Falsified Rabies Vaccine: India

Falsified rabies vaccine is circulating through unauthorised sources in India

On 13 January 2025, falsified Abhayrab vaccine was first reported to the Drug Controller General of India by Indian Immunologicals Limited (manufacturer) [1]. They report this falsified product poses a significant threat to public health due to the possibility of lack of efficacy, harmful components and the risk of treatment failure in preventing rabies, a fatal disease.

The public health agencies in the four nations of the UK are conducting a look-back exercise to identify any travellers who reported receiving rabies vaccine following an animal bite in India from November 2023 onwards, to determine whether further rabies vaccination may be recommended.

Rabies is a rare but extremely serious viral infection which is almost always fatal once symptoms appear, but vaccination and early treatment can prevent it. It can be difficult to determine whether an animal is infected with rabies or not, so cleaning the wound and seeking prompt medical advice after a possible rabies exposure is important.

Advice for travellers

• Avoid contact with all animals.
• Following a possible exposure (bite, scratch or lick to broken skin or mucous membranes, e.g. nose, mouth, eyes), clean any wounds thoroughly with soap and water, apply a suitable disinfectant such as 70 percent alcohol or tincture/aqueous solution of povidone-iodine if available and seek an urgent local medical assessment, even if the wound appears trivial. If animal/bat saliva gets into eyes, nose or mouth, wash face thoroughly with clean water as soon as possible and seek an urgent local medical assessment.
• Post-exposure treatment and advice should be in accordance with national guidelines.
• Travellers should discuss any concerns about the legitimacy of a vaccine with a healthcare provider and should keep a written record of any vaccines they are given abroad. Consider taking a photo of the vaccine product.
• Travellers still in India who think they may have received this falsified vaccine in India between November 2023 to the present day should seek advice from the centre where they were vaccinated regarding the product they received, and any additional treatment advised.
• A detailed review is being carried out for travellers who have returned to the UK but received part of their rabies post-exposure vaccine course in India.
• In England, Wales and Northern Ireland, the traveller’s GP will be informed by public health agencies if additional vaccination is recommended.  
• In Scotland any identified traveller will be referred to local assessment pathways for further assessment and management.
• If travellers have confirmation that they received a different brand of rabies vaccine in India, then they can be reassured that they will not require additional vaccine.
• Travellers who received a complete course of rabies vaccine for post-exposure management of an animal bite or scratch in India during this period and did not seek any further medical advice upon return to the UK should contact their GP or travel clinic for advice on whether more vaccine is recommended. Travellers in Scotland should call NHS24 on 111 or their local GP.
• Travellers who received pre-exposure rabies vaccine in India during this period should contact their GP or travel clinic for advice on whether more vaccine is required. Travellers in Scotland should call NHS24 on 111 or their local GP.

Advice for health professionals

In England healthcare professionals with concerns about a patient who may have received falsified rabies vaccine in India can call the UK Health Security Agency Rabies and Immunoglobulin Service (RIgS) for further advice.

For Scotland healthcare professionals should access their local post exposure assessment and treatment pathway or contact their local Health Protection Team.

For Wales healthcare professionals should contact the AWARe service who will begin the risk assessment AWARe/Health Protection Team.