Cost Rabies Vaccine
August 1st, 2023
My reception staff often get asked
How much does rabies vaccine cost? Will I need to have rabies vaccine etc.
The short answer is that it is complicated and thats why you need to see the doctor to plan if you need it and how best to have it.
It’s not like having a tetanus vaccine.
The Cost of Rabies Vaccine varies depending on how it is given.
The course can be given by different means: intramuscular (IM) or intradermal (ID).
Travel medicine clinics can give the vaccine intradermally (ID) to certain – especially persons under 50 years age. ID used a smaller volume of vaccine so if the vial can be shared, it is cheaper for the traveller: ID also has generally less side effects.
Cost example as at 12 Feb ( prices are subject to change without notice)
You need to come twice: the second visit is at least 7 days after the first visit- ideally 2 weeks between doses gives a bit more time for the immune system to work
IM is $169 x2 = $338
ID is $70 x2 = $140
NOTE The number of Rabies doses recommended prior to a trip has recently been was reduced from 3 doses to 2 doses by The World Health Organisation in April 2018. Australian guidelines changed mid December 2023.
ID vaccination works because the top layers of the skin (the dermis) have more of the special cells that help to make antibodies, so travel doctors can use a smaller dose of vaccine, and still get the result you want. Some other vaccines are licensed to give ID e.g. TB, and influenza.
Giving ID Vaccine is a specialised skill
ID vaccination is more technically difficult to administer, so it is recommended to be given in specialised travel clinics where the staff are appropriately trained. Also in order to share the vial with other travellers, the clinic needs to be seeing many travellers that day who need rabies vaccine.
You also need to have a blood test after ID vaccination to confirm that the antibodies to rabies have developed. This is usually covered by medicare.
Giving rabies vaccine by the ID method is known as an off-label use – it is not what the vaccine product information says to do.
How long does it take to complete the course
Rabies vaccine can take 1-4 weeks to complete the course – depending on which course that you and the doctor decide is best.
Rabies Vaccine is not recommended for everyone
Not all travellers are recommended to have rabies vaccine, but if it is recommended, it may be tempting to avoid the vaccine and imagine the things you could do with the money you don’t spend on rabies vaccine. BUT you might also spend a moment imagining what it would be like to be bitten by a dog in a risk country and not being able to access best practice medical care. This is not uncommon, and it is very scary. We are “on call” for the clinic after hours and the most common call we get is a stressed traveller who has not had rabies vaccine who is bitten unexpectedly in a high risk country.
In the persons who have never had rabies vaccine, treatment must be started on the day of the bite. What if you are bitten on the trail to Machu Pichu? or while trekking in Burma? or the steppes of Outer Mongolia? etc
The cost of rabies vaccine is a deterrent to some persons, but the good news is that once one has had the primary course, known as ‘ pre immunisation’ for rabies. Sometimes boosters are recommended, but one does not have to repeat a primary course when you go on your next trip, so it is a lifetime investment.
If you are pre-immunised for rabies, you would still need two boosters if you are bitten by an animal in a rabies-infected country, but you would never need to have the Rabies Immune Globulin (RIG). RIG is a blood product so it is hard to manufacture, scary because it could even be contaminated, and usually not readily available in the remote parts of the world.
It is a good idea (of course) to avoid patting dogs in countries that have rabies, but many persons who get a rabies risk bite are not patting dogs, they are just going about their business of being a traveller.
Dog wandering amongst the Gers during my recent trip to Mongolia. ( Christine here in this photo is pre-immunised )
References for more information
My other blog post on who needs rabies vaccine
ABC news about Bali and Rabies – Rabies shots priceless
Dr Deb has published in the international literature on ID rabies
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Tags : Cost Rabies Vaccine
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Can I have the ID method for the rabies vaccine if I’m a career of bats in Australia and want to be covered for the lyssaavirus
No – as the lyssavirus and the rabies virus are not identical. Flying Fox carers are recommended IM rabies vaccine
I have recently had the rabies vaccine, but my second dose was administered on day 11 instead of day 7 and dose 3 on day 29. Will this decrease the effectiveness of the vaccine?
Thanks
Jade
Hi Jade, the effectiveness will be fine.. regards Dr Deb
In September 2010 I had 3 shots of Rabipur. In March 2013 I had 1 booster shot of Rabipur (pre-boost titer reading was 0.56). I will soon be travelling extensively in SE Asia and India.
Should I have a blood test and/or booster shot to ensure sufficient level of protection, or; are the past shots sufficient pre-immunization?
Thank you for your advice.
Once a level of 0.5 has been reached, the body has ‘learned’ to make antibodies, so it is not necessary to have more pre-immunisation. Boosters are required if bitten
Regards Dr Deb
Hi, I had the initial 3 dose course in 2003, with a booster in 2008 then again in 2012. Would you recommend a blood test to determine my antibody levels now? If current levels are below .5 would another booster be recommended? Or is any level ok and just the 2 boosters required if bitten or licked?
Hi
If you are a bat carer, you need to keep your levels above 0.5 to be safe if you have inapparent exposure. For a traveller, you just need a full pre-exposure course and then no boosters unless you are bitten.
Regards Dr Deb
I was bitten in China, I injected 2 dose of vaccine, Need I finish the others?
Urgently…..Coz In Australia, I can’t find the place to do injection of rabies vaccine.
Yes you need to finish the course – call 1300 42 11 42 from anywhere in Australia to find your nearest travel medicine clinic. regards Dr Deb
I wanted to ask about testing for rabies neutralising antibodies after prevaccination or booster shots. You seem to say in the post that this testing is usually covered by Medicare. Are there criteria for Medicare to cover this testing? And if it is not covered by Medicare, how much would it cost the patient? Thank you for an informative and helpful post and string of replies.
Any travel in connection with work is not covered by medicare. If the blood test is clinically relevant for a person’s healthcare and they are travelling for non-work purpose then blood testing is covered whether it be tests for rabies, measles, Hep B, varicella etc. The cost for the test varies depending on the local path lab but can be in the range of $20- 40
I just finished my PEP treatment on Wednesday the 23, I was potentially exposed again to rabies and was wondering if I was still protected by the vaccine. Or if I would have to go and get another shot.
If you have had 4 or 5 doses of rabies vaccine for post exposure that is more than one would get for pre exposure so you dont need anymore unless you get another exposure and at that time you would only need 2 doses of vaccine and no RIG
Hello, I’ve just taken my two daughters to get their pep vaccine for rabies, the nurse said they only need to get two shots on days 0 and 7, and that the third is not really required anymore, saying that this is new info from the world health organisation but I can’t find evidence online to back it, just want to make sure I’m doing the right thing before our trip
yes guidelines are shifting
2 doses before departure will cover you for this trip so you won’t need the RIG ( blood product ) if you are bitten on this trip
but three doses will prime your immune system for life so I would recommend still have three unless you will never travel again
Best Regards, Dr Deb
Hi, recently, I made the dumb decision to touch a dead bat that was dried up already, it’s only been a day but I’m really paranoid that I Have rabies. I live in Malaysia and I’ve done some research which suggests that the rabies virus cannot live past 2 hours of the temperature exceeds 30c. The bat was really dried up, I know this because I snapped it in half with my hand. Right after I realised what I had done, I washed my hands 3 times with antabax soap. I have no cuts on my skin on my fingers. I’m not sure if I should get treated for rabies just in case. What do you think?
You dont need treatment
Hi. Today I went kayaking with some friends and a baby bat flew into a waterfall. We rescued it from drowning but afterwards it was licking us, almost as though it was trying to suckle, And it bit me. It did not bite hard and did not break the skin that I can see. I have been researching all night ever since to see if I needed a vaccine. I am taking it to a wildlife rehab in the morning. The bat has been very Calm, Almost lethargic. It was hanging upside down in my friends hair During the kayak ride back. Really it has just been sleeping since the incident. I am so worried about rabies. Do you know anyone who will give me a pep shot at a low cost or with a payment plan? Or do I need it?
^I have no insurance and no money and time is of the essence. Should I wait to see if the bat dies and then have it tested? I am so lost on what to do. Th I have no insurance and no money and time is of the essence. Should I wait to see if it dies, and then have it tested? I am so lost on what to do. Thanks.
HI Chelsea – you should go for treatment, but if you are in Australia, you can get rabies treatment free from public health. If you go to your nearest travel medicine clinic they will be familiar with rabies vaccine and how to access the free vaccine. Regard Dr Deb
Hi,
I’m traveling last minute to Malawi and plan to either get the first two shots of the rabies vaccine or do the accelerated protocol I’ve been reading about. My question is whether it is harmful to still get the antibodies upon exposure. Because I would have only had a partial treatment before leaving and rabies is so dangerous it seems better to play it safe and get the full course of treatment if exposed (the antibodies and the pep vaccines). Is there any downside to doing this? Could I be tested for the antibodies at a rural hospital?
Nat
HI Natalie, yes get two doses of vaccine before departure, then you will not need the Rabies Immune Globulin blood product into the wound if you are bitten. The third ‘ pre immunisation’ dose could be done on return. Australian Guidelines currently still recommend three doses for LIFETIME pre exposure cover but WHO says after two doses you dont need the RIG if you get an animal rabies risk expsoure. It would not be harmful to have RIG if you did not needed – it would just a a waste of pain and money. NO chance of having rabies antibodies tested in rural hospitals. Bon Voyage, Dr Deb
Is it harmful to receive RIG (rabies immune globulin) upon exposure even if you are pre-immunised against rabies just to be on the safe side in case you failed to develop the antibodies after the shots or the shots might not have given correctly? I read that RIG is contraindicated upon exposure for people who are pre- immunised. Could I get your opinion, please?
Yes it is harmful and unnecessary to have RIG if you are already immunised. REgards Dr Deb
Hi Dr Deb,
Hoping you are still responding here. I lived in the Philippines for 2 years (without any vaccines… young and dumb) and was bitten by a puppy. This was around 7 years ago now. The puppy was ours but it would be hard to say how exposed it could have been to street dogs. I know it was so long ago but I have read about how long rabies can incubate for. Is it worth getting the vaccine still?
Thanks for being so informative on this issue.
Hi thanks for your question
for peace of mind, yes have the vaccine, however if the puppy grew up and had a long life, it could not have had rabies so then not needed
regards Dr Deb
Hi Dr Deb, what is the youngest age one can receive the rabies vaccine? My daughter is two and a half and we are travelling to a rabies area in one week for three months. Can we get her two doses now (one today and one on day seven which is also the day we fly) and the third three months later? Is she old enough and is it a bad idea to get a vaccine on same day as flight in case of side effects? Thanks so much
HI
There is no age restrictions on rabies vaccine. You it would work to have two doses one week apart to give Rabies pre-exposure for this trip and get third one onreturn.
Rabies vaccine is often given on the day of the flight – it is a ‘dead’ vaccine so seldom causes troublesome side effects, Regards Dr Deb
Hey Dr Deb. I live in South India. I have a lot of cats around my house. When I tried break up a scuffle during dinner time one of the kittens bit me. This was on Thursday morning. This kitty is 3 months old and has not had any shots yet. Will cat bites give rabies? How do I know if I have rabies? Can you please advise me on what to do? Thanks
Hi – yes cats can have rabies – recently a tourist died in morocco from an infected cat bite. There is no way to tell if you have rabies until it is too late so you need to get vaccinated now just in case, regards Dr Deb
Hi Dr Deb, about 13 years ago a bat flew into my hair for a few seconds and then flew away. I did not know to get a rabies vaccine. Now I am about to travel abroad – can I still get the pre-exposure vaccine despite this incident? Thank you!
Hello Dr. Deb,
I have a family friend who has a 5 year old dog, who stays mostly inside and acts normal, looks healthy, is very friendly but they have not kept on his vaccines, they did take him to the vet about 2 days ago to get his shots caught up and mentioned to the vet it had been about 3 years since his last rabies shot. The vet said nothing about but that they would be able to tell if he had rabies. They claim he has not been sick and that he does not really come in contact with other animals, even though they do live in more rural area. About 4 days ago, he scratched me playing, do you think I need to go get a rabies shot? Like i said, he acts the same as he always has and they mentioned the lack of vaccination to the vet who said did not mention being concerned about rabies and the family is certain that he does not have rabies, but I am sort of panicking about it.
HI
Rabies is transmitted by animals saliva. Generally the dog has to be unwell. It would likely would be less stressful for you to have your dog fully vaccinated against rabies if they are living in a rabies area to decrease stress in this situation.
Hi Dr Deb, I lived in brisbane, Australia. My 4years old daughter was bitten by a friend’s dog yesterday night. As everyone said there is no rabies on dogs in Australia, so do I still need to give my daughter post exposure vaccine immediately? The latest time I can give her first vaccine is tomorrow(2days after bitten), is that still effective of the vaccine. I was very worrying about her, could you give me some advice? Most local doctor said she doesn’t need any treatment because no rabies on dogs in Australia. Is that true or still have the risk to get the rabies. Thanks!
It is true there is no rabies in Australia in dogs ( only a type of rabies in Flying Fox ) so your daughter does not need rabies vaccine. Regards Dr Deb
Hi Dr Deb,
My Dr said I only need 2 doses of MIRV prior to travel, but I can only find information on 3 doses. Is 2 enough now? Thanks.
HI Helen great question thanks
Yes the WHO position paper on Rabies from April 2018 suggested that 2 doses a week apart is likely enough to avoid the need for RIG. However the data is extrapolated and mainly been looked at in young persons with excellent immune function. Also this recommendation has not yet been ratified by the Australian authorities yet so it is off label in Australia. If leaving at short notice, or on a tight budget, it may be an excellent option to discuss with your travel health provider for a coming trip.
We usually say 3 doses gives lifetime priming – so no need for further boosters unless you are bitten
Mybe 2 doses does as well, but (and its a very big ‘but’)….
Rabies is very fatal .. if we get it wrong someone with die – since we cannot fix established rabies.
Some would say we doctors lean to being paranoid – we have to be. We really don’t like things going wrong.
so for me I would say ..I don’t think the data is strong enough to say 2 doses is ok in all persons, at all ages, to rely on being adequate priming for the next 50 years of travelling, but for a trip next week – different story.
Hi Dr Deb,
I had been immunised against rabies in 2013 with 3 ID vaccines along with 1 ID booster in 2014 to be fully protected. Recently I did a titer and it showed that my antibody level is below protective level again. I don’t know if it indicates my initial sets of vaccination was not sufficient to provide a long term immunity. Should I be looking into getting the full sets of vaccination again or should I just get a booster and hope that it will last longer this time? Thanks.
HI Stephanie
The human immune system tries to be very efficient with its resources, so it does not maintain high levels of circulating antibodies in the blood forever, however the immune system maintains memory cells in the bone marrow, that know how to make the necessary antibodies
You do not need to restart the course.
If you have one booster and test the levels about 3 weeks afterwards, your blood levels will pop up again as the memory cells leap into action.
This is why if you get a bite while travelling, you need to have boosters at day 0 and day 3, to get the blood levels to climb quickly.
Go MEMORY CELLS!
Hi Deb
If time is short pre travel , can we do a 2 dose course at 0 and 7-8 days and hope the new WHO advice you describe is correct regarding 2 doses being effective in the immunocompetent, but then do a booster 2 or 3 months later on returning to Au to be sure for long term protection.
If we forget to do the 2nd dose and don’t get it for 2 months , do we have to start from scratch? If if will still work , how long do we get the 3rd dose after the delayed 2nd dose? Still the recommend 3weeks after the 2nd dose?
Thanks
For the record, the two-dose WHO recommendation has not yet been ‘approved’ in Australia. That being said, Two doses day 0, 7 will avoid the need for RIG if you are exposed, but we do not know how long this priming will last for- so you need to get the third dose when you can.
You never need to start again with vaccine courses but on current data, one dose of rabies vaccine cannot reliably prime the immune system enough to avoid the need for RIG. VAccine doses can be late but not early so get them as soon as you can after the recommended date. REgards Dr Deb
Hello Doctor,
You have a very impressive web-presence!
Anyway, I’m a 63yo vet that had a course of rabies pre-exposure vaccinations in 1987/88, then a booster ten years later. I think they were Rhone-Poulenc products, but I didn’t keep a record, and of course self-administered…
I probably need a booster, as there is a possibility of handling bats. And for sure going back to SEAsia whenever travel is permissible…
Do I need to present a prescription from a medico to get a booster, or can I just order it myself?
Cheers
Greetings, thanks for your comment and feedback. You could do a blood test first to check your levels as some persons have antibodies a very long time after. If you need the rabies vaccine I would suggest you go to a travel medicine clinic near you (eg http://www.travelmedicine.com.au) as they will likely have the vaccine in stock or you can get a script frm GP and get it from a pharmacy. I have tried ordering vaccines for my puppies and it was not allowed so guessing that it is likely the same the “other way round” for Vets trying to order human vaccines. If you will handle flying fox, you need to have a serology level 2-3 weeks afterward to document it is in the effective range. Regards Dr Deb