8 ms·

Why is rabies vaccine so expensive as to be rationed?

planteen 8y ago
I got vaccinated against rabies in 2010. It was 3 shots at $300 each if I remember right. It was hard to find a clinic that stocked it. I live in Colorado, I think only two clinics in the state had it. Note that is for pre-exposure shots, not post-exposure. It's not a common vaccine, typically it is only given to vets and vet techs. I think that is a public health decision - rabies exposure is very rare in the United States. I was getting it because I was going to Peru for a caving expedition. It probably wasn't necessary for me, but the travel pharmacist said it could get it due to possible stray dog exposure in remote Peru and possible bat exposure in caves. I never saw a single bat in the caves there. But since the travel pharmacist recommended it, my insurance paid, which was nice.
- vorpalhex 8y ago
  How painful of a series was it? What was the time between injections?
  - planteen 8y ago
    Not painful at all. Just like a flu shot. The painful shots are the post-exposure ones that go in the gut. I received Imovax. It was a brilliant purple color - it was the prettiest vaccine I have ever seen. Shot #2 is 1 week after the first, shot #3 is 3-4 weeks after the first. https://www.vaccineshoppe.com/image.cfm?doc_id=5983&image_type=product_pdf https://www.vaccineshoppe.com/image.cfm?doc_id=5983&image_ty...
    - appleiigs 8y ago
      I got post-exposure shots and they were in the arm. 5 shots: 2 shots day 1, then 1 shot day 3, 7, 14.
zerr 8y ago
That's not the case in Europe.
- carlmr 8y ago
  It was still 210€ for 3 shots when I took it. (Germany)
  - stargazer-3 8y ago
    Yet it is fully covered by public health insurance in Germany (got my rabies shots refunded by the TK).
    - carlmr 8y ago
      Not fully and not by all public insurers AFAIK. But the price of the vaccination itself is still high anyway.
- kyzn 8y ago
  Free in Turkey, even if you have no insurance. You just need to go to an ER that has shots. They give you a schedule for up to 5 shots. If you decide to skip one, they send police to your house, who will take you to ER.
classichasclass 8y ago
This is essentially asking, if rabies is so terrible, why isn't everyone vaccinated? Yes, it's terrible, but in the USA and most developed countries it's so rare (as in just 23 cases nationwide from 2008-2017) that the trivial risks of the vaccine and the small number of people who will have an adverse reaction are generally greater than the benefit in the general population, which is almost nil. This isn't true for people who work with animals, but even with them it's quite rare to have an exposure. Rabies vaccine and BCG are two of my rebuttals when I hear the allegation public health doesn't consider risks and benefits when selecting vaccines. You can add OPV to that list, too.
- ghaff 8y ago
  Yes. There are a large number of diseases for which vaccines exist but for which people aren't routinely vaccinated in the US if they aren't traveling somewhere for which a particular vaccine is recommended. For traveling, I've had all sort of vaccines (yellow fever, typhoid, encephalitis, etc.) that I wouldn't get if I just stayed in the US.
pg_bot 8y ago
Rabies is far less common than other diseases that you are vaccinated for. The market is small enough (~50K vaccines per year) that it is unlikely that multiple players will be able to enter the marketplace and survive. Vaccines also expire regularly and are typically money losers for most clinics. Add to that the crazy sticker price scheme that most hospitals have in place in order to negotiate with insurance companies and you wind up with insane bills. If you vaccinated everyone for rabies, the cost per vaccine would come down but you would likely do more harm than good. Vaccines (like all medicines) come with risks. I've printed the specific risks for the Rabies vaccine taken from the CDC so you can get an example. Mild problems • soreness, redness, swelling, or itching where the shot was given (30%–74%) • headache, nausea, abdominal pain, muscle aches, dizziness (5%– 40%) Moderate problems • hives, pain in the joints, fever (about 6% of booster doses)
- pvaldes 8y ago
  The risk of suffering collateral damage increases each time you are vaccinated again, and there are several strains.
brohee 8y ago
And why is it more expansive than for dogs. It's pretty well known that you can user veterinary antibiotics to treat humans for a fraction of the price, I wonder if rabies vaccine doesn't make the cut too...
- namibj 8y ago
  Go to the vet. Ask vet for the correct dose of the vaccine for you, including the tooling to administer it. Administer the vaccine yourself in the vet office. Pay the vet. Come back at the right time for the booster dose. There should not be any difference in suitability between the vaccines, but you might want to check if the same style of vaccination (i.e., kind of disease and procedure of deriving the vaccine) is used for both humans and some animal the vet would use the vaccine for if you hadn't come. You might do that with a different vaccine, but there isn't much difference between mammalian vaccinations.
- pvaldes 8y ago
  Sounds reasonable to me. The legal risks associated for the company selling it are much higher.
jartelt 8y ago
I had to get the post-exposure series of shots after getting bit by an unvaccinated dog earlier this year. The rabies vaccine shots themselves are not too expensive. I want to say Kaiser charged on the order of $500-1000 for the series of vaccine shots. The real cost came with the Human Rabies Immune Globulin shots I had to get after being potentially exposed to the virus. These are shots of the rabies antibody that they administered in the area where the dog bit me. Kaiser charged $15,000 for this stuff (insurance brought it down to $1,250 to me). It is costly because they make it by vaccinating humans and then collecting antibodies from their blood/plasma. I would add that the rabies vaccine shots themselves were not painful and are like flu shots. However, I ended up being allergic to the shots and would break out in hives and get flu-like symptoms for days after each one. I actually stopped the vaccine series early because the symptoms kept getting worse after each shot and by the time the last shot was due animal control told me the dog that bit me made it out of quarantine without showing rabies symptoms. The Immune Globulin shots were the most painful because it was a thick gauge needle and a super viscous material. I could see a big, swollen lump under my skin after getting the series of Immune Globulin shots. There was pain and bruising for a few days, but it eventually went away.
joncfoo 8y ago
It's not expensive outside the USA. Personal experience as travel was involved; for the full round of shots: - 1 USD in Nepal - 5 USD in India - free in UAE - ~350 USD in Texas This was without insurance.
goobynight 8y ago
I can't see a good reason, aside from US labor being more expensive, but even that doesn't bring the cost up THAT much. We have to be one of the only countries where this is so expensive. My friend's dog nibbled my ankle in Vietnam and I picked up a few precautionary shots. Perhaps 3 of them and it wasn't a financial crisis. I thought about it just as much as I think about buying lunch. I don't even recall the number. Probably like $20-40 out the door after all 3, with walk-in service. Being able to monitor the animal to see that it is fine saved me a few bucks. You have to get more if the animal dies or is in the wild. I had no idea this was something you would want to insure against in the US. Totally absurd.

I got vaccinated against rabies in 2010. It was 3 shots at $300 each if I remember right. It was hard to find a clinic that stocked it. I live in Colorado, I think only two clinics in the state had it. Note that is for pre-exposure shots, not post-exposure. It's not a common vaccine, typically it is only given to vets and vet techs. I think that is a public health decision - rabies exposure is very rare in the United States. I was getting it because I was going to Peru for a caving expedition. It probably wasn't necessary for me, but the travel pharmacist said it could get it due to possible stray dog exposure in remote Peru and possible bat exposure in caves. I never saw a single bat in the caves there. But since the travel pharmacist recommended it, my insurance paid, which was nice.

vorpalhex 8y ago
How painful of a series was it? What was the time between injections?
- planteen 8y ago
  Not painful at all. Just like a flu shot. The painful shots are the post-exposure ones that go in the gut. I received Imovax. It was a brilliant purple color - it was the prettiest vaccine I have ever seen. Shot #2 is 1 week after the first, shot #3 is 3-4 weeks after the first. https://www.vaccineshoppe.com/image.cfm?doc_id=5983&image_type=product_pdf https://www.vaccineshoppe.com/image.cfm?doc_id=5983&image_ty...
  - appleiigs 8y ago
    I got post-exposure shots and they were in the arm. 5 shots: 2 shots day 1, then 1 shot day 3, 7, 14.

zerr 8y ago

That's not the case in Europe.

carlmr 8y ago
It was still 210€ for 3 shots when I took it. (Germany)
- stargazer-3 8y ago
  Yet it is fully covered by public health insurance in Germany (got my rabies shots refunded by the TK).
  - carlmr 8y ago
    Not fully and not by all public insurers AFAIK. But the price of the vaccination itself is still high anyway.
kyzn 8y ago
Free in Turkey, even if you have no insurance. You just need to go to an ER that has shots. They give you a schedule for up to 5 shots. If you decide to skip one, they send police to your house, who will take you to ER.

classichasclass 8y ago

This is essentially asking, if rabies is so terrible, why isn't everyone vaccinated? Yes, it's terrible, but in the USA and most developed countries it's so rare (as in just 23 cases nationwide from 2008-2017) that the trivial risks of the vaccine and the small number of people who will have an adverse reaction are generally greater than the benefit in the general population, which is almost nil. This isn't true for people who work with animals, but even with them it's quite rare to have an exposure. Rabies vaccine and BCG are two of my rebuttals when I hear the allegation public health doesn't consider risks and benefits when selecting vaccines. You can add OPV to that list, too.

ghaff 8y ago
Yes. There are a large number of diseases for which vaccines exist but for which people aren't routinely vaccinated in the US if they aren't traveling somewhere for which a particular vaccine is recommended. For traveling, I've had all sort of vaccines (yellow fever, typhoid, encephalitis, etc.) that I wouldn't get if I just stayed in the US.

pg_bot 8y ago

Rabies is far less common than other diseases that you are vaccinated for. The market is small enough (~50K vaccines per year) that it is unlikely that multiple players will be able to enter the marketplace and survive. Vaccines also expire regularly and are typically money losers for most clinics. Add to that the crazy sticker price scheme that most hospitals have in place in order to negotiate with insurance companies and you wind up with insane bills. If you vaccinated everyone for rabies, the cost per vaccine would come down but you would likely do more harm than good. Vaccines (like all medicines) come with risks. I've printed the specific risks for the Rabies vaccine taken from the CDC so you can get an example. Mild problems • soreness, redness, swelling, or itching where the shot was given (30%–74%) • headache, nausea, abdominal pain, muscle aches, dizziness (5%– 40%) Moderate problems • hives, pain in the joints, fever (about 6% of booster doses)

pvaldes 8y ago
The risk of suffering collateral damage increases each time you are vaccinated again, and there are several strains.

brohee 8y ago

And why is it more expansive than for dogs. It's pretty well known that you can user veterinary antibiotics to treat humans for a fraction of the price, I wonder if rabies vaccine doesn't make the cut too...

namibj 8y ago
Go to the vet. Ask vet for the correct dose of the vaccine for you, including the tooling to administer it. Administer the vaccine yourself in the vet office. Pay the vet. Come back at the right time for the booster dose. There should not be any difference in suitability between the vaccines, but you might want to check if the same style of vaccination (i.e., kind of disease and procedure of deriving the vaccine) is used for both humans and some animal the vet would use the vaccine for if you hadn't come. You might do that with a different vaccine, but there isn't much difference between mammalian vaccinations.
pvaldes 8y ago
Sounds reasonable to me. The legal risks associated for the company selling it are much higher.

jartelt 8y ago

I had to get the post-exposure series of shots after getting bit by an unvaccinated dog earlier this year. The rabies vaccine shots themselves are not too expensive. I want to say Kaiser charged on the order of $500-1000 for the series of vaccine shots. The real cost came with the Human Rabies Immune Globulin shots I had to get after being potentially exposed to the virus. These are shots of the rabies antibody that they administered in the area where the dog bit me. Kaiser charged $15,000 for this stuff (insurance brought it down to $1,250 to me). It is costly because they make it by vaccinating humans and then collecting antibodies from their blood/plasma. I would add that the rabies vaccine shots themselves were not painful and are like flu shots. However, I ended up being allergic to the shots and would break out in hives and get flu-like symptoms for days after each one. I actually stopped the vaccine series early because the symptoms kept getting worse after each shot and by the time the last shot was due animal control told me the dog that bit me made it out of quarantine without showing rabies symptoms. The Immune Globulin shots were the most painful because it was a thick gauge needle and a super viscous material. I could see a big, swollen lump under my skin after getting the series of Immune Globulin shots. There was pain and bruising for a few days, but it eventually went away.

joncfoo 8y ago

It's not expensive outside the USA. Personal experience as travel was involved; for the full round of shots: - 1 USD in Nepal - 5 USD in India - free in UAE - ~350 USD in Texas This was without insurance.

goobynight 8y ago

I can't see a good reason, aside from US labor being more expensive, but even that doesn't bring the cost up THAT much. We have to be one of the only countries where this is so expensive. My friend's dog nibbled my ankle in Vietnam and I picked up a few precautionary shots. Perhaps 3 of them and it wasn't a financial crisis. I thought about it just as much as I think about buying lunch. I don't even recall the number. Probably like $20-40 out the door after all 3, with walk-in service. Being able to monitor the animal to see that it is fine saved me a few bucks. You have to get more if the animal dies or is in the wild. I had no idea this was something you would want to insure against in the US. Totally absurd.