Also See WARNINGS and CONTRAINDICATIONS Sections for Additional Statements

Reactions after vaccination with HDCV are less common than with previously available vaccines. (10,12, 20) In a study using five doses of HDCV administered intramuscularly, local reactions such as pain, erythema and swelling or itching at the injection site were reported in about 25% of recipients; mild systemic reactions such as headache, nausea, abdominal pain, muscle aches and dizziness were reported in about 20% of recipients. (9)

Clinical experience with Mérieux Imovax Rabies l.D., Rabies Vaccine, has resulted in a low incidence of adverse reactions comparable to those following intramuscular vaccination when administered by the intradermal route except that a slight increase in transient local reactions has been observed following intradermal vaccination, especially when the vaccine is given in the forearm rather than in the lateral aspect of the upper arm. Local reactions consist of redness, itching, mild pain and minimal swelling at the site of injection. Generalized reactions are uncommon.( 7) Mild local or systemic reactions can be treated with anti- inflammatory, antipyretic agents, e. g., aspirin and antihistamines. Systemic allergic or anaphylactic reactions following primary immunization have been reported to be less than 1%. (14) If an anaphylactic reaction should occur, epinephrine is indicated.

For "immune complex-like" reactions in persons receiving booster doses of HDCV see WARNINGS. Advice and assistance on the management of serious adverse reactions in persons receiving primary or booster rabies immunization may be sought from the state health department or CDC.( 9)

Antimalarial drugs such as chloroquine have been associated with a reduction in the antibody response to Rabies Vaccine administered by the intradermal route. Although it is apparent that antimalarial agents are not the sole factor responsible for the reduced antibody response, it is recommended that persons on corticosteroids and other immunosuppressive drugs receive Rabies Vaccine (3 doses/1.0 ml each) by the intramuscular route until more definitive data is available. (16,17,18)

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