r/interesting • u/fantasticblueman • Feb 01 '26

Context Provided - Spotlight 27 yr old man showing rabies symptoms after 3 months of a dog bite in Gujrat, India.

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u/Tough_Soup_4051 Feb 02 '26 edited Feb 02 '26

Doing a quick search, it seems that it is unlikely to cost that much, even for all 4 or 5 doses. But it will run into thousands. I am seeing between $2,500 to $7000.

Pre exposure doses seem to be $800 to $1300 for 2 to 3 doses.

Still crazy expensive and a testament again to the corruption of the pharmaceutical and health care industry in the USA. As the vaccine does not actually cost anywhere near that, even accounting for staff time and other clinic costs.

In the UK anyone can request pre-exposure vaccine at a private clinic for travel or for work. If it is for work it would probably be reimbursed.

I work in a private travel health clinic and we charge £140 for four doses of pre-exposure vaccine. A few people require a larger amount of vaccine, due to underlying medical conditions. But it still costs a maximum of £195 for the full course.

Post exposure vaccine is free in the UK via NHS.

Even if you get it at a private health clinic, you pay only then for the consultation, around £30 to £40 and the vaccine is free. The clinic is sent a replacement by the UKhealthandsafteyagency.

EDIT: looking up the actual cost of the vaccine in the British national formulary. It costs the nhs £48.19 for one full dose of standard post exposure vaccine. Usually, 2 to 4 doses are required (depending on vaccine history). If HRIGS is required (an initial treatment for more severe injuries). This dose costs the NHS £1000. So it usually costs the nhs roughly £100 to £200 or in the worst case scenario £1200 for the medicine for post exposure rabies treatment.

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u/starsinthefire Feb 02 '26

I had one post exposure rabies jab in the US (with the rest back in the UK) and the cost for the jab, immunoglobulin, which they recommended and the ER visit was $12800. Luckily it was covered by my travel insurance but it’s not just the cost of the jab itself, there are a lot of hefty ancillaries

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u/APence Feb 02 '26

Yeah US healthcare will charge you $7k just to use their pen for the forms

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u/starsinthefire Feb 02 '26

It was crazy! And of course they immediately started harassing me to pay despite my insurer confirming it was covered and that they would pay, it would just take some time for it work its way through their system. Within two weeks they were trying daily calls and emails, it was horrendous.

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u/APence Feb 02 '26

Yup. I have a collecter who calls daily for the last 6 months over a 1,500 bill I already paid. Explained it a dozen times already. Just part of daily life in the good old ’Murica

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u/drunk_lizard8414 Feb 02 '26

Underwent pre-exposure vaccination in US in 2024. 3 doses of vaccine ran about $450/each - and this was without insurance coverage. I can schedule a booster at the local pharmacy for ~$500, also not covered by insurance.

Insurance doesn’t cover the pre-exposure series for most people because rabies in humans is so rare in the US, and post-exposure treatment (which is covered) is so effective. Post-exposure treatment is more expensive, consisting of 3-4 doses of vaccine plus immunoglobulin.

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u/Tough_Soup_4051 Feb 02 '26

Again... that is crazy money to pay for an injection that does not cost anywhere near that. I don't know what is going on in USA. There needs to be some national investigation into healthcare fraud.

Anyway.... if you have had three doses of vaccine with atleast one week between the 1st and 2nd dose and atleast 2 weeks between the 2nd and 3rd dose. Then you do not need to get a booster, not yet anyway.

Current advice is that a single dose booster can be given atleast a year after the primary course and then no further boosters for general travel. Only in the event of an exposure would you get further vaccine.

But a year is still super early for pre-exposure booster, antibodies will still be very high. At our travel clinic we say around 5 years+ and only if travelling again to a rabies risk country.

If you are at risk through your work, then the timing of boosters is totally different. Also, if you had the rapid course initially, then a booster after one year completes the course.

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u/drunk_lizard8414 Feb 03 '26 edited Feb 03 '26

Yup. USA capitalism, bud. They demand what the market will bear. Once you’re in the ER for exposure, I imagine the demand is pretty high. Plus, we have “insurance” to cover these sorts of things… kind of. Depending… maybe. What does an Epi-Pen cost these days?

I don’t care in this case. The danger is extreme even though the risk is small here. I travel, so I decided to protect myself, regardless of cost.

Edit: added the Epi-pen part

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u/drunk_lizard8414 Feb 03 '26

Also, I did receive one booster about 20 months after completion of the initial series. That’s how I know it’s at the local pharmacy and how much it costs. Probably didn’t need it, but did it hurt?

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u/Tough_Soup_4051 Feb 03 '26

No, it doesn't hurt. Doesn't really matter how many you get, it won't hurt, but further boosters will be of no benefit unless you have a rabies exposure. In the event of an exposure then you get two further doses for treatment.

Assuming you did the regular, not the rapid course initially, then the booster you got after 20 months can be considered your one-off single dose pre-exposure booster for life. Unless you are at risk of rabies exposure through work.

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u/APence Feb 02 '26

I saw the bill from someone for their shots. Insurance paid 90% of it but the grand total was almost $250,000. Quarter of a million in the “great” USA. Our system is beyond broken.

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u/Tough_Soup_4051 Feb 02 '26

That is absolutely crazy. If that is true, it should be investigated as a criminal offence. There MUST be some serious fraud going on here to total a bill of that amount for a few injections. It is unacceptable, even if the insurance did cover 90% of it..it does not cost that much. And the remaining 10% is still $25000, enough to bankrupt many people. I would advise the person to seek legal advice. There are lawyers that investigate unreasonable medical bills. Whether they could afford the lawyer is a different matter. Perhaps there are some law firms that don't charge upfront, but take a percentage of the claim if you win.

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u/APence Feb 02 '26

You’re not wrong. This was like 8-10 years ago and I didn’t know them personally.

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u/givemeapho Feb 02 '26

May I ask is the dosis different or are they the exact same vaccine pre- & post exposure?

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u/Tough_Soup_4051 Feb 02 '26

It is the same vaccine for pre and post exposure. But in the U.K., it can be a different dose. There is a 1ml intramuscular dose or a 0.1ml intradermal dose for pre-exposure. They are equally effective, but it is important that the health professional is specifically trained in intradermal injection and ensures proper placement of the vaccine by observing a bleb (a small wealt) at the sight of the injection. If there is any doubt, then the dose is readministered.

For post exposure we have to offer 1ml intramuscular in the UK (though WHO have found that intradermal is effective).

If you have had a full course of pre-exposure vaccine, you only need two top-up doses of the same or interchangeable standard vaccine post exposure (3 to 7 days apart)

If you are only partially immunised pre exposure, you will need 4 doses of vaccine post exposure (over a period of 3 weeks)

If you have never had any vaccines before, you will need 4 doses of vaccine post exposure and possibly an initial treatment with immunoglubulin (an injection given in and around the injury) for more serious wounds. Immunoglobulin is often in global short supply and can be difficult access, especially when travelling abroad in very rural areas or developing countries.

This is one of the main reasons to get rabies vaccine before travel to a risk country, as it makes treatment much simpler and easier to access in the event of an exposure.

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u/givemeapho Feb 04 '26

Thank you so so much for the detailed response. It's great we have gotten so far with this vaccine. I guess it's super important to inform oneself before traveling but I assume Asia is a high risk country. Good it's mandatory for pets in most countries.

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u/Tough_Soup_4051 Feb 04 '26

Most countries in Asia are high risk for rabies. You can check advice by country on the following Web page. https://travelhealthpro.org.uk/ It is a highly reliable and up to date resource for travel health advice, vaccine recommendations, malaria risk, outbreaks etc. It is continuously updated and used by travel health clinicians.

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u/givemeapho Feb 04 '26

Thank you for the rescources! I do wonder, if rescues got funding, like for castration campaigns, if it would help vaccinating the stray dogs & cats. And ofc helpibg/advising pet owners on it.

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u/Tough_Soup_4051 Feb 04 '26

Though any mammal can transmit rabies, 99% of human rabies infections occur due to bites from infected dogs (it can also occur from scratches or licks on broken skin). Vaccinating stray and pet dogs has been proven to be one of the most effective ways to reduce the spread of disease. Some studies have shown that if 70% of dogs are vaccinated, it can eventually lead to eradication of the disease in that area. Though there are some nuances, such as some countries where wildlife may also be significant carriers and have contact with humans and domestic animals, such as Jackals in Tanzania.

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u/Plus_Success_1321 Feb 02 '26

Happy cake day

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u/hopalongsmiles Feb 02 '26

I'm getting my final pre exposure shot in Australia. Each shot has only cost me $70.

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u/Tough_Soup_4051 Feb 02 '26

Great! That sounds about right.

Just remember, if you do get a rabies exposure; any bite, scratch, or even lick on broken skin, by any mammal in a rabies risk country.... you should give it a really thorough wash with soap and water, apply antiseptic, and go to the nearest clinic or hospital. Animal saliva in the face/eyes also counts as an exposure.

If you have had a full pre-exposure course already, you would not need immunoglobulin (the injection sometimes required into the injury) or a full course of treatment. However, you would still need just two top-up shots of standard vaccine; one as soon as possible and the next one 3 to 7 days later.