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Instructions to submit a Public Records Request
Health advisory: Decrease in human rabies vaccine supplies
June 23, 2008

ACTION REQUESTED:

  • Review indications for rabies post-exposure prophylaxis (PEP) to minimize inappropriate use of rabies vaccine.
  • Contact Public Health at 206-296-4774 to report possible rabies exposures and discuss need for PEP.
  • Order rabies vaccine on a case-by case basis when indicated for PEP from Sanofi Pasteur by calling 1-800-VACCINE (1-800-822-2463).
  • Continue to administer rabies immune globulin (RIG) to patients requiring rabies PEP with first dose of vaccine and put systems in place to recall patients after vaccine is obtained.

Background:

The Centers for Disease Control and Prevention (CDC) has been notified that Novartis Vaccines, maker of RabAvert (Rabies Vaccine), will temporarily cease to provide their rabies vaccine for both pre- and post-exposure prophylaxis uses to health care providers. A second company, Sanofi Pasteur, produces IMOVAX (Rabies Vaccine), and will continue to supply vaccine to health care providers for post-exposure prophylaxis (PEP). In certain circumstances, such as an allergic reaction to one company’s vaccine product, the other company’s vaccine product can be obtained to complete a vaccination series on a case-by-case basis: Consult with Public Health for more information. Overall, both manufacturers have limited supplies of rabies vaccine, necessitating the need for judicious use of these products. It is expected that supplies of RabAvert sufficient to meet the demand for pre-exposure vaccinations will be available on the market in July 2008.

Priority use of rabies vaccine will be for post-exposure prophylaxis (PEP) following ACIP human rabies prevention recommendations. Clinicians should carefully review the ACIP recommendations and consult with Public Health to ensure that PEP is needed. Call Public Health at 206-296-4774, 7 days a week 24 hours a day.

Vaccine for rabies PEP is being released by Sanofi Pasteur on a case-by-case basis and shipped to health care providers. It may take up to 2 days for vaccine to be received. Because rabies PEP is a medical urgency and not an emergency, this delay should not represent a risk to patients. Clinicians should inform Sanofi Pasteur of especially high risk exposures, including bites to the head, face and neck, and request expedited shipment in such cases. Contact Sanofi Pasteur at 1-800-VACCINE (1-800-822-2463).

Due to the limited supplies, distribution of vaccine for pre-exposure prophylaxis (PreP) will be approved by state and federal public health authorities after consultation with Public Health. Priority will be given for those individuals at greatest rabies exposure risk (e.g., rabies laboratory workers, animal control officers, veterinary staff, wildlife workers). In lower risk rabies exposure categories (e.g., travelers, veterinary students, etc.), human rabies PreP should be delayed until vaccine supply levels are restored.

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