The Rabies PEP Schedule — Day 0, 3, 7 Explained
The WHO-recommended Essen protocol requires 4 doses of Anti-Rabies Vaccine (ARV): on Day 0 (as soon as possible after the bite), Day 3, Day 7, and Day 21. For immunocompromised individuals, a Day 14 dose is also added. Missing or delaying a dose reduces protection. The vaccine is given intramuscularly in the deltoid muscle — never in the gluteal region, which has poor immunogenicity. All four doses can be administered at home by an immidit nurse.
What to Do Immediately After a Dog Bite
Step 1: Wash the wound thoroughly with soap and running water for at least 15 minutes — this alone can reduce infection risk by up to 80%. Step 2: Apply povidone-iodine if available. Step 3: Book an immidit nurse for your Day 0 ARV dose. Step 4: If the bite is deep, the dog is unknown, or the wound is near the face or neck, go to a hospital immediately for HRIG (Human Rabies Immunoglobulin) in addition to the vaccine — HRIG must be given on Day 0 and cannot be administered at home.
Is Home Vaccination Safe for the Full ARV Course?
For Category II bites (scratches, minor nibbles without breaking skin), the full 4-dose ARV course can safely be administered at home. For Category III bites (deep punctures, multiple bites, bites near the face), HRIG is required on Day 0 — this must be done at a hospital or clinic. immidit nurses are trained to triage bite severity; if your nurse assesses a Category III wound, they will advise immediate hospital transfer while still completing the vaccine dose. After Day 0, subsequent doses (Day 3, 7, 21) can be done at home.