On what days post expsosure should the rabies vaccine be administered?

Previously the recommendation was days 0, 3, 7, 14, and 28.

On July 2009 (this is late breaking!!) the Advisory Committee on Immunization Practices (ACIP) recommended a change to a 4-dose regimen instead on days 0, 3, 7 and 14. The committee members made this decision after hearing that a large number of Americans exposed to rabies each year only get 3 or 4 shots and none of them have developed rabies. The shots cost between $100 - $200 each.

Despite this ACIP recommendation, none of the power house references including the CDC, Sanford Guide, or UptoDate have yet to change their recommended 5 dose regimen. Perhaps it's in the works but until then, I'm sticking with 5 shots. Call me a meanie but I think that if you tell patients they only need 4 doses they'll end up getting only 2 or 3.


Source

"ACIP Provisional Recommendations for the Prevention of Human Rabies" http://www.cdc.gov/vaccines/recs/provisional/downloads/rabies-July2009-508.pdf. 10 July 2009.

Herriman, R. "Advisory Committee on Immunization Practices: just 4 rabies shots needed post-exposure" examiner.com. http://www.examiner.com/x-7707-Infectious-Disease-Examiner~y2009m6d28-Advisory-Committee-on-Immunization-Practices--just-4-rabies-shots-needed-postexposure