Imovax
Imovax is one of the available rabies vaccines for people. It's used to help prevent rabies in adults and children either before or after potential exposure to the rabies virus; Imovax isn't a routine vaccine that everyone needs to get. Imovax is given as an injection into the muscle. The number of injections you'll need depends on when you're exposed to the rabies virus and whether you've been vaccinated for rabies in the past. Side effects include itchiness, redness, and pain at the injection site; headache; and dizziness.
What is Imovax?
What is Imovax used for?
Prevention of rabies in adults and children
How Imovax works
Imovax is an inactivated vaccine that protects you from rabies. The vaccine helps your body's immune system make antibodies against the virus that causes rabies. These antibodies help attack the virus if it ever infects your body.
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What are the side effects of Imovax?
Common Side Effects
- Pain, redness, swelling, or itching at the injection site (25%)
- Headache (20%)
- Dizziness (20%)
- Nausea (20%)
- Stomach pain (20%)
- Muscle ache (20%)
Other Side Effects
- Weakness
- Fever
- Chills
- Joint pain
- Vomiting
- Diarrhea
- Shortness of breath
- Swollen lymph nodes
Serious Side Effects
- Serious allergic reactions: hives, rash, shaking, itching, nausea, flushing, dizziness, difficulty breathing, chest pain
Source: DailyMed
More on Imovax side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Incidence not known
Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
confusion
difficulty with moving
difficulty with swallowing
fast heartbeat
feeling of discomfort
irritability
lack or loss of strength
muscle pain, stiffness, or weakness
paralysis or severe weakness of the legs
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
rash
seizures
skin rash, hives, or redness
stiffness of arms, legs, or neck
swelling of the joints
swollen, painful, or tender lymph glands in the neck, armpit, or groin
tightness in the chest
unusual tiredness
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Imovax
Pros
Works well at protecting against rabies
Safe choice for people with an egg allergy
Can switch back and forth with RabAvert (another rabies vaccine) for your shots
Cons
Needs to be given as an injection into the muscle by a healthcare professional
Might need booster shots, depending on your risk
Contains albumin (a protein made from human blood), so people from certain religious background(s) might not be able to or want to get it
Pharmacist tips for Imovax
Let your healthcare professional (HCP) know if you have any allergies to certain medications, particularly antibiotics. They'll check whether you're at risk for having an allergic reaction to Imovax and decide whether this vaccine is safe for you.
You'll need several doses of Imovax to become fully vaccinated against rabies. Be sure to write down the dates for each of your Imovax injections on your calendar to help you stay on track. This helps the vaccine protect you against rabies as best as possible. Call your HCP if you accidentally miss an appointment by a few days. They might be able to get you back on track.
If you feel sick, ask your HCP first whether you can get your Imovax shot. Most times, you can still get your shot if you feel mildly sick, like with a cold or low-grade fever. But it's best to wait until you're feeling better if you're very sick.
If you've gotten exposed to the rabies virus (e.g., bitten by a rabid animal) and you haven't gotten any preventative care before, your care team will also give you human rabies immunoglobulin (HRIG) with your first Imovax shot. HRIG helps your body fight against rabies until your body can make enough of its own antibodies to fight rabies.
If you're planning for a trip, check whether it's recommended to get vaccinated against rabies for the destination you're traveling to.
If your work or your traveling often exposes you to rabies, you might need to get regular lab work or Imovax booster shots to keep you protected from the virus. Ask your HCP whether you need any booster shots and how often you should get them.
Report any severe reactions to Imovax to the vaccine adverse event reporting system (VAERS) website or by calling 1-800-822-7967.
Read the vaccine information statement for more information on Imovax.
Frequently asked questions about Imovax
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What are the risks and warnings for Imovax?
Imovax can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reaction
Risk factors: Allergy to neomycin
As with any vaccine, there's a rare chance that you might have a severe allergic reaction to Imovax. Let your healthcare professional (HCP) know if you're allergic to things like neomycin. This might affect your risk for an allergic reaction to Imovax. Your HCP might ask you to stay at the pharmacy or clinic for a little longer after they've given you your shot. They can make sure you get proper care if you have a serious allergic reaction.
Sometimes, allergic reactions can happen after you've already left the medical office. Get medical help right away if you notice symptoms of a severe allergic reaction, such as swelling of the face, closing of the throat, difficulty breathing, hives, rash, feeling faint, dizziness, or chest pain.
Fainting
Risk factors: Fainting before or after vaccines in the past
Similar with other vaccines, it's possible to faint after you receive Imovax. Let your HCP know if you've ever fainted after any vaccinations in the past. You might need to sit down and stay at the medical office so the care team can look after you during your vaccination.
Serum sickness-like reaction after booster doses
Some people had an immune reaction that looks similar to serum sickness after they got a booster dose of a rabies vaccine like Imovax to prevent rabies before potential exposure. Most times, this reaction appeared about 2 days to 3 weeks after getting the booster shot. Let an HCP know if you notice symptoms like widespread hives, joint pain, nausea, vomiting, fever, weakness, or swelling of the face.
Problems affecting the nervous system
Although very rare, some people reported getting nerve-related problems, such as Guillain-Barré syndrome (GBS), after they've received a Imovax shot. In these cases, the nerve problems got better in about 3 months. Let your HCP know right away if you experience any symptoms of nerve-related problems, such as muscle weakness, prickly feeling in the hands and feet, neck stiffness, difficulty seeing, movement or reflex problems, or unsteadiness on your feet. Your HCP can see what supportive care you need.
Lower response to Imovax in people with a weakened immune system
Risk factors: Medical conditions that weaken the immune system | Taking medications that lower your immune system
Imovax might not work as well in people with a weakened immune system. This can put them at higher risk of getting rabies, even after they've received the vaccine. People with a weakened immune system who get vaccinated with Imovax after exposure might need blood draws done at certain specific times to check how protected they are.
Make sure your care team knows about the medical conditions you have and the medications you take before you get vaccinated with Imovax. Certain conditions, like human immunodeficiency virus (HIV) and cancer, and certain medications, like high-dose corticosteroids and transplant medications, can weaken your immune system.
Maintain necessary precautions to prevent rabies before possible exposure
Although Imovax works very well, it isn't guaranteed that the vaccine will work to protect everyone completely from rabies and that you won't get infected. For the best protection against rabies, you should receive Imovax, if needed, and take other necessary precautions. Make sure your pets are also vaccinated against rabies. Avoid direct contact with wild animals and wash any animal bites or scratches right away with soap and water.
Rare but possible transmission of other viruses
Imovax contains a protein called albumin that's taken from human blood. Although very rare, there's a possible risk that viruses from blood donors might be passed onto people who are receiving the vaccine. It can potentially put people at risk for conditions such as Creutzfeld-Jakob Disease (CJD).
Note that this risk is only a theory. Blood donors are carefully screened and the manufacturing process for the Imovax vaccine is regulated to minimize the risk. There aren't any known reported cases at this time.
More on Imovax warnings
Imovax dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 1ml of 2.5 units | 1 vial | $432.00 | $432.00 |
Typical dosing for Imovax
Imovax is given as an injection (1 mL) into the muscle.
Adults and older children: The injection is given into the shoulder muscle.
Babies and smaller children: The injection is given into the thigh muscle.
Dosing directions from the manufacturer:
Prevention of rabies BEFORE potential exposure to the rabies virus
Primary series: The typical dosing schedule is 1 injection on day 0, day 7, and either day 21 or day 28.
Booster series: The typical dose is 1 injection as needed. The need for a booster shot depends on your risk of exposure to the rabies virus and the levels of the rabies antibodies in your body.
Prevention of rabies AFTER exposure to the rabies virus
Previously unvaccinated or partially vaccinated with Imovax: The typical dosing schedule is 1 injection on day 0 (right after exposure), day 3, day 7, day 14, and day 28. Imovax is usually given together with human rabies immune globulin (HRIG) on day 0.
Previously fully vaccinated with Imovax: The typical dosing schedule is 1 injection on day 0 (right after exposure) and day 3. These people don't need human rabies immune globulin.
Please note: Your healthcare professional might suggest a different dosing schedule for Imovax following the CDC's recommendation. The CDC's recommendations can differ from the manufacturer's guidance. Talk to your HCP if you have more questions about the dosing schedule for this vaccine.
Interactions between Imovax and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this vaccine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Receiving this vaccine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Chloroquine
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References
Best studies we foundCenters for Disease Control and Prevention. (n.d.). Destinations.
Centers for Disease Control and Prevention. (n.d.). Rabies.
Centers for Disease Control and Prevention. (2022). Rabies vaccine VIS.
Centers for Disease Control and Prevention. (2024). Classic Creutzfeldt-Jakob disease.
Centers for Disease Control and Prevention. (2024). Explaining how vaccines work.
Centers for Disease Control and Prevention. (2024). Guidelines for vaccinating pregnant women.
Centers for Disease Control and Prevention. (2024). Rabies biologics.
Centers for Disease Control and Prevention. (2024). Rabies post-exposure prophylaxis.
Centers for Disease Control and Prevention. (2024). Rabies pre- and post-exposure prophylaxis.
Centers for Disease Control and Prevention. (2024). Rabies pre-exposure prophylaxis.
Centers for Disease Control and Prevention. (2024). Rabies prevention and control.
Centers for Disease Control and Prevention. (2024). When to seek medical care for rabies.
Eriksson, A., et al. (2013). Animal derived products may conflict with religious patients' beliefs. BioMed Central Medical Ethics.
Immunize.org. (2024). Ask the experts: Rabies.
MedlinePlus. (2024). Serum sickness.
Sanofi Pasteur Inc. (2024). Imovax rabies (rabies strain pm-1503-3m antigen- propiolactone inactivated and water kit [package insert]. DailyMed.
World Health Organization. (2020). How do vaccines work?
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