Recent advisories issued by Australia, the U.K., and the U.S. asking travellers vaccinated in India to review their rabies shots have triggered anxiety around vaccine safety. The concern centres on alleged counterfeit batches of Abhayrab, one of India’s most widely used rabies vaccines. Given that rabies is almost universally fatal once symptoms appear, even a hint of compromise in vaccine integrity carries serious public health implications.
Why Rabies Remains a High-Risk Disease
Rabies is a viral infection transmitted through the saliva of infected animals — most commonly dogs, but also cats, monkeys and bats. Once clinical symptoms set in, including hydrophobia, hallucinations and paralysis, survival is exceedingly rare. Prevention therefore depends entirely on timely post-exposure prophylaxis, which includes immediate wound washing, rabies vaccination, and, for severe bites, administration of rabies immunoglobulin.
India bears a disproportionate share of the global burden. The World Health Organization estimates 18,000–20,000 rabies deaths globally each year, with India accounting for nearly 36% of them. Children under 15 constitute a large share of victims, underscoring the disease’s social and economic cost.
What Triggered the International Advisories
Health authorities in Australia, followed by the U.K. and the U.S., issued alerts after reports that counterfeit versions of Abhayrab might have been circulating in India since late 2023. The warned that counterfeit vaccines may be ineffective or even harmful, citing a rabies case in a U.S. traveller from India.
The U.K. initiated a retrospective “look-back” exercise to identify travellers vaccinated in India who might require additional doses. These advisories were precautionary, reflecting the zero-tolerance approach adopted by countries where rabies incidence is extremely low.
What Is Abhayrab and What Went Wrong?
Abhayrab is manufactured by the Human Biologicals Institute, a division of , a public sector enterprise and one of the world’s largest producers of rabies vaccines. The company holds roughly 40% of India’s rabies vaccine market.
According to Indian Immunologicals, only one batch — identified in January 2025 — was found in circulation with packaging that differed from the original. The company alerted regulators and law enforcement immediately. Subsequent testing by the Central Drug Testing Laboratory in Kasauli found that the vials contained genuine vaccine; the irregularity lay in the outer packaging. This suggested diversion of government-supplied stock into the private market rather than a failure of vaccine formulation itself.
Why the Issue Still Matters for Public Confidence
Even if the biological content was genuine, the episode exposes vulnerabilities in supply chains, monitoring and enforcement. International advisories, though cautious, risk fuelling vaccine hesitancy within India — particularly in rural or resource-poor settings where Abhayrab may be the only vaccine available.
Public health experts stress that hesitation or delay is far more dangerous than the perceived risk from the vaccine. Rabies prevention allows no margin for error.
Does Vaccination Still Protect If One Dose Is Doubtful?
Experts from the have sought to reassure the public. In India, post-exposure prophylaxis typically involves multiple doses of the rabies vaccine, along with immunoglobulin for severe (Category 3) bites.
According to WHO protocols, protection is achieved with at least three intramuscular doses or two intradermal doses when combined with immunoglobulin. Even if one dose were compromised — a scenario not conclusively established — the remaining doses significantly reduce the risk of disease.
Were There Recent Vaccine Failures?
Concerns around vaccine efficacy surfaced earlier in Kerala, where a spike in rabies deaths was reported in 2022 despite some victims having received vaccines. A committee constituted by India’s Union health ministry found that these cases were linked not to vaccine failure, but to delayed wound washing and the absence of immunoglobulin in severe bites.
This highlights a critical point: vaccination alone is not enough. Immediate and thorough wound cleaning, followed by correct categorisation of bites and complete prophylaxis, is essential.
What This Episode Reveals About India’s Rabies Control
India’s has improved reporting and awareness, but undercounting remains significant. Supply shortages of vaccines and immunoglobulin, weak enforcement against diversion, and gaps in public awareness continue to undermine control efforts.
The Abhayrab episode underscores the need to strengthen regulatory oversight, secure supply chains, and communicate risks transparently — without eroding trust in life-saving interventions.
What to Note for Prelims?
- Rabies is nearly 100% fatal once symptoms appear.
- India accounts for about 36% of global rabies deaths.
- Post-exposure prophylaxis includes wound washing, vaccination, and immunoglobulin.
- Abhayrab is one of India’s most widely used rabies vaccines.
What to Note for Mains?
- Analyse the public health implications of counterfeit or diverted medicines.
- Discuss challenges in rabies control in India despite vaccine availability.
- Evaluate the role of regulatory oversight in maintaining vaccine confidence.
- Examine how international advisories affect domestic public health responses.
The Larger Public Health Lesson
The global alerts on Abhayrab are less about India’s vaccine science and more about system integrity. In diseases like rabies, where prevention is the only cure, trust in vaccines is as vital as their availability. Strengthening surveillance, ensuring uninterrupted access to immunoglobulin, and preventing diversion must therefore be seen as integral to India’s fight against one of its oldest yet most preventable killers.
