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Rabies vaccine
My 4 year old was bit by a stray pup. It was over the trouser, the wound was not deep but skin was broken, it did not bleed but there was an abrasion and we could see redness. We washed the wound after almost 2 hours with luke warm water and antiseptic. We started with vaccine on day 0. 4 out of 5 shots were administered in buttock and the last one was administered in the shoulder after we pointed the same to the doctor that the rabies shots are not preferred in the buttock. My kid completed the vaccine schedule 15 days back and is alright as of now. The wound has healed totally. Should I be concerned since the 4 shots were not administered in the right place? Is there any need to repeat the vaccine? I have no clue if the pup survived or not.
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No need to repeat vaccination
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Consult with Pediatrician physically for further evaluation and treatment
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Rabies vaccine given in the gluteal region is considered invalid Gluteal injections are not recommended because: The gluteal area has thick fat, and the vaccine may be injected subcutaneously instead of intramuscularly. This can lead to reduced immunogenicity and inadequate antibody levels. Since rabies has 100% mortality rate hence repeating the schedule is ideal Alternatively, anti rabies antibodies titre can be checked and if low , repeating the schedule becomes mandatory
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repeating the schedule or getting anti rabies antibodies titre levels checked
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Visit physically to nearby pediatrician.
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No, you do not need to be overly concerned, and repeating the vaccine series is not necessary in this case. Modern rabies vaccines (cell-culture based ones like Rabipur, Verorab, etc.) are very immunogenic and effective when given intramuscularly (IM) on the correct schedule — even if some doses were given in the gluteal area. Guidelines from WHO, CDC, and others strongly prefer deltoid (upper arm/shoulder) in children >2 years or anterolateral thigh in younger kids, and explicitly advise against gluteal injections because: There's more fat in the buttocks → risk of the vaccine going partly subcutaneous instead of deep IM. This can lead to somewhat slower/lower antibody response in some cases (especially noted with hepatitis B and older rabies data). However: For rabies PEP specifically, gluteal administration does not make the doses invalid in the way it does for some other vaccines. There are documented cases and general expert consensus (including from immunization bodies) that doses given in the gluteal area are usually still considered protective and do not require repeating — especially if the child completed the full course, responded normally (no immunosuppression), and is clinically well. The last dose was correctly given in the deltoid, and the series was completed on time. The bite was relatively minor (abrasion through clothing, no heavy bleeding/deep puncture), wound cleaned (though delayed), and PEP started promptly.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.