Here's What It's Like to Get Rabies Shots
Unfortunately if you want a public health nurse to tell you don’t need rabies shots, those were the wrong answers. She had wanted to know whether we could say with any assurance that we had been aware of the bat’s whereabouts and that those whereabouts didn’t include our skin. But we couldn’t say that.
She told us that a doctor from the health department would call by about 9:30 today, with more questions and instructions, but that we’d have to start treatment. Where do we do that? One of us could pick up the vaccine and the immunoglobulin at the health department office in New Rochelle, she said, and bring it to our doctors. We’d need a vaccination and immunoglobulin on the first day, and then more vaccine on the third, seventh, fourteenth and twenty-eighth days.
Someone from the health department finally called at around 11 the next morning. Her instructions weren’t quite the same as Jennifer’s, or quite as simple. Your doctor has to order the vaccine and the immunoglobulin, she said. Then it’ll be sent via overnight courier.
I called my doctor and at 2 p.m. he got back to me. He’s a good doctor, always sympathetic, and I like him because about seven years ago he saved my life; but he and his colleagues run the New Canaan Medical Group like a business and if something is inefficient or gets in the way of their practice, they don’t tolerate it.
Such is the case with rabies shots. They gave up administering them about five years ago, he told me, mainly because it was too much trouble. He said we’d have to go to the emergency room at Norwalk Hospital, and they’d make an appointment for us to get the shots at a place called Express Care.
Express Care turned out to be the part of the Norwalk Emergency room where they treat people who don’t quite have real emergencies. It also turned out that the word “Express” was something of an overstatement.
We got there at 5 and checked in with the emergency room nurses, who were happy to make jokes about the numerous shots we’d be getting. Rabies immunoglobulin is administered based on weight. The more you weigh, the more you need. A smaller person will need fewer shots than a larger person, the nurse told us, and she looked at me with her eyebrows raised and a little smile on her lips, as if to say, “You’re in trouble, buddy.”
She said that when she was a kid, she and her friends caught bats, and no one worried about rabies. To me that emphasized the one undeniable truth of this episode: if a bat flies into your room, you don’t really need rabies shots, but no public health official or doctor or nurse is willing to tell you that.
We were sent to the waiting room. After a few minutes, a woman emerged from an office and called my wife’s name and then another woman emerged and called my name. They were ready to register us. Each went back into her office and had us sit in a chair separated from her by a thick plastic ticket booth-type window. My registrar, whose name was Colleen, told me bats had been living in the attic of her house and found their way into her son’s room three times. He got the shots the first time, she said. The second and third times he didn’t bother.
We went back to the waiting room. Soon a nurse came out of the Express Care doors and called our names. She had orange hair and wore blue scrubs – the Mets colors, I noted irrelevantly. She led us into a small room set up for eye exams.
“Wait here and someone will be in to talk to you, to figure out if you need the shots.”
“You mean we might not need the shots? That’s not what everyone has been saying.”
“Were you bitten?” she said, and she smiled as if she knew something we didn’t.
She shut the door and we waited. We read. We chatted. We looked at the eye charts on the wall. After half-an-hour a doctor came in. He told us that rabies treatment was effective but that it wasn’t really based on science: there’s no evidence that you’ve been exposed and there’s no evidence that you can get rabies from a bat being in your room. But we’ll treat you anyway, he said.
“The truth is,” I said, “no one is willing to say we don’t need the shots.”
“I’m not saying you do and I’m not saying you don’t,” he said. “It’s your decision.”
He told us he had ordered the immunoglobulin and the vaccine and that it would be up soon. Gina was particularly worried that the immunoglobulin shots would make her muscles sore over the next couple of days.
“How much of it do we need?” she asked.
“One shot,” the doctor said. “For you, one teaspoon full. For you [he looked at me], two teaspoons.”
He left. Outside at the desk the staff was talking about the immunoglobulin and the vaccine, and about the schedule for future shots. A nurse was trying to write down on a form when we’d need to return – day three, day seven, day 14, day 28 – and was having an extremely difficult time figuring out when those days would be.
After about 10 minutes, two nurses – a man and a woman – approached bearing hypodermic needles. The woman told us we’d get the vaccine in the arm and the immunoglobulin in “the heiney,” as she put it.
“Two for you,” she said to Gina, “and four for you.”
Although my courage has improved in recent years, I’m still an enormous baby when it comes to getting injections. I don’t like to see other people getting a needle, I don’t even like to look at the needle. The nurses’ plan was to administer the immunoglobulin and the vaccine to me and Gina at the same time, in the eye-exam room. But I didn’t want to have to see and hear her getting her shots, so I asked if we could do it separately. The nurses were surprised but happy to accommodate us. I stepped out into the area near the main desk and as I waited, my nurse decided she might as well at least administer the vaccine and so with surprising quickness, she wiped my upper arm with an alcohol pad, jabbed the needle into me, wiped it clean, and we were done with that part.
As for the four shots of immunoglobulin, I’m afraid I have to report that they weren’t so bad. The nurse was quick and reasonably skilled – the first shot didn’t hurt at all, the second hurt a fair amount, and the other two were in between. By 6:50 we were done and on our way home.
We have to return to Express Care four times over the next month for more vaccine. Unfortunately they do not make appointments and we were told that each time, we’ll have to register anew, and so there’s no telling how long it will take for what should be a five minute procedure.
But do we need it? I don’t know. All I know is that no one was willing to say we didn’t.