For an almost invariably fatal disease, people sometimes take a surprisingly lax approach to rabies prevention. Much attention is paid to vaccination of pets (well, not by everyone, but it’s pretty good) – and that’s great, but sometimes people do a better job of vaccinating their dogs than themselves. It’s not because they care about their dog’s health more than theirs, it’s likely due to one of two things:

  1. Needle-aversion
  2. Lack of awareness

Most people in North America don’t need rabies vaccination. Unless you work with animals (or rabies virus), your risk is low and routine vaccination isn’t indicated. However, something that’s often neglected is rabies vaccination for travelers. Rabies is rampant in wildlife and, more importantly, stray animals in many regions of the world outside of North America, and travel-associated rabies is a real concern. If someone will be working with animals or is traveling to an area where rabies is very active, vaccination is recommended. People tend to do a pretty poor job overall when it comes to pre-travel medical counseling and vaccination, and it’s not surprising that rabies vaccination often gets overlooked.

A recent study in Vector Borne and Zoonotic Diseases (Dolan et al 2014) examined this issue. The authors looked at travel medicine clinics, studying 13 235 travelers.

Here are some highlights:
2% of travelers had been vaccinated against rabies previously (e.g. veterinarians, persons with prior rabies exposure). We’ll ignore them for the rest of the results.

62% of the remaining travelers were going to countries were rabies vaccination is strongly recommended.

  • 3% received rabies vaccine at their consultation.

21% of the 62% were going to be traveling for 1 month or more (which means more time to get exposed. Also, if you’re away for longer, it’s more likely that you’ll have to try to find treatment while traveling or cut your vacation short to get it at home).

  • Only 9% of these individuals were vaccinated. Thirty percent (30%) declined vaccination and in 50% of cases, the travel physician thought their itinerary was low risk.

Leisure travelers were less likely to be vaccinated.

Take home messages:

  1. Go to a travel clinic before you travel (and do it early enough for vaccination to be effective – going the day before doesn’t help much).
  2. Talk to the doctor about the potential for rabies exposure where you’re going.
  3. If you’re going to make the effort to do 1 and 2, take their advice.
  • Ross Pezzack

    Although controversial, should previously vaccinated individuals not attempt to assess their immune status to rabies especially if there has not been a vaccine for a number of years, especially if travelling to an area where post exposure vaccine may be difficult to acquire?