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Veterinarians have an essential role in protecting public health through rabies vaccination, but laws surrounding rabies vaccination and exposure vary across the United States. Here’s what to know.
About 59,000 people worldwide die each year from rabies,1 with the overwhelming majority of cases occurring after a dog bite. Thanks to aggressive rabies vaccination campaigns in the 1950s, the annual death rate from this infectious disease in the United States is usually fewer than 3 people, demonstrating the essential role of vaccination in rabies control programs.
In a lecture at the 2020 AVMA Convention, Richard Ford, DVM, MS, DACVIM, DACVPM(Hon), stressed that it is the veterinarian’s responsibility to vaccinate pets for rabies to protect public health. He discussed the essential information that all veterinarians should know about rabies law and cautioned practitioners that clinics may incur significant liability if clients or staff are exposed to a rabid patient.
State public health veterinarians develop the laws surrounding rabies vaccination in each state. However, the content of these regulations varies widely between states, and local jurisdictions may have additional laws or regulations that must be followed. Dr. Ford stressed that there are several essential questions that veterinarians must be able to answer to be assured that their rabies vaccination protocols fulfill all state and local obligations.
Surprisingly, only 39 states mandate rabies vaccination for dogs; 11 states have no statewide legal requirement for rabies vaccination of any species. Feline rabies vaccination is required in 34 states, and vaccination of ferrets is required in 20 states.
Depending on jurisdiction, those who can legally administer a rabies vaccination range from licensed veterinarians to veterinary technicians or assistants under direct veterinary supervision. In some states, pet owners are authorized to administer the vaccination.
Medical exemption varies by state. What is consistent between states is that a vaccine titer is not recognized as an index of immunity and cannot be used in lieu of revaccination.
Rabies exposure is determined by the state public health veterinarian, not the examining veterinarian. A pet may be considered exposed based on contact with a known or suspected rabies-infected animal.
Even in states that do not have rabies vaccination laws, there are laws surrounding rabies exposure. The consequences of exposure depend on the pet’s vaccination status. For an exposed pet that is not currently vaccinated, most states recommend euthanasia and testing. However, the owners may elect to pay for a 4- to 6-month quarantine at a state facility.
A pet is only considered “currently vaccinated” by law when the following criteria are met:
Because the immune system takes time to mount a response to a vaccine, a pet is not considered currently vaccinated until 28 days after receiving its first rabies vaccine, regardless of age. Legally speaking, a pet is no longer current on vaccination if it is even 1 day past due for a booster. However, after any subsequent vaccination, a pet is considered currently vaccinated immediately after receiving a booster, even if overdue.
If a pet bites a human, regardless of vaccination status, the pet must be quarantined for 10 days. An infected animal will only shed the virus for 6 to 8 days before displaying clinical signs of the disease. Thus, even if they were infected at the time of the bite, if they are healthy at the conclusion of a 10-day quarantine, they were not shedding the virus at the time of the bite. A pet that is not currently vaccinated at the time of the bite should be re-vaccinated on release.
The first crucial step of post-exposure prophylaxis (PEP) for a human following an animal bite is proper wound management. The rabies virus is fragile and can be killed by soap and water. Subsequent PEP depends on whether the bitten human was previously vaccinated and has a current positive titer.
Because rabies laws vary by state, and sometimes by local jurisdiction, it can be frustrating for practitioners to know for certain that they are fulfilling their legal duty to their patients and the public. In an effort to help raise awareness of rabies law, Boehringer-Ingelheim and the National Association of State Public Health Veterinarians have developed a centralized website that compiles state law, rabies surveillance data, and contact information for the appropriate public health officials. Take a few minutes to review your state and local laws surrounding rabies vaccination. The knowledge can save you and your clinic from liability and might save the life of a patient, client, or team member.
Dr. Boatright, a 2013 graduate of the University of Pennsylvania, is an associate veterinarian and freelance speaker and author in western Pennsylvania. She is actively involved in organized veterinary medicine at the local, state and national levels and is a former national officer of the Veterinary Business Management Association.
1. Rabies around the world. Centers for Disease Control and Prevention. ReviewedJuly 29, 2020. Accessed August 18, 2020. https://www.cdc.gov/rabies/location/world/index.html