Rabies vaccine supply restricted, physicians must have approval before ordering and using some vaccines

The second large vaccine manufacturer has notified the Centers for Disease Control and Prevention that the supply of human rabies vaccine has been used at a higher rate than expected and may affect availability of the vaccine, according to a CDC Health Update.

Novartis, maker of the rabies vaccine RabAvert®, alerted the CDC of a low supply of vaccine for rabies post-exposure prophylaxis, which the Texas Department of State Health Services says is partly caused by contamination at a manufacturing facility in Germany that removed much of the supply from the U.S. market. This announcement follows one by Sanofi Pasteur that their vaccine, IMOVAX®, will not be available until late September or early October. Sanofi shut down and is renovating a production facility in France. In response to limited supply, the CDC recommends that physicians and the public take steps to use the existing supply appropriately and judiciously to ensure that patients exposed to rabies can access vaccines.

To ensure that rabies vaccine is available, the CDC has asked both manufacturers to limit distribution of the vaccines to requests from medical providers and on a case-by-case basis. Novartis requires that physicians conduct a risk assessment, confer with public health officials and obtain a confirmation code from a state health department before ordering vaccine doses for post-exposure prophylaxis, according to the CDC bulletin. Confirmation codes will be updated at a frequent interval and will be released after a state/local health authority has reviewed the facts of an exposure and determined it indicates a sufficient level of exposure risk as outlined in the Advisory Committee on Immunization Practices’ human rabies prevention recommendations.

Physicians can also play a role by alerting their patient to take precautions to prevent rabies infections. The precautions include vaccinating pets and livestock that have close human contact, avoiding stray and wild animals, and alerting animal control officials to safely capture or detain biting animals.

For more information about rabies and its prevention, and for updates regarding vaccine supply, contact your state or local public health official or CDC at (800) CDC-INFO or visit www.cdc.gov/rabies.