left arm
Day 3 Vaccin Dose 2
Etc.
Or only the Vaccin??
I did cleanse the wound actually with water and soap afterwards (don't know if done in a correct manner but nonetheless I did it and put a Betadine Bandage around it).
I think I found the cat again although I am not completely sure.
So if I understand you correctly I have to go back to the hospital, ask for another dose of HRIG, and start again with the vaccin.
Day 0 (Today) In this case 5ml HRIG (or 10ml??) in wound and leftover in upper right arm.
Day 0 (Today) Vaccin in upper left arm
Day 3 Vaccin Dose 2
Etc.
Or only the Vaccin??
Brief Answer:
the vaccine only
Detailed Answer:
You're welcome!
I would have asked for the vaccine only but as I told you already the cat scratch is not considered suspicious. The local authorities may provide more information as to rabies incidence in the area and whether a more aggressive approach is required. Otherwise proceed with revaccination just to be sure.
Kind Regards!
the vaccine only
Detailed Answer:
You're welcome!
I would have asked for the vaccine only but as I told you already the cat scratch is not considered suspicious. The local authorities may provide more information as to rabies incidence in the area and whether a more aggressive approach is required. Otherwise proceed with revaccination just to be sure.
Kind Regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I will ask for a new vaccin shot in the opposite arm this time, and leave the HRIG as it is, thanks a lot.
In Egypt Rabies does occur but nonetheless not that much.
The wound was bleeding but the cat wasn't agressive so I am not too worried.
I think the general advise is to get some treatment because of the country and Rabies does occur among animals. But the first doctors never even heard of HRIG and that was in the big more Western Hospitals. Then I talked to someone producing vaccination and she told me to get the HRIG and that I had to go to a government hospital. The government hospital, lower standards, did have the HRIG but I had to ask for it like 10 times before he even understood what I was talking about (all kind of medicines were shown) and he did it almost all wrong.
The positive side to this story is that the government hospitals give it for free so it didn't cost me to much money.
Thank you again and I will follow your advice regarding this and keep staying aware of the cat (also considering the fact that a scratch is supposed to be less suspicious).
In Egypt Rabies does occur but nonetheless not that much.
The wound was bleeding but the cat wasn't agressive so I am not too worried.
I think the general advise is to get some treatment because of the country and Rabies does occur among animals. But the first doctors never even heard of HRIG and that was in the big more Western Hospitals. Then I talked to someone producing vaccination and she told me to get the HRIG and that I had to go to a government hospital. The government hospital, lower standards, did have the HRIG but I had to ask for it like 10 times before he even understood what I was talking about (all kind of medicines were shown) and he did it almost all wrong.
The positive side to this story is that the government hospitals give it for free so it didn't cost me to much money.
Thank you again and I will follow your advice regarding this and keep staying aware of the cat (also considering the fact that a scratch is supposed to be less suspicious).
Brief Answer:
You're welcome!
Detailed Answer:
You're welcome!
I'm sure everything will be all right!
Best wishes!
You're welcome!
Detailed Answer:
You're welcome!
I'm sure everything will be all right!
Best wishes!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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