What are the severe adverse reactions to rabies vaccine?
Nov 25, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, rabies vaccines are highly safe, but a small number of people may experience severe adverse reactions, including anaphylactic shock, allergic purpura, angioneurotic edema, acute disseminated encephalomyelitis, and severe local reactions. After receiving the rabies vaccine, individuals should remain on-site for 30 minutes for observation, so that any adverse reactions can be promptly identified and managed.
Rabies vaccines are generally considered highly safe, but a small number of individuals may experience severe adverse reactions, including anaphylactic shock, allergic purpura, angioedema, acute disseminated encephalomyelitis, and severe local reactions. Detailed descriptions are as follows:
1. Anaphylactic shock: Usually occurs within minutes to one hour after vaccination, characterized by a sudden drop in blood pressure, loss of consciousness, difficulty breathing, laryngeal edema, accompanied by pallor, cold clammy extremities, and weak pulse.
2. Allergic purpura: Typically appears 1–7 days after vaccination, with skin purpura as the hallmark symptom. The rash is commonly seen on the lower limbs and buttocks, symmetrically distributed and appearing in successive batches. In severe cases, it may affect the gastrointestinal tract, causing abdominal pain, vomiting, or bloody stools, or damage the kidneys, leading to hematuria and proteinuria.
3. Angioedema: Mainly表现为 rapid swelling of the injection site and surrounding tissues, which may spread to the eyelids, lips, face, or limbs. If the swelling involves the throat, it can cause breathing difficulties; involvement of the respiratory tract increases the risk of hypoxia.
4. Acute disseminated encephalomyelitis: A rare but serious neurological reaction that typically develops several days to weeks after vaccination. Symptoms include fever, headache, and vomiting, followed by limb weakness, numbness, and altered consciousness. In severe cases, it may lead to paralysis.
5. Severe local reactions: Large areas of redness, swelling, and pain at the injection site (exceeding 5 cm in diameter), often accompanied by induration, blisters, or ulceration, lasting more than one week. Some patients may develop swollen and painful local lymph nodes; secondary infection can result in pus formation.
After receiving the rabies vaccine, individuals should remain on-site for observation for 30 minutes to allow prompt detection and management of any adverse reactions. People with a history of allergies or compromised immune function should inform their healthcare provider before vaccination.
