How many times is immunoglobulin administered after a tick bite? - briefly
One dose of rabies immunoglobulin is administered immediately after the tick bite. Subsequent protection relies on the active vaccine series.
How many times is immunoglobulin administered after a tick bite? - in detail
Immunoglobulin for rabies exposure after a tick bite is given as a single administration. The dose is calculated at 20 IU per kilogram of body weight. The calculated volume is divided, with as much as possible infiltrated directly around the wound(s) and any remaining volume injected intramuscularly at a site distant from the vaccine injection.
The immunoglobulin is administered concurrently with the first dose of rabies vaccine, ideally within 24 hours of the bite and no later than the seventh day after the initial vaccine dose. No repeat doses of immunoglobulin are recommended; the vaccine series provides the subsequent protective immunity.
Typical vaccine schedule accompanying the immunoglobulin:
- Day 0 – first vaccine dose and immunoglobulin
- Day 3 – second vaccine dose
- Day 7 – third vaccine dose
- Day 14 – fourth vaccine dose
- Day 28 – fifth dose (administered to immunocompromised patients)
Key points for proper administration:
- Ensure thorough wound cleaning before immunoglobulin infiltration.
- Use human rabies immunoglobulin when available; equine products are acceptable alternatives.
- Do not exceed the calculated dose; excess volume should be administered intramuscularly.
- Monitor the injection site for local reactions; systemic adverse events are rare.