New recommendations for the use of rabies vaccine for postexposure prophylaxis have been approved by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC). These recommendations, posted on July 10, 2009 (www.cdc.gov/vaccines/recs/provisional/downloads/rabies-July2009-508.pdf), are considered pro-visional until approved by the CDC and published in the CDC’s Morbidity and Mortality Weekly Report.

A four-dose regimen of rabies vaccine begun as soon as possible after possible rabies exposure is now recommended for previously unvaccinated persons who are not immunosuppressed; immunosuppressed patients continue to warrant five doses of vaccine. Recommendations for use of rabies immune globulin (RIG) remain unchanged. Rabies vaccine should be given intramuscularly on days 0, 3, 7 and 14.

ACIP’s decision was based in part on an extensive review of published and unpublished studies of rabies virus pathogenesis, experimental animal studies, human clinical trials and epidemiologic surveillance data, which was initiated...

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