This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility: A new study has found that expanding dog vaccination, rather than introducing routine pre-exposure vaccination for children, is the most effective and cost-effective way to eliminate rabies deaths in people in Kerala, India. The research, led by the University of Glasgow in collaboration with researchers from the Directorate of Medical Education, Kerala University of Health Sciences, School of Public Health, Directorates of Health and Animal Husbandry in Kerala, and The London School of Economics and Political Science, is published in Lancet Regional Health.
The study also found that adding a routine pre-exposure rabies vaccination would cost millions but prevent few additional deaths. The findings are published in The Lancet Regional Health - Southeast Asia journal. The research addresses an ongoing public health issue in Kerala, where human rabies deaths continue to occur despite widespread access to lifesaving treatment after animal bites.
Rabies is always fatal once symptoms develop but is entirely preventable through timely vaccination. Currently, post-exposure prophylaxis (PEP) is given free of charge to almost 1 million people in Kerala every year, and the state has one of the highest vaccination completion rates in India. Despite this, Kerala reported 33 human rabies deaths in 2025, including deaths among children.
Rabies causes an estimated 59,000 deaths globally each year, with India accounting for the largest share of the burden. The WHO's "Zero by 30" strategy aims to end human deaths from dog-mediated rabies by 2030. The ongoing deaths in Kerala have prompted debate over whether adding routine pre-exposure prophylaxis (PrEP)—vaccinating people in advance, before any bite occurs—could provide an additional layer of protection.
However, the study found that introducing routine PrEP would cost an additional $10 million and provide very little additional benefit, preventing fewer than 10 additional deaths, when access to PEP is already strong. The research suggests that, by contrast, increasing vaccination coverage among dogs produced dramatically larger reductions in human deaths at a much lower cost. Under scenarios in which 70% of dogs were vaccinated, the study's mathematical model predicted that annual rabies deaths in Kerala would fall to near zero within around three years.
The study's analysis also showed that switching to the WHO-recommended one-week PEP regimen could save around $6.3 million (INR 580 million) over 10 years without increasing the risk of death. The research also uncovered evidence that Kerala's dog population may be substantially larger than current official estimates. The patterns observed by the researchers in rabies surveillance data suggest that the unowned dog population may be around five times larger than the official census estimate, giving a total dog population of around 2.3 million animals across the state.
Extract — continue reading at the source.
