| Bavarian Nordic's vaccine for mpox is a hot topic at the moment — particularly in central Africa where people, many of them children, are bearing the brunt of a deadly new strain of the virus. But it's not the only vaccine the Danish drugmaker makes that's in high demand, as anyone planning a trip to a country where rabies is prevalent, like me, will know. I've spent the past month bouncing around clinics in London in search of three doses ahead of a trip to Tanzania. Rabipur, a leading vaccine for rabies — a preventable disease usually caused by an animal bite but which is almost always fatal once clinical signs appear — is out of stock as of June, according to Britain's National Travel Health Network and Centre. That's because surging demand is "way above expectations" and outpacing the rate at which the shot can be made, a Bavarian Nordic spokesperson says. Other vaccines for rabies, which kills about 70,000 people worldwide every year, are also scarce. Sanofi's Verorab is limited, with the French drugmaker citing a spike in demand due to shortages of others shots, such as Rabipur. Demand for pre-exposure rabies vaccines has surged ever since Covid travel restrictions were lifted, according to Kath Lynch, lead nurse at Trailfinders Travel Clinic, a private UK provider of travel vaccines. "Nobody expected travel to rebound so quickly post-Covid," she says. "It's almost like there's a backlog of travelers." At one point earlier this year, supply was so tight that Trailfinders offered travelers only two doses, rather than the usual three "so that more people had some protection as opposed to fewer people having the full pre-exposure course," Lynch says. Trailfinders has since resumed using three doses. Over the past two years, the short notice of intermittent supply issues with the rabies vaccine has been a challenge to manage, says Andrew Lewis, chief executive officer of MASTA and Nomad Group, private providers of travel vaccines in the UK. MASTA and Nomad administered almost 15,000 rabies vaccines in 2023, just a fraction of the almost 38,000 doses given in 2019. However, there are signs that the shortage is starting to ease, says Lewis.
At least for patients in big cities, that is, as they generally have better access to larger travel clinics (with more ordering clout) than smaller towns and villages. Orders for smaller batches of doses "aren't prioritized over the bigger clinics where we get hundreds in, so we do get favorable ordering priority," says Lynch. The good news about a rabies shot, if you can find one, is its longevity. Although protection can decline over time, most travelers will not need a booster. About 95% of people who have had three doses will have some protection, according to the UK National Health Service. "Maybe 20 years ago, you did your one trip of a lifetime," says Lynch. "People travel a lot more now, so there's more value. It's a one-off course and then you're primed for life." — Jennifer Creery | 
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