Temporary Decrease in
Human Rabies Vaccine Supplies
The Centers for Disease Control and Prevention (CDC) has
been notified that Novartis Vaccines, maker of RabAvert (Rabies Vaccine), will
temporarily cease to provide their rabies vaccine for both pre- and
post-exposure prophylaxis uses to health care providers. This includes
physicians, nurse practitioners, hospitals, clinics, etc. A second company,
Sanofi Pasteur, produces IMOVAX Rabies (Rabies Vaccine), and will continue to
supply vaccine to health care providers for post-exposure prophylaxis
(PEP). In certain circumstances, such as an allergic reaction to one
company’s vaccine product, the other company’s vaccine product can be obtained
to complete a vaccination series after consultation with state health
departments and CDC, on a case-by-case basis. Overall, both manufacturers have
limited supplies of rabies vaccine, necessitating the need for judicious use of
these products by health care providers. (It is expected that
additional RabAvert will be available on the market in July 2008. When that
occurs, it is expected that the demand for pre-exposure vaccinations can be
fully met with RabAvert.)
Due to temporarily limited supplies,
distribution of vaccine for pre-exposure prophylaxis (PreP) will be approved by
state and federal public health authorities. Priority will be given for those
individuals at greatest rabies exposure risk (e.g., rabies laboratory workers,
animal control officers, veterinary staff, wildlife workers) and in
consideration of available rabies vaccine supplies. In lower risk rabies
exposure categories (e.g., travelers, veterinary students, etc.), human rabies PreP should
be delayed until vaccine supply levels are restored.
Priority use of rabies vaccine will be
for post-exposure prophylaxis (PEP) following ACIP human rabies prevention
recommendations (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5703a1.htm). IMOVAX rabies vaccine is
available for PEP and providers should carefully review the ACIP
recommendations and guidelines from their states to ensure that PEP is needed.
They are also strongly encouraged to consult with local/state public health
departments.
Public health authorities and health care
providers are encouraged to educate the public concerning the need to take
appropriate precautions to avoid rabies
exposure and actions to take if an exposure occurs. Appropriate
precautions include vaccination of pets, as well as livestock having close
human contact, avoiding stray and wild animals, and safely capturing or
detaining biting animals or obtaining owner contact information for follow up.
Such practices will decrease the need for rabies PEP and thus allow for the
responsible management of currently limited vaccine supplies.
CDC is working closely with both vaccine
companies and state and federal public health authorities to ensure that health
care providers receive up to date information on supply fluxes. Discussions
among federal, state, and local public health personnel are ongoing to review
additional strategies to manage the current supply of rabies vaccines. State
and local health departments are working to ensure that health care providers
are informed and have available consultation regarding best practices for the
use of rabies vaccine.
Information about rabies, its prevention, and
updates on the rabies vaccine situation can be obtained on the CDC rabies
website http://www.cdc.gov/rabies/ or by calling
1-800-CDC-INFO. The rabies web site will be updated as new information becomes
available.