Rabies vaccines and immunoglobulins: WHO position

The new WHO recommendations for rabies immunization supersede the 2010 WHO position on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for rabies. These updated recommendations are based on new evidence and directed by public health needs that are cost-, dose- and time-sparing, while assuring safety and clinical effectiveness. In addition, new guidance on prudent use of rabies immunoglobulins (RIG) is provided. The following sections summarize the main points of the updated WHO position as endorsed by the Strategic Advisory Group of Experts on immunization (SAGE) at its meeting in October 20171. The full version of the WHO position on rabies vaccines and immunoglobulins will be published in the Weekly Epidemiological Record2 in April 2018. Rabies prevention involves two main strategies: (i) dog vaccination to interrupt virus transmission to humans; and (ii) human vaccination as a series of vaccine administrations before or after an exposure. Currently, rabies vaccines made from inactivated cell cultures are extremely well tolerated and have no contraindications.