Dubious rabies vaccine

MEGHNA UNIYAL

In January 2025, the Supreme Court dismissed a petition filed by the Kerala Pravasi Association seeking the formation of an independent expert committee to evaluate the effectiveness of the Intradermal Dermal Rabies Vaccine (IDRV), as well as the anti-rabies vaccine given to dogs in India. This was after several people died after being administered the post-bite, anti-rabies vaccine. The petition highlighted treatment protocols and the efficacy of the vaccine itself. However, the Apex court asked the petitioner to submit a representation to the Union Ministry of Health & Family Welfare.

In December 2025, the Australian Technical Advisory Group on Immunisation (ATAGI) issued an alert about counterfeit batches of the Abhayrab vaccine in India, which is manufactured by the Human Biologicals Institute, a key division of Indian Immunologicals Ltd (IIL), a PSU.  ATAGI warned that “People who received the fake vaccine may not be fully protected against rabies and are advised to get replacement doses to ensure they are adequately protected.”

Rabies is a 100 percent fatal disease and perhaps the most horrific disease known to mankind. The medical community as well as the government claimed that the anti-rabies vaccines are effective but may fail due to improper handling or other critical factors. They said that not all bites are the same and some (like Category 3 wounds) are far more dangerous and require urgent and specific medical intervention. Also, that timely and complete post-exposure treatment, including wound care and immunoglobulin, is essential to preventing rabies, that public awareness is low, with many people assuming all bites need the same treatment or skipping key steps and that the bite location and viral load impact severity, influencing how fast the virus reaches the brain and how effective the body's response can be.

However, questions that need to be addressed urgently are not being raised:  Why have fully vaccinated patients (including those given Rabies Immune Globulin) still died of rabies despite full compliance? Why are rabies deaths not publicly audited or investigated with postmortems? Why are vaccine failure reports in pets ignored in the national rabies strategy discussions? Why is there no data or reference to AEFI (Adverse Event Following Immunization) reports? Why is there an assumption of protocol deviation in every death but no consideration of product-level failure?

The grim reality is that multiple deaths, despite timely post-bite vaccination, have occurred across India. In several recorded deaths immunoglobulin was reportedly administered, and vaccination followed the required protocol. In almost all cases the burden of responsibility is put on patients, rather than looking at the vaccine itself. While there is no unified public reporting system to assess treatment failures, making blanket statements of patient error are unfair and unscientific.

In several recent deaths, bites were not always in high-risk areas, indicating the need for an audit of the vaccine rather than blaming bite severity alone. Therefore, instead of examining failures in the system, the blame is subtly shifted to supposedly incorrect protocols and victims themselves. These considerations deflect attention from the vaccine itself and promote the idea that the vaccines themselves are infallible.

But real-world evidence says otherwise: Children are dying despite full compliance with treatment protocols. There is no attention given to a lack of post-marketing surveillance (pharmacovigilance). This reinforces the monolithic solution that ‘vaccine is the only saviour.’ This singular focus on “get the shot and trust the system” erases public choice, shuts down discussion and absolves state failure. Adverse events are underreported or dismissed, and there is no transparent public registry of AEFI cases for anti-rabies vaccines.

Defending anti-rabies vaccine efficacy also completely ignores the growing number of reported cases where pets vaccinated on schedule still contracted or transmitted rabies. This omission is serious because it undermines the core assumption that vaccination — whether in humans or animals — is fail-safe.

While courts are willing to consider compensation in cases before it, what must be noted is that compensation is often routed under medical negligence or improper handling, and not for vaccine efficacy as the burden of proof is on the victim thus making it very difficult for the victim or their family to prove the same. It also needs to be emphasized that compensation comes from tax payer money and makes little difference to the government agency doling it out. Most importantly, compensation does not bring victims back to life.

Taking cognizance of the issues with the efficacy of the anti-rabies vaccine, some in the medical community are now recommending mandatory pre-exposure prophylaxis, especially for children. The suggestion that mandatory, pre-exposure vaccination for the entire human population can fix this problem, is fraught with exactly the same issues as post-bite vaccination and is an absurd, unacceptable proposition.

To build an argument that rabies vaccines are 100 percent effective, the burden of proof must include rigorous, transparent, and systematic explanations for every failure case, without defaulting to blame-shifting. Declaring 100 percent efficacy without room for scrutiny, failure of documentation or system accountability, turns a scientific claim into dogma.

It is irrelevant whether 50 people die of rabies or 50,000. Even one rabies death is one too many and unacceptable. Animal attacks, and especially India’s 80 million free roaming dog population, aren’t about disease alone. They primarily include physical and mental trauma of victims, medical costs, man-hours lost and lifelong injury, disfigurement or disability.

Disease control primarily necessitates that the vector is removed — in this case free roaming dogs. Coupled with criminal, medical and financial liability for pet owners and strict pet control laws, prevention of zoonotic diseases and risks is better, more effective, cheaper and more practical than any proclaimed cure, especially when human life and safety are
at stake. 

Meghna Uniyal is Director, Humane Foundation for People and Animals