3 children dead despite rabies vaccine, questions over quality control in Kerala

On April 9, a 12-year-old girl from Pathanamthitta district died of rabies despite taking the vaccine, and on April 29, a five-year-old girl succumbed to rabies, again after being vaccinated.

In all three cases, the victims sustained deep injuries to their heads and hands. “The virus usually sticks to the wound. However, when bitten on the face and hands, where there are more nerves, the animal’s saliva is more likely to come into contact with the nerves. In such cases, the virus can enter the nerves before we can do anything. To prevent the virus from reaching the nerves and to reduce the risk, the wound should be washed with soap and water. If that does not happen, the virus may reach the nerves by the time the patient is taken to the hospital,” she said.

The minister said the government had in 2022 formed an expert committee to look into the efficacy of anti-rabies vaccines, and samples collected from vaccinated people showed they all had antibodies as per the prescribed standards.

“Hospitals in Kerala use vaccines only after a quality test at Central Drugs Laboratory in Kasauli (Himachal Pradesh), and each batch is tested at the lab and supplied in Kerala only after ensuring quality,” she said.

Opposition leader V D Satheesan said the death of the three children is a matter of concern. “In the last five years, of 102 persons who died of rabies, 20 had been vaccinated. Despite the repeated deaths, the health department claims the vaccines are safe. Innocent children are being made scapegoats for the corruption of the health department,” he claimed.

As per government data, as many as 1,69,906 doses of anti-rabies vaccine have been administered to people bitten by dogs, cats, or other animals.

Till May 2 this year, the state has reported 13 deaths due to rabies. In 2024, the number of confirmed deaths was 22 and suspected four. In 2023, the state had 17 confirmed rabies deaths and eight suspected ones.

The Lancet, in an article published in 2023, raised concerns over rabies deaths in Kerala among vaccinated individuals. The article, Emergence of rabies among vaccinated humans in India: a public health concern, said deaths among vaccinated individuals were due to the nature of wounds and failure to seek prompt care.

“Awareness about first aid measures after an animal bite in the country is inadequate. In a survey in six Indian states, only 38 per cent of victims of animal bites reported washing wounds after biting with soap and water,” said the paper published in The Lancet.

The 2022 report said that the number of infected dogs has doubled in the past five years. “Among 300 samples taken from dogs, 168 samples (56%) were found to be positive for rabies, compared to 32% in a similar study conducted in 2016. The state has reported more than 200,000 dog bite cases and 21 deaths (12 deaths were laboratory confirmed) in 2022 which is almost double the deaths reported during 2021,” it said.

The report said that, considering the increase in animal bite cases and rabies deaths, Kerala should consider giving a course of rabies vaccination before potential exposure to the virus, which is known as pre-exposure prophylaxis for rabies, as a temporary measure until canine control is achieved.