As nations flag Indian rabies vaccine, how treatment works, Pg9

Key Highlights:

• Concerns arose in 2023 regarding potentially counterfeit batches of the Abhayrab rabies vaccine in India, manufactured by the Human Biologicals Institute.
• The Australian, UK, and US health departments issued advisories regarding rabies vaccines administered in India.
• Indian Immunologicals identified a specific batch (#KA24014) with altered packaging in January 2025 and notified Indian regulators.
• Abhayrab holds approximately 40% of the rabies vaccine market share in India.
• The WHO estimates that India accounts for nearly 36% of global rabies deaths.

Detailed Insights:

• The counterfeit vaccines were found in cities like Delhi, Mumbai, and Agra, with reports indicating that the outer packaging was altered to divert government supply.
• Testing by the Central Drug Testing Laboratory in Kasauli found the vaccines to contain the genuine product, despite the packaging issues.
• The UK advisory specified that vaccines administered after November 2023 should be checked based on the date printed on the faulty packaging, with genuine vaccines manufactured in 2024.
• The standard rabies vaccination schedule involves multiple doses, and even if one dose is of doubtful efficacy, the other doses and immunoglobulin can still provide protection.
• A Union Health Ministry committee investigating a spike in rabies cases in Kerala in 2022 attributed the cases to faulty wound washing and non-administration of immunoglobulin for severe bites.
• Proper and timely wound cleaning, along with immunoglobulin administration, is critical to prevent rabies, especially in nerve-rich areas where the virus can directly enter the nervous system.

Key Concepts Involved:

• Rabies: A viral infection transmitted through the saliva of infected animals, nearly 100% fatal once developed.
• Immunoglobulin: Antibodies administered to provide immediate, passive immunity against the rabies virus.
• Vaccine Hesitancy: Delay in acceptance or refusal of vaccination despite availability of vaccination services.