AVMA Answers: Rabies titers

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Who should be vaccinated against rabies?

Dr. Lynne White-ShimDr. Lynne White-Shim, AVMA Scientific Activities Division assistant director, responds:

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices published a set of recommendations regarding human rabies prevention in 2008. These recommendations state that rabies pre-exposure vaccines should be offered to individuals with high risk for exposure to rabies, which includes veterinarians and their staff, as well as animal handlers and some researchers and laboratory personnel.

How often should veterinarians and their support staff have their rabies titers checked?

Most practicing veterinarians in the United States are considered to have a frequent risk for exposure to rabies and should have their titers checked every two years, per the CDC's ACIP recommendations. However, some veterinarians might need their titers checked more or less often, so veterinarians should consult the CDC's ACIP recommendations—Table 6 provides a summarized guide—to determine their relative risk of exposure to rabies. Veterinarians should take the CDC's ACIP resource with them to their physician's office for the titer check.

Two other helpful resources, which are developed by the National Association of State Public Health Veterinarians, are the Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel, and the Compendium of Animal Rabies Prevention and Control. The NASPHV advises that state health departments have information regarding the availability of rabies biologics and the presence of animal rabies locally and regionally.

What should veterinarians do if their rabies titer falls below an acceptable antibody level?

The CDC's ACIP resource indicates that if a rabies titer has fallen below the minimum acceptable antibody level, a single pre-exposure booster dose of vaccine is recommended for persons at frequent risk, which are most practicing veterinarians, or continuous risk of exposure to rabies.

If veterinarians or their physicians have further questions, the CDC can be contacted at (800) 232-4636. Or, they can go to the following websites:
nasphv.org/Documents/VeterinaryPrecautions.pdf, and