Rabies is almost always fatal once clinical symptoms develop, but timely vaccination and post-exposure treatment can prevent the disease. This makes the question of whether children should receive a rabies vaccine before any dog bite particularly important in India.
Pre-exposure prophylaxis, or PrEP, is designed for people who face a continuing or increased risk of exposure to the rabies virus. The World Health Organization recommends PrEP for people with continual, frequent or increased exposure risk because of where they live or their occupation.
India’s National Rabies Control Programme also identifies several high-risk groups for PrEP, including animal handlers, veterinarians, laboratory workers and people travelling from rabies-free areas to endemic regions. The national guidelines note that the Indian Academy of Pediatrics has recommended PrEP for children and that it may be considered voluntarily.
However, PrEP does not eliminate the need for medical assessment after an animal exposure. WHO classifies minor scratches or abrasions without bleeding as an exposure requiring immediate vaccination, while more serious bites or scratches may also require rabies immunoglobulin.
After a suspected exposure, the Indian government advises washing and flushing the wound thoroughly with soap and running water for at least 15 minutes and seeking medical care promptly.
Children are particularly vulnerable to dog bites, and WHO notes that injuries to the head and neck can be more serious in children. Decisions about PrEP should therefore be based on individual exposure risk and medical guidance rather than giving every child the vaccine automatically.
