Maintaining the cold chain is essential for preserving vaccine potency. Regular monitoring and random potency testing must be an integral part of the vaccination program. However, it is also important to note that the lyophilized rabies vaccine, such as Serum Institute’s Rabivax-S, which is used in government supply, is one of the most heat-stable vaccines available.
The rabies vaccine which is currently used in our govt hospitals comes with a Vaccine Vial Monitor (VVM) Type 30 , which means it can tolerate a temp of 37°C (approximating room temp) for up to 30 days before reaching the discard point. Therefore, minor variations in the cold chain are unlikely to compromise the vaccine’s efficacy in real-world conditions.
That said, we must continue to ensure strict adherence to cold chain guidelines and carry out periodic genomic surveillance of the rabies virus. While viral mutations are rare, they are possible and could, in theory, affect vaccine efficacy.
Moreover, in most PEP failure deaths in kerala the incubation period is 2 to 3 weeks . It is crucial to understand that rabies vaccines take up to two weeks to elicit full protection. During this critical period, proper wound washing and prompt administration of rabies immunoglobulin (RIG) are the only defenses against the virus.
Therefore, rather than focusing solely on cold chain concerns, a comprehensive rabies control strategy must include:
1.Mass dog vaccination is highlighted as the most cost-effective strategy for preventing human rabies in endemic regions.Vaccinating at least 70% coverage to break the transmission cycle.
2.Community awareness campaigns on rabies prevention, including first aid after animal bites.
3.Animal birth control and robust animal rabies surveillance systems.
4.Pre-exposure prophylaxis (PrEP) is generally considered less important when the above measures are effectively implemented, but it remains crucial until those measures are properly in place.
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