Rabies Prevention, First Aid & PEP
Complete guide to preventing rabies and what to do after exposure. Expert-verified protocols for immediate action.
- Rabies is preventable—vaccinating pets and avoiding wildlife are key.
- After a bite/scratch, wash for 15 minutes and seek PEP promptly.
- PEP is nearly 100% effective when started before symptoms.
- Community dog vaccination (≥70% coverage) breaks transmission.
Immediate first aid
- 1.Wash for 15 minutes with soap and water; irrigate with povidone-iodine if available.
- 2.Avoid primary closure of wounds if possible until after RIG is infiltrated (if indicated).
- 3.Tetanus prophylaxis ± antibiotics per standard bite-wound care.
World Health Organization
Unvaccinated exposure
HRIG: 20 IU/kg once, preferably Day 0
Infiltrate into/around all wounds; inject any leftover IM at a site distant from the vaccine site. Give only up to Day 7 after the first vaccine dose. Never mix in same syringe/site as vaccine.
Vaccine (IM, deltoid; thigh ok for small children; never gluteal):
Days 0, 3, 7, 14. Add Day 28 if immunocompromised.
CDC
Previously vaccinated
No HRIG
Give vaccine Days 0 & 3 only
CDC
Clinician notes
Pregnancy/children are not contraindications to PEP.
Avoid gluteal injections.
Separate HRIG and vaccine sites.
CDC
WHO intradermal (ID) option (where used)
Resource-efficient schedule: 0.1 mL ID at 2 sites on Days 0, 3, 7 (Category II/III exposures). Add RIG for Category III. Do not give RIG after Day 7.
World Health Organization
Can PEP wait for observation/testing?
If a healthy dog/cat/ferret can be observed for 10 days or the animal can be tested quickly, public health may advise deferring or discontinuing PEP if the animal stays healthy/tests negative. Wildlife and unknown animals usually require PEP.
CDC
Pre-Exposure Prophylaxis (PrEP) — travelers & high-risk jobs
2 doses on Days 0 & 7.
Then either a one-time titer between year 1–3 or a one-time booster between 3 weeks and 3 years after dose 1, depending on your risk category.
CDC
Pets & community prevention
- Vaccinate dogs/cats starting at ~12 weeks, then boosters per product/local law.
- Sustained ≥70% dog vaccination coverage is the key threshold for breaking transmission in communities.
WHO Apps
What to do after an exposure
Clean the wound
Wash 15 minutes with soap + water → Irrigate with povidone‑iodine if available.
Assess the animal
Known dog/cat/ferret? Observe 10 days or test promptly. Wildlife/unknown? Start PEP unless advised otherwise.
Start indicated care
Unvaccinated: HRIG + vaccine 0,3,7,14 (±28). Previously vaccinated: vaccine 0 & 3. Avoid gluteal injections.
FAQs
Need immediate help?
If you've been exposed to rabies, don't wait. Find a clinic that provides PEP treatment.
Rabies Laws by State
Review vaccination rules, reporting requirements, and animal control regulations in your state.
Compare requirements in Texas, Florida, and California, then continue with our prevention & safety blog, clinic finder, and risk assessment tool.
References
- World Health Organization (WHO) — Rabies Fact Sheet: who.int/news-room/fact-sheets/detail/rabies
- Centers for Disease Control and Prevention (CDC) — Rabies Medical Care: cdc.gov/rabies/medical_care
- WHO position on dog vaccination coverage: who.int/activities/eliminating-dog-mediated-human-rabies
This page summarizes CDC/WHO guidance. Always follow your local health department's advice.
Last reviewed: January 16, 2025 | Sources: CDC, WHO, santacruzhealth.org