Anxiety over Rabies Shot placement

Posted by perpetualpsyduck @perpetualpsyduck, Aug 31 12:53pm

Hi all,
25M from India.
On Saturday, I was bit by a stray dog on my leg. Since I was wearing jeans there were wounds but not many.
Couldn't immediately clean the wound but got Rabies ChiroRab vaccine and a Tetanus shot within 25-30 minutes but both the shots had been near buttocks region.
On Tuesday when I went for the 2 shot, asked the doctor to give the shot on my hand after reading that rabies Shot shouldn't be given near buttocks. But he said that I won't be able to bear the pain in the hand, and gave the shot again near the buttocks.
I am anxious regarding this now and don't know what to do. Haven't been able to let the thought go off from my mind.
Should I repeat this 2 shots now or take the rest of the shots near my shoulder and let it be.
Please advice.

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Hi all,

Got bit by a stray dog on Saturday in leg. Since was wearing jeans there were wounds but not many.
Couldn't immediately clean the wound but got Rabies ChiroRab vaccine and a Tetanus shot within 25-30 minutes but both the shots had been near buttocks region.
On Tuesday when I went for the 2 shot, asked the doctor to give the shot on my hand after reading that rabies Shot shouldn't be given near buttocks. But he said that I won't be able to bear the pain in the hand, and gave the shot again near the buttocks.
I am anxious regarding this now and don't know what to do. Haven't been able to let the thought go off from my mind.
Should I repeat this 2 shots now or take the rest of the shots near my shoulder and let it be.

REPLY
@perpetualpsyduck

Hi all,

Got bit by a stray dog on Saturday in leg. Since was wearing jeans there were wounds but not many.
Couldn't immediately clean the wound but got Rabies ChiroRab vaccine and a Tetanus shot within 25-30 minutes but both the shots had been near buttocks region.
On Tuesday when I went for the 2 shot, asked the doctor to give the shot on my hand after reading that rabies Shot shouldn't be given near buttocks. But he said that I won't be able to bear the pain in the hand, and gave the shot again near the buttocks.
I am anxious regarding this now and don't know what to do. Haven't been able to let the thought go off from my mind.
Should I repeat this 2 shots now or take the rest of the shots near my shoulder and let it be.

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Hi @perpetualpsyduck, you're quite right. According to the guidelines from the CDC, "The gluteal area [buttock] should never be used for rabies vaccine injections because observations suggest administration in this area results in lower neutralizing antibody titers." Read more here: https://www.cdc.gov/rabies/medical_care/vaccine.html

Note that it says "lower neutralizing antibody titers". This means that the vaccine has some effect.

Please note that the recommended protocol is 4 doses. "A regimen of four 1-mL doses of HDCV or PCEC vaccines should be administered intramuscularly to previously unvaccinated persons. The first dose of the four-dose course should be administered as soon as possible after exposure. Additional doses should be administered on days 3, 7, and 14 after the first vaccination. For adults, the vaccination should always be administered intramuscularly in the deltoid area (arm)."

I suggest that you see a different doctor to get subsequent vaccination shots in the arm (not the hand).

REPLY

In January 2020, I was bitten on my hand by a neighborhood cat and took the four-shot rabies series. My hand was examined by the ER doctor. I told him that I was familiar with the cat, it looked very healthy and this cat was usually very friendly, but it was not used to me touching it and I had "provoked" it by trying to clean something off its face. The doctor really thought I didn't need the rabies series and said that very few "domestic" animals in my Texas city, especially cats, were exposed to rabies. However, I had read that once rabies symptoms start to "show," you were a goner and that these can take even years to manifest and knew this possibility would cause me a lot of anxiety over the years, so I insisted that I be given the shots.

Here in Texas, you HAVE to get the first shot at a hospital emergency room unless your PCP just happens to have the rabies series. I was given immunoglobulin injections in various places around the bite on my hand (yes, I felt them, but they were not agonizing) and then, the first rabies shot was given in my shoulder. The other three subsequent shots were also given in my arm by a place that specializes in vaccinating folks going overseas (not many places keep, or have access to the rabies vaccine and the hospital ER was going to be $$$s already).

ALL four of my rabies vaccine shots were given in the SHOULDER—neither the ER doctor, or the specialty overseas vaccines center doctor even suggested another location for the injections.

Even WITH health insurance, I had to pay over $1,000 for the hospital ER that billed my insurance $10,000. The other shots were $425 each upfront at the passport vaccination center; after submitting much paperwork and intervention by a Compass Health Service (now Alight) customer advocate, I was reimbursed about half by my BCBS health insurance for the three shots I paid for out of pocket. Despite the expense, the peace of mind I got from taking the rabies series was worth it to me.

REPLY
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