June 26, 2008 -- U.S. rabies vaccine supplies are "limited," the CDC says.
"Nobody who really needs rabies vaccine is going without," CDC rabies chief Charles E. Rupprecht, VMD, PhD, tells WebMD. "We do not have a rabies vaccine shortage. But we are in a supply limitation situation where rabies vaccine supplies are less than ideal."
Vaccine supplies are being saved for people who have been bitten by animals. CDC is discouraging preventive use of the vaccine by people, such as travelers to areas with widespread dog rabies or cave explorers, who are at increased risk of bites from rabid animals.
Rupprecht today told the CDC's Advisory Committee on Immunization Practices that plans are under way to prepare for an actual rabies vaccine shortage, but that stopgap measures should extend supplies until normal vaccine production resumes.
The shortfall does not affect rabies vaccines for animals. In fact, the CDC strongly recommends that people make sure their pet dogs, cats, and ferrets get their rabies vaccinations.
Sanofi Pasteur, which supplies about half of the U.S. rabies vaccine for humans, in June 2007 began renovating its Imovax Rabies vaccine facility in France. Before then, the company stockpiled enough vaccine to meet expected demand through mid-to-late 2009, when the facility should come back on line.
But the company guessed wrong -- there was an increase in rabies among wild animals, and demand spiked. That shouldn't have been a problem, except that the FDA discovered manufacturing problems with the Novartis RabAvert vaccine. Novartis had been supplying the other 50% of the U.S. market.
Suddenly, Sanofi Pasteur found itself with greatly increased demand and no supply of new vaccine. Short supplies have led the CDC to suspend recommendations for preventive rabies vaccination and to make contingency plans for how to deal with shortfalls.
Fortunately, Rupprecht says some lots of the Novartis vaccine have been released by the FDA, with more lots expected in July and later this fall.
"We are not out of the woods yet -- summer is rabies season -- but we have breathing room," Rupprecht says. "Not all is well, but we are in a code yellow situation, not code red."
Until rabies vaccine supplies are back to normal, Rupprecht says, people -- especially travelers -- should avoid contact with animals.
"You don't need to get that picture with the monkey on your shoulder," he says. "And if you are going to be a tourist, you need to be attuned to the fact that uncontrolled dog rabies exists around the world."
The CDC recommends the following steps:
- Vaccinate all pet dogs, cats, ferrets, and other animals that have frequent contact with humans. Consider vaccinating horses and other livestock.
- Do not let pets roam free.
- Spay or neuter pets to reduce dog and cat overpopulation.
- Don't feed or water pets outside -- even empty bowls attract wild animals.
- Keep garbage securely covered.
- Do not keep wild animals as pets.
- Never handle unfamiliar or wild animals, even if they appear friendly.
- If you see a wild animal acting strangely, report it to animal control officials.
- Bat proof your home in the fall and winter.