A Case of Serious Adverse Reaction Following Rabies Vaccination

Area of Science:

• Pediatric Infectious Diseases
• Vaccinology
• Clinical Case Reports

Background:

• Rabies is a fatal zoonotic viral disease requiring prompt post-exposure prophylaxis (PEP).
• Adverse reactions to rabies vaccines can complicate PEP, particularly in pediatric populations.
• Managing vaccine hypersensitivity requires careful clinical evaluation and risk stratification.

Observation:

• A 10-year-old girl developed systemic adverse events, including anaphylaxis symptoms, after the second dose of rabies vaccine.
• The patient experienced breathlessness, abdominal cramps, and facial swelling post-vaccination.
• Subsequent doses were administered successfully using a graded challenge protocol with premedication.

Findings:

• The pediatric patient exhibited a systemic allergic reaction to the rabies vaccine.
• Graded challenge with premedication enabled the completion of the rabies PEP course.
• Transient hypotension occurred after the final dose but resolved spontaneously.

Implications:

• This case highlights the importance of individualized risk-benefit analysis for rabies PEP in children with potential vaccine hypersensitivity.
• Careful monitoring and management strategies, such as graded challenges, can facilitate vaccine completion.
• Prompt recognition and management of adverse vaccine events are critical in preventing severe outcomes from both rabies exposure and vaccination.