CDC - News (September 30, 2011): RabAvert Rabies Vaccine Supply Limitation - Rabies

RabAvert Rabies Vaccine Supply LimitationPosted: September 30, 2011

CDC has been notified that Novartis Vaccines currently has a limited supply of their human rabies vaccine, RabAvert, in their inventory. However, there is a normal supply of RabAvert in the wholesaler/distributor channels. At this time, there are no changes to the ACIP recommendations for either pre or post-exposure prophylaxis. Novartis does have a limited supply of RabAvert in inventory and can make product available to physicians who are not able to order through a wholesaler/distributor (see below) and who need RabAvert for post-exposure prophylaxis. Novartis expects to have additional supply of product available in November.

CDC is working together with FDA and the vaccine producers to ensure that no rabies vaccine shortage develops. Public health professionals are reminded that the Compendium of Animal Rabies Prevention & Control  [PDF - 103 KB] and ACIP human rabies prevention guidelines are useful documents to consider throughout the year to prevent and manage exposures to rabid animals. To minimize the need for human post-exposure prophylaxis, we continue to recommend public health engagement that includes:
•exposure risk assessments
•prompt laboratory diagnosis
•confinement and observation of suspect dogs, cats or ferrets.
In addition, continued health communication and education efforts can help minimize potential rabies exposures. Messages should focus primarily on avoiding bites and other exposures from wild animals and responsible pet ownership (including up-to-date vaccinations). CDC's rabies and families page contains prevention messages in plain language that may be useful for engaging consumers.

CDC will provide updates to the supply situation as needed.

Contact information for RabAvert *wholesalers/distributors that have available RabAvert as of September 30, 2011 is provided below. * Please note that this list may not be complete.
AmerisourceBergen:
See list of distribution centers and phone numbers  [PDF - 180 KB].
Cardinal Health:
(614) 757-5000
Specialty Pharmaceutical Distribution: (866) 476-1340
McKesson:
(800) 482-3784
Medico-Mart, Inc:
(800) 242-6248 or (262) 446-2323
* Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

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full-text:
CDC - News (September 30, 2011): RabAvert Rabies Vaccine Supply Limitation - Rabies

CDC is working together with FDA and the vaccine producers to ensure that no rabies vaccine shortage develops. Public health professionals are reminded that the Compendium of Animal Rabies Prevention & Control  [PDF - 103 KB]
http://www.nasphv.org/Documents/RabiesCompendium.pdf

ACIP Recommendations

Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies

Summary

This report summarizes new recommendation and updates previous recommendations of the Advisory Committee on Immunization Practices (ACIP) for postexposure prophylaxis (PEP) to prevent human rabies (CDC. Human rabies prevention---United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR 2008;57[No. RR-3]). Previously, ACIP recommended a 5-dose rabies vaccination regimen with human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV). These new recommendations reduce the number of vaccine doses to four. The reduction in doses recommended for PEP was based in part on evidence from rabies virus pathogenesis data, experimental animal work, clinical studies, and epidemiologic surveillance. These studies indicated that 4 vaccine doses in combination with rabies immune globulin (RIG) elicited adequate immune responses and that a fifth dose of vaccine did not contribute to more favorable outcomes. For persons previously unvaccinated with rabies vaccine, the reduced regimen of 4 1-mL doses of HDCV or PCECV should be administered intramuscularly. The first dose of the 4-dose course should be administered as soon as possible after exposure (day 0). Additional doses then should be administered on days 3, 7, and 14 after the first vaccination. ACIP recommendations for the use of RIG remain unchanged. For persons who previously received a complete vaccination series (pre- or postexposure prophylaxis) with a cell-culture vaccine or who previously had a documented adequate rabies virus-neutralizing antibody titer following vaccination with noncell-culture vaccine, the recommendation for a 2-dose PEP vaccination series has not changed. Similarly, the number of doses recommended for persons with altered immunocompetence has not changed; for such persons, PEP should continue to comprise a 5-dose vaccination regimen with 1 dose of RIG. Recommendations for pre-exposure prophylaxis also remain unchanged, with 3 doses of vaccine administered on days 0, 7, and 21 or 28. Prompt rabies PEP combining wound care, infiltration of RIG into and around the wound, and multiple doses of rabies cell-culture vaccine continue to be highly effective in preventing human rabies.
Complete MMWR Report (Download  [PDF - 580 KB])

Human Rabies Prevention --- United States, 2008
Recommendations of the Advisory Committee on Immunization Practices

Summary

These recommendations of the Advisory Committee on Immunization Practices (ACIP) update the previous recommendations on human rabies prevention (CDC. Human rabies prevention---United States, 1999: recommendations of the Advisory Committee on Immunization Practices. MMWR 1999;48 [No. RR-1]) and reflect the status of rabies and antirabies biologics in the United States. This statement:

1. provides updated information on human and animal rabies epidemiology;
2. summarizes the evidence regarding the effectiveness/efficacy, immunogenicity, and safety of rabies biologics;
3. presents new information on the cost-effectiveness of rabies postexposure prophylaxis;
4. presents recommendations for rabies postexposure and pre-exposure prophylaxis;
5. presents information regarding treatment considerations for human rabies patients.

Complete MMWR Report (Download  [PDF - 547 KB])