How this schedule is built
India's National Centre for Disease Control (NCDC) recommends two vaccination regimens for post-exposure prophylaxis (PEP), depending on the route used. Both use purified cell-culture / embryonated-egg rabies vaccines.
"Previously vaccinated" means a documented complete PEP or pre-exposure course with a cell-culture vaccine, generally at any point in the past (not time-limited) — such patients need only the abbreviated booster and never require immunoglobulin, regardless of exposure category.
WHO / NCDC exposure categories & immunoglobulin
| Category | Exposure | Management |
|---|---|---|
| I | Touching or feeding animals; licks on intact skin | Wash exposed skin; PEP not required |
| II | Nibbling of uncovered skin; minor scratches or abrasions without bleeding | Wound care + vaccine (ID or IM); no immunoglobulin |
| III | Single/multiple transdermal bites or scratches, licks on broken skin, contamination of mucous membranes, or any bat contact | Wound care + vaccine + rabies immunoglobulin (RIG) |
RIG (human 20 IU/kg, or equine 40 IU/kg) is infiltrated into and around all wounds, with any remainder given intramuscularly at a distant site. It should be given as close to Day 0 as possible — if not immediately available, it can still be given up to 7 days after the first vaccine dose, but never after that, and never for patients on the booster-only schedule.
Clinical use
- Wound care first: immediate, thorough washing of all bite/scratch wounds with soap and running water for a full 15 minutes is the single most effective rabies-prevention step, and should never be delayed for vaccine or RIG.
- Route choice: ID regimens use a fraction of the vaccine per session (dose-sparing) and are officially recommended in India's national programme; IM (Essen) remains widely used, particularly outside dedicated ID-trained centres.
- Missed doses: if a patient misses a scheduled visit, continue from where the schedule left off rather than restarting — but note this calculator assumes doses are taken on schedule and does not adjust for delays.
- Animal observation: for a healthy dog/cat available for 10-day observation, PEP may be discontinued if the animal remains healthy throughout — a clinical decision outside the scope of this tool.
Frequently asked questions
What is the anti-rabies vaccine (ARV) schedule?
The post-exposure vaccination course given after a possible rabies exposure — either the 5-visit IM (Essen) regimen or the 4-visit ID (updated Thai Red Cross) regimen, both described in detail above.
What's the difference between ID and IM rabies vaccination?
ID (intradermal) uses a fraction of the vaccine dose per session across multiple small injection sites, which is dose-sparing and officially recommended in India's national programme. IM (intramuscular) uses a full vaccine vial per visit and remains widely used, especially outside ID-trained centres.
How many rabies vaccine doses are needed?
For a new (unvaccinated) patient: 5 IM doses over 28 days, or 4 ID visits (8 total injection sites) over 28 days. Previously vaccinated patients need only an abbreviated 2-visit booster, regardless of route.
Do I need the full vaccine schedule if I've been vaccinated before?
No — a documented complete prior rabies vaccination course means only the abbreviated 2-visit booster schedule is needed on re-exposure, and immunoglobulin is never required in this group.
References
- National Centre for Disease Control (NCDC), Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India. National Guidelines on Rabies Prophylaxis, 2019.
- World Health Organization. WHO position paper on rabies vaccines. Wkly Epidemiol Rec. 2018;93(16):201–219.
- World Health Organization. Rabies vaccines and immunoglobulins: WHO position — updated guidance, 2018.