Latest Rabies Vaccination Guidelines 2025

Non-level III exposures that occur within 1 year after a full course of rabies vaccination in healthy people do not require a booster shot; Level II exposures caused by domestic animals with clear records of more than two rabies vaccinations and qualified antibody tests within the past six months can be applied to the 10-day observation method, and there is no need to start the full course of vaccination at the first time; the scope of application of pre-exposure prophylaxis has been added to outdoor working groups such as takeaways and couriers who have high contact with stray animals.

Don’t think that these adjustments have nothing to do with you. Last week, a girl in my community was scratched by a British shorthair that she had raised for 3 years and had been vaccinated against rabies every year. According to the 2023 version of the guide, she had to get at least 2 booster shots. Last week, she went to the community hospital. The doctor gave her a wound washing order and asked her to go home and observe the cat for 10 days.

Many people are still confused about when injections are needed and when not. To put it bluntly, you just touch the wound: if there is no broken skin or red marks, but it was just rubbed by an animal, then it is nothing, and there is no need to flush. If there are red marks or slight scratches but no bleeding, it is level II. If there is bleeding or the wound was licked by an animal, it is level III. This grading standard has not changed, but the subsequent treatment process has changed.

Speaking of the 10-day observation method, the industry has actually been arguing about it for almost 10 years. Experts on the public health prevention and control side have been reluctant to let go. After all, the rabies virus-carrying rate of stray animals in my country is still about 0.17%. If we let it go casually and let everyone use the observation method, no one will be responsible for the delay in vaccination time if we encounter stray animals with venom. However, most of the vaccination doctors on the clinical frontline support this adjustment. I contacted the community Dr. Li from the breeding site said that among the cases of domestic animal injuries she encountered last year, more than 90% of the cats and dogs had formal vaccination records. Previously, they had to get injections according to the old guidelines, and many people had to take time off for several trips. This was a completely unnecessary waste of medical resources. This time the prerequisites for domestic animals have been clarified, which is equivalent to loosening the shackles of reliable pet owners.

The most frequently asked question is whether pregnant women and children can be vaccinated against rabies? The 2025 version of the guide specifically adds a large sample of clinical data to prove that the rabies vaccine is an inactivated vaccine. Whether it is pregnant women, infants, or the elderly with normal immune function, vaccination will not have any additional side effects, let alone teratogenic. If you are bitten by an ownerless animal, don’t hesitate to get vaccinated as soon as possible. Previously, I met a pregnant mother who was 4 months pregnant and got a red mark from a stray dog. She held on and did not dare to vaccinate. In the end, she was anxious for half a month. In fact, it is completely unnecessary.

Of course, not everyone can apply the simplified process. If you are taking immunosuppressants or have an immunodeficiency disease such as AIDS, no matter what the injury, you must follow the strictest process. Not only do you need to be fully vaccinated, but you also need to add rabies immunoglobulin. There is no room for negotiation on this point. After all, the antibody production rate of immunodeficiency people is about 40% lower than that of healthy people, so you cannot take risks.

There is another change that has attracted a lot of attention this year, that is, the nasal spray rabies vaccine has been officially approved for pre-exposure prophylaxis. It does not require a needle, just spray the nose twice. Many parents have asked whether they should arrange it for their children. Let’s be honest here. The advantage of nasal spray is that it is non-invasive and the mucosal antibodies produced are more effective in protecting against contact exposure. However, the disadvantage is that the antibody titer rises slowly. If you have been bitten, you still have to get the traditional intramuscular vaccine. Don’t choose the nasal spray to save trouble. As for whether to take pre-exposure prophylaxis, if you often come into contact with stray animals, or have cats and dogs at home that often run outside, whether you are an adult or a child, there is definitely no harm in taking pre-exposure prophylaxis. Now some cities have included pre-exposure rabies vaccination for minors in medical insurance, which is very cost-effective.

I have two cats and one dog, and I take them for rabies antibody tests every year. If I get scratched, I usually just rinse it with soapy water, and there have been no problems for so many years. But I also have to remind everyone that if you are bitten by an unknown stray animal or a pet of unknown origin, don’t insist on using the 10-day observation method. First, rinse with soapy water for 15 minutes, and then go to the vaccination point. Get whatever is needed. After all, the mortality rate of rabies once it develops is 100%, and this bottom line cannot be relaxed.