Immune Globulin, Rabies in Pregnancy and Breastfeeding

Risk Factor: CM
Class: Serums, toxoids, and vaccines / Serums

Contents of this page:
Fetal Risk Summary
Breast Feeding Summary
Questions and Answers

Fetal Risk Summary

Rabies immune globulin is used to provide passive immunity following exposure to rabies combined with active immunization with rabies vaccine (1). Because rabies is nearly 100% fatal if contracted, both the immune globulin and the vaccine should be given for postexposure prophylaxis (1). No risk to the fetus from the immune globulin has been reported (see also Vaccine, Rabies (Human)) (1,2). The American College of Obstetricians and Gynecologists Technical Bulletin No. 160 recommends use of rabies immune globulin in pregnancy for postexposure prophylaxis (1).

Breast Feeding Summary

No data are available.


  1. American College of Obstetricians and Gynecologists. Immunization during pregnancy. Technical Bulletin. No. 160, October 1991.
  2. Amstey MS. Vaccination in pregnancy. Clin Obstet Gynaecol 1983;10:1322.

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Questions and Answers

how bad is it to get a rabies vaccine without getting the immune globulin shot along with it>?, i had to get the vaccination but there is a nationwide shortage of the immune globulin

Normally you only get the vaccine as a preventative measure against rabies and it does not get administered with gamma globulin.

The globulin is only used as a post-exposure measure in the event you have been bitten or exposed to the live virus.

Short answer, you should not get gammaglobulin

Changes in post exposure rabies treatment?, don't ask me why I even began thinking about this, it's all curiosity on my part.
I remember as a child being told that the treatment if you were exposed to rabies was horrific. It involved a series of very painful shots given in a very painful part of the body.
So just now for the heck of it, I checked out what the treatment is and found that it involves one shot immediately of rabies immune globulin given close to the area bitten, a shot of the vaccine and 4 additional shots of vaccine given on day 3,7, 14 and 28. The shots given in the deltoid muscle of the arm.
That doesn't sound so horrific to me, has there been a major change in the treatment in the last 30 or so years ?

Yes, the treatments use to be given in a series of shots in the abdomen, very painful.
I do not know how old you are but when I was a child, we feared the ideal of having been bit by any animal that might have rabies...
I grew up in St. Louis and often seen the dogcatchers called to capture a dog with rabies, it was scary to watch.
But here is the explanation that a friend of mine gave me when a dog that was suspected of having rabies bit her.

A dog bit her when she was 10 years old and ended up getting 23 shots in her stomach to avoid getting rabies. She said they were very painful. They were given at the hospital, I’m not sure but I think she had to be hospitalized to get them. Not out as an out patient.
I had many friends who were afraid to report an animal bite because the treatment was so severe.