PHYSICIAN INSTRUCTIONS FOR ADMINISTERING
RABIES POST–EXPOSURE PROPHYLAXIS (PEP)
PATIENT INFORMATION
Last name: ____________________________ First name: ____________________________
Date of birth: ________/_____/____
YYYY/ MM/ DD
Weight: ______________ kg lbs
PACKAGE CONTENTS
# doses of rabies VACCINE
ImoVAX® Rab
ies (HDCV) or
RabAvert® (PCECV)
# vials of rabies IMMUNE GLOBULIN
ImoGAM® 150 IU/mL (2 mL) or
HyperRAB® 150 IU/mL (2 mL) or
HyperRAB® 300 IU/mL (1 mL) or
KamRab® 150 IU/mL (2mL)
ADMINISTRATION SCHEDULE
P
atient has not previously been immunized against rabies Patient has previously completed
a full course of rabies immunization
DAY 0: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose (1mL) IM in the deltoid.
In infants <12 months, VACCINE should be given IM in the
anterolateral thigh.
IMMUNE GLOBULIN:
Rabies IMMUNE GLOBULIN is supplied in 150 IU/mL (2 mL) or 300
IU/mL (1 mL) vials (check vial label). Calculate the dose required:
For 150 IU/mL IMMUNE GLOBULIN in 2 mL vials:
20 IU/kg x (client
wt in kg) ÷ 150 IU/mL = dose in mL OR
9.09 IU/lb x (client wt in lb) ÷ 150 IU/mL = dose in mL
For 300 IU/mL IMMUNE GLOBULIN in 1 mL vials:
20 IU/kg x (client wt in kg) ÷ 300 IU/mL = dose in mL OR
9.09 IU/lb x (client wt in lb) ÷ 300 IU/mL = dose in mL
The calculated dose should not be exceeded. Discard the remainder.
Using a different syringe and needle than for the VACCINE, infiltrate
as much IMMUNE GLOBULIN as possible into and around the
wound(s), similar to freezing a wound. If it is not possible to infiltrate
the entire calculated dose into the wound, the remainder of the dose
should be injected IM at one or more site(s) distant from the site of
VACCINE administration (e.g., gluteal area, anterolateral thigh), using
a new needle.
If there are multiple or extensive wounds present, IMMUNE
GLOBULIN can be diluted in a diluent permitted by the specific product
labelling in order to provide the full amount of immune globulin required
for thorough infiltration of all wounds.
DAY 0: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose
(1mL) IM in the deltoid.
In infants <12 months,
VACCINE should be given IM in
the anterolateral thigh.
Rabies IMMUNE GLOBULIN
should not be given to persons
who have previously received
appropriate rabies immunization.
DAY 3: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose IM in the deltoid.
DAY 3: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose
IM in the deltoid.
DAY 7: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose IM in the deltoid.
No further doses of VACCINE are
required for persons who previously
completed a full course of rabies
immunization.
DAY 14: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose IM in the deltoid.
A fifth dose of rabies VACCINE is required only if the patient is
immunocompromised or taking immunosuppressant or
antimalarial medication:
DAY 28: ________/_____/____
YYYY/ MM/ DD
VACCINE: Administer one dose IM in the deltoid.
Vaccine schedule deviations: Vaccination schedules for rabies PEP should be adhered to as closely as possible. It is
essential that all doses be received. If a dose of vaccine is delayed, it should be given as soon as possible and the schedule
resumed, maintaining the intervals between doses. If there has been a significant deviation from the recommended vaccination
schedule, immunity can be assessed with serology testing 7 to 14 days after the last vaccine dose.
For more information or questions about rabies post-exposure prophylaxis:
Canadian Immunization Guide: http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-rabi-rage-eng.php
Call Toronto Public Health, Healthy Environments call 416-338-7600 (8:30 am-4:30 pm) or 311 (after hours)
Revised: September 2020
Toronto Public Health File No.
