Do Children Need Rabies Vaccines After Dog Bites?

Rabies vaccine

Hello Dr.
Hsu, my child was bitten on the palm by a neighbor's dog last night and has already received a tetanus vaccine.
Should we also administer a rabies vaccine?

Miss Lin, 30~39 year old female. Ask Date: 2006/12/06

Dr. Xu Kaixi reply Surgery

Dear Miss Lin,
First, it is essential to determine whether the neighbor's dog has rabies (symptoms include foaming at the mouth, obvious aggression, or abnormal behavior).
If it is a normal pet dog, there is no need to worry about the risk of rabies.
Administering tetanus toxoid (not the vaccine) is sufficient.
If the child is under 5 years old and has been receiving regular vaccinations, it may not be necessary to administer tetanus toxoid.
Wishing you good health and a Happy New Year from the Department of Surgery, Tainan Hospital.

Reply Date: 2006/12/06

More Info

When it comes to rabies vaccination after a dog bite, especially in children, there are several important factors to consider. Rabies is a viral disease that is almost always fatal once symptoms appear, making timely intervention critical.
Firstly, the necessity for rabies vaccination depends on several factors, including the vaccination status of the dog, the nature of the bite, and the local prevalence of rabies. If the dog that bit your child is up to date on its rabies vaccinations and is healthy, the risk of rabies transmission is significantly lower. However, if the dog is a stray, unvaccinated, or has an unknown vaccination history, the situation becomes more concerning.

In your case, since the child has already received a tetanus shot, it’s important to assess whether rabies vaccination is warranted. The Centers for Disease Control and Prevention (CDC) recommends rabies post-exposure prophylaxis (PEP) if the following conditions are met:
1. The dog is suspected to be rabid: If the dog shows any signs of illness or abnormal behavior, or if it is a stray, rabies vaccination is recommended.

2. The dog is not available for observation: If the dog cannot be observed for 10 days to ensure it does not show signs of rabies, vaccination is necessary.

3. The bite is severe: Deep bites or bites that break the skin increase the risk of rabies transmission.

Given that your child was bitten, it is advisable to consult with a healthcare professional immediately. They will likely recommend starting the rabies vaccination series if there is any doubt about the dog’s rabies status or if the dog cannot be observed.

The rabies vaccination series typically consists of five doses administered on days 0, 3, 7, 14, and 28 after exposure. It is crucial to begin this series as soon as possible after the bite, ideally within 24 hours.
In terms of the tetanus vaccine, if your child has received a tetanus booster within the last five years, additional tetanus vaccination may not be necessary. However, if it has been more than five years since the last booster, a tetanus shot may be warranted.

In summary, if the dog is healthy and vaccinated, and if the bite was minor, you may not need to worry about rabies. However, if there is any uncertainty regarding the dog’s health or vaccination status, it is best to err on the side of caution and initiate rabies vaccination. Always consult with a healthcare provider for personalized medical advice, especially in cases involving children and potential rabies exposure.
Lastly, it’s essential to monitor the child for any signs of infection at the bite site, such as increased redness, swelling, or discharge, and seek medical attention if these occur.

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