Veterinarians examining a dog


By USPPG Editorial Team | Last updated: October 2026

RabAvert is a rabies vaccine that protects patients before an exposure and stops infection after one. Bavarian Nordic markets it in the U.S. as a purified chick embryo cell vaccine (PCECV) for all ages. Also, every dose is 1 mL in the muscle.

This guide covers the current CDC schedules for pre-exposure and post-exposure prophylaxis. It also explains how to give and store RabAvert and what to plan before you stock it. When you’re ready to order, you’ll find details on the RabAvert group pricing page.

Table of Contents

  Key Takeaways:

  • RabAvert works for both rabies pre-exposure and post-exposure prophylaxis in every age group.
  • Pre-exposure vaccination now takes two doses, on days 0 and 7, instead of three.
  • After an exposure, unvaccinated healthy patients need four doses plus HRIG on day 0.
  • Adults get the dose in the deltoid, while small children get it in the anterolateral thigh.
  • Store it at 2°C to 8°C away from light, then use it right after reconstitution.

How the RabAvert Rabies Vaccine Works

RabAvert contains inactivated rabies virus grown in purified chick embryo cells. Vaccination then prompts the body to make rabies virus neutralizing antibodies. That protection has to be in place before the virus reaches the central nervous system.

Timing matters because rabies has no effective treatment once it takes hold. In fact, CDC describes rabies as nearly always fatal once symptoms begin. CDC has also estimated that approximately 60,000 people in the U.S. receive post-exposure prophylaxis each year. Moreover, contact with rabid bats is the leading cause of human rabies in the country.

The FDA label covers two uses:

  • Pre-exposure prophylaxis (PrEP): a primary series and boosters for people whose work, hobbies or travel put them at ongoing risk.
  • Post-exposure prophylaxis (PEP): vaccination after a bite, scratch or other possible exposure, along with human rabies immune globulin (HRIG) when the patient has no vaccine history.

CDC recommendations also apply to the other U.S. rabies vaccine type, human diploid cell vaccine (HDCV). So the schedules below hold for either product.

Rabies Pre-Exposure Prophylaxis Schedule

Rabies PrEP is two 1 mL doses, first on day 0 and then on day 7. This two-dose schedule replaced the older three-dose series, so patients need fewer visits. As a result, a practice still following the three-dose version gives one more dose than CDC currently recommends.

Follow-up, however, depends on the patient’s risk. For that reason, CDC sorts people into five categories:

CDC risk category Typical patients Primary series Follow-up
1 Lab workers who handle live or concentrated rabies virus Days 0 and 7 Titer every 6 months
2 People who often handle bats, enter caves with many bats, or perform animal necropsies Days 0 and 7 Titer every 2 years
3 Veterinarians, vet technicians, animal control officers, wildlife workers, trappers, spelunkers and some travelers, when the risk lasts more than 3 years Days 0 and 7 One titer check 1 to 3 years after the series, or one booster between 3 weeks and 3 years after the first dose
4 The same groups as category 3, when the risk lasts 3 years or less Days 0 and 7 None
5 The general U.S. population Not recommended None

Travelers deserve a closer look. Specifically, CDC places some travelers to areas where dog rabies is common in categories 3 and 4. A practice with a travel medicine service will therefore see these patients most often. For destination planning, though, the CDC Travelers’ Health pages remain the best reference. Our guide to travel vaccines for practices also covers the rest of a travel consult.

PrEP does not replace post-exposure care. After a bite, a vaccinated person still needs wound care and two vaccine doses. However, PrEP removes the need for HRIG and for two of the four PEP doses.

Rabies Post-Exposure Prophylaxis Schedule

Every PEP course begins with the wound before any injection. In particular, CDC recommends immediate, thorough cleansing of all wounds with soap and water. Where available, clinicians can also irrigate with a virucidal agent such as povidone-iodine.

Then comes the vaccine and, for unvaccinated patients, HRIG. The schedule then depends on the patient’s immune status and vaccine history:

Patient HRIG Vaccine doses (1 mL each)
No prior rabies vaccine, immunocompetent 20 IU/kg on day 0 Days 0, 3, 7 and 14
No prior rabies vaccine, immunocompromised 20 IU/kg on day 0 Days 0, 3, 7, 14 and 28, then an antibody titer check
Prior PrEP or prior PEP Do not give Days 0 and 3

HRIG basics

The patient receives HRIG once, when PEP starts, at a dose of 20 IU/kg. Whenever possible, CDC advises infiltrating the full dose around the wound. Any remaining volume then goes into a muscle at a site away from the vaccine.

If the patient missed HRIG on day 0, clinicians can still give it through day 7. Beyond day 7, however, CDC no longer recommends it. Since HRIG is a separate product from the vaccine, practices that offer PEP need their own supply plan for it.

Immunocompromised patients

Immunosuppression can blunt the response to rabies vaccine. That’s why CDC adds a fifth dose on day 28 and recommends an antibody check after the series. State health officials or CDC can also advise on timing. When a patient doesn’t respond well, state or CDC rabies experts should help decide the next step.

CDC also offers a PEP calculator that builds the dose dates for each patient. It’s a useful check before you schedule return visits.

How to Administer RabAvert

Unlike some vaccines, RabAvert goes into the muscle only. Also, the dose stays at 1 mL for adults, children and infants alike.

  • Adults: deltoid muscle.
  • Infants and small children: anterolateral thigh.
  • Gluteal area: avoid it, because CDC notes absorption there is unreliable and the injection can harm the sciatic nerve. Therefore, repeat any dose that went into the gluteal area.
  • With HRIG: never draw the first vaccine dose into the HRIG syringe or inject it at the same site.

Reconstitute each kit with the diluent inside it, then give the dose right away. Indeed, the label calls for use immediately after reconstitution.

Storage and Handling

RabAvert ships as a single-dose kit. Each kit holds one vial of freeze-dried vaccine and a prefilled syringe with 1 mL of diluent.

Item Requirement
Storage temperature 2°C to 8°C (36°F to 46°F)
Light Keep away from light
After reconstitution Use immediately
Expiration Discard after the date on the package and container

Generally, practices order rabies vaccine in small amounts. Because of that, expiry dates deserve a regular check, especially when a practice keeps a small PEP reserve rather than a steady PrEP supply.

Contraindications and Allergy Considerations

The prescribing information treats PrEP and PEP differently.

  • Pre-exposure: a history of anaphylaxis to the vaccine or any of its components rules out vaccination.
  • Post-exposure: the label lists no contraindication, even during pregnancy.

Also note that RabAvert contains residues of egg and chicken proteins, including ovalbumin. In addition, each dose contains processed bovine gelatin (polygeline), a small amount of human serum albumin, and trace neomycin, chlortetracycline and amphotericin B.

When a patient has had anaphylaxis after egg or chicken protein, the label asks that staff and facilities be ready to manage it. Epinephrine (1:1,000) must also be on hand. In a true exposure, though, the risk of rabies outweighs these concerns. So screening should shape how you give the dose rather than whether you give it.

Should Your Practice Stock a Rabies Vaccine?

Many primary care offices refer bite cases elsewhere, so they never stock rabies vaccine. Even so, some settings see enough rabies risk to keep vaccine on hand:

  • Urgent care centers that treat animal bites, since they need to start PEP on day 0.
  • Travel clinics, especially those giving PrEP to travelers headed to areas where dog rabies is common.
  • Practices near veterinary schools, animal shelters or wildlife programs, especially those with patients in CDC risk categories 2 to 4.
  • Occupational health programs that vaccinate animal control officers, lab staff or veterinary teams.

Before you add it, plan the full course of care. For example, a PEP patient needs to return on days 3, 7 and 14, and sometimes 28. HRIG also has to be ready on day 0. Your local or state health department can help with exposure assessments, and it may know which nearby facilities carry HRIG.

If you’re building out a vaccine formulary, our vaccine stocking guide for primary care shows where a rabies vaccine fits alongside more common adult and pediatric products.

Frequently Asked Questions

What is RabAvert for?

RabAvert prevents rabies both before and after an exposure. Clinicians use it for pre-exposure prophylaxis in people at ongoing risk and also for post-exposure prophylaxis after a bite or scratch. In addition, the FDA licenses it for all age groups, and each dose is 1 mL in the muscle. Bavarian Nordic markets this purified chick embryo cell vaccine (PCECV) in the U.S.

How many doses of RabAvert does a patient need after a bite?

When a healthy patient has no rabies vaccine history, CDC recommends four doses on days 0, 3, 7 and 14. The patient also receives human rabies immune globulin (HRIG) on day 0. Immunocompromised patients, however, need a fifth dose on day 28. By contrast, a patient who had PrEP or earlier PEP needs only two doses, on days 0 and 3, and no HRIG.

Is rabies pre-exposure vaccination two doses or three?

Two. Since CDC replaced the older three-dose schedule, PrEP takes two doses on days 0 and 7. However, some people at ongoing risk also need antibody titer checks or a single booster, depending on their risk category. For example, lab workers who handle live rabies virus need a titer every six months.

Can a pregnant patient receive RabAvert?

For post-exposure prophylaxis, yes. The RabAvert prescribing information lists no contraindication to PEP, including pregnancy, because rabies is nearly always fatal once symptoms begin. Pre-exposure vaccination during pregnancy, on the other hand, is a separate clinical decision that depends on the patient’s risk.

How do you store RabAvert?

Keep RabAvert in the refrigerator at 2°C to 8°C (36°F to 46°F) and protect it from light. In addition, each single-dose kit holds a vial of freeze-dried vaccine and a prefilled 1 mL diluent syringe. After you reconstitute the vaccine, give it right away. Finally, check the expiration date on the package before use.

Where do you inject RabAvert?

Give adults the dose in the deltoid muscle. For infants and small children, the anterolateral thigh works best. Never use the gluteal area, because absorption there is unreliable. Also, during post-exposure care, keep the vaccine out of the HRIG syringe and away from the HRIG injection site.

For practices that stock RabAvert, USPPG members can review contract details and ordering steps on the RabAvert vaccine page.

Sources

This article offers general information for healthcare providers and practice administrators. It does not replace the prescribing information or current CDC guidance, so clinical decisions should follow both. Because vaccine pricing, program availability and manufacturer contracts can change, contact USPPG for the most current program details.