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Comment by kleopullin | Hacker News Reader

This is a badly written article, journalists should have a little science background.

"... the bats .... were carriers of a rabid and highly contagious virus."

Yes, it is a rabid virus...

"A person usually has some time before it is necessary to get the post-exposure prophylaxis vaccination."

A friend had to handle a bat in her cabin, and she was not told she had "some time" before the shots. If you've been exposed get your butt to the ER.

"An estimated 40,000

people in the US who might not be up-to-date on vaccinations

get preventive treatment for rabies after a bite or scratch from a dog or cat."

Statistically 100% of peeps aren't up to date on rabies vaccines. Vets, bat researchers, and bat house zookeepers may be up-to-date, but no one else is.

Rabies shots costs thousands of dollars, btw. Tricare, for military dependents, doesn't charge a copay for rabies post-exposure injections. My friend's insurance had something like $4000 copayment.

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"Rabies shots costs thousands of dollars"

I assume you mean in the US. Really? I had no clue. They are like $5 in Eastern Europe.

Edit: I am referring to the post-exposure shots.

Edit 2: All of this reads like a bad joke - if our numbers are representative, rabies treatment is 20-2000x the cost of other countries in the US. Would be interesting to see someone play devil's advocate on this.

In India they are free in State owned hospitals.

Free in Canada, as well.

Free in Spain, if I'm not wrong

Completely free and everybody is vaccinated because they vaccinate kids in schools, I assume it's the same in every country of the first world.

Hum, not. Is obligatory for dogs (it was like 50€ or so), but children aren't vaccinated from rabies normally in Spain at the school.

Rabies is endemic in Ceuta and Melilla in any case. I don't know if people in those places are systematically vaccinated but would be a surprise to me.

Wow, I stand corrected! I thought rabies was in the programme. My mistake.

About Ceuta and Melilla, there have been efforts to have pets vaccinated for free: https://elfarodeceuta.es/sanidad-vacunacion-gratuita-rabia/

I got them in the us about 10 years ago (international travel with likely animal exposure). About $600.

Parent is talking about post-exposure rabies shots, not the rabies vaccine. If you read https://www.vox.com/policy-and-politics/2018/2/7/16851134/ra... it's actually still very expensive in the UK as well.

Oh! I got rabies shots in 2014 after being bitten by a dog.

The course of treatment is injections 0day, 3day, 7day, and 14day. I went to the emergency room to get these injections, at the recommendation of my primary doctor.

Unfortunately I don't have the bills anymore, but the total cost was a bit over $20,000, which insurance adjusted down to about $500/visit.

Basically, it would have bankrupted me if I didn't have insurance. Yes, the US healthcare system is really this broken.

Yep, my family had to do the same ER visit for our treatments. Immune globulin is a blood product and I was told it is atypical for any medical center outside of a hospital to have it available. Having to go the ER added a not insignificant amount to our total bill, but we did only have to pay for a single visit to the ER - our followups, we just walked in and a nurse would give us the shot.

On the somewhat funny side, it's weird walking into an ER and being greeted by first name and a wave . . .

Hah yeah, it was kind of funny that by the 4th shot, the ER docs and police there knew me as "the rabies guy".

I also was told that the immune globulin is a bit complicated because it needs to be prepared specifically for the person's weight. So unlike off the shelf vaccines, it requires an on duty pharmacist to actually do something before they can give it to you, which I'm sure adds to the cost.

I can also confirm this. Similar situation and similar pre-insurance costs.

I got the post-exposure series with rabies vaccine and immune globulin shots earlier this year. The total insurance charge was around $20,000 for me as well. $15,000 for the immune globulin and $5,000 for ER/Vaccine/etc. My out of pocket cost was below a few thousand after insurance, but it was expensive nonetheless.

With those kind of costs, you're probably going to hit the out-of-pocket maximum even if your insurance covers 80% or whatever which is going to be a few thousand dollars for most people. (But might be more with a cheaper high deductible plan.)

Pre-exposure rabies vaccination is generally not included with statuatory health insurance in Germany. Still, the insurance carrier often covers it if the vaccination is indicated for a country you travel to. The three shots cost about 200-300 Euros combined, IIRC.

Yes, post-exposure costs in the US for human rabies immune globulin (antibodies isolated from the blood of a vaccinated person) in the United States is roughly a $10,000 to $15,000 expense per person (dosage is based on body weight). The vaccine cost is much less, well under $1,000 total per person.

I know these costs from direct experience. I also know that insurance coverage for this cost varies widely as well.

My entire family had a nighttime (meaning the family members were in bed asleep) exposure to an untested bat. Following the U.S. Center for Disease Control and local health department guidelines, plus the advice of infectious disease MD specialists, we had to receive both the immune globulin and rabies vaccine. These costs were not covered expenses under my (otherwise pretty solid) medical insurance plan - we wound up having to pay approximately 30% of the total cost.

In the end, I felt fortunate that at least our insurance kicked in to cover 70% of the costs and that we were in a financial position that allowed us to pay the low five-figure out-of-pocket expense for our treatment without undue hardship.

I'm actually debating keeping our vaccinations up-to-date going forward - I think the booster vaccine, while still uncovered by my medical insurance plan, is relatively low cost and incidences of rabid animal encounters seems to be steadily rising in my home state.

> I'm actually debating keeping our vaccinations up-to-date going forward - I think the booster vaccine, while still uncovered by my medical insurance plan, is relatively low cost and incidences of rabid animal encounters seems to be steadily rising in my home state.

You can get a rabies titer to see if you need the vaccine booster.

https://www.cdc.gov/rabies/specific_groups/doctors/serology....

I took my wife/daughter/myself to the ER to figure out if we should get it since it is the only place that carries the vaccine near us. We ended up not getting it and still walked out with a $3000 bill.

Or in Vietnam it was about 10 euro a shot and probably would have been free if I had been a local.

> A friend had to handle a bat in her cabin, and she was not told she had "some time" before the shots. If you've been exposed get your butt to the ER.

The article doesn't claim otherwise. Rabies can usually be treated successfully days or weeks after the initial bite. Obviously you should get the shots ASAP regardless; it's more likely to take hold with every day that passes.

> Statistically 100% of peeps aren't up to date on rabies vaccines. Vets, bat researchers, and bat house zookeepers may be up-to-date, but no one else is.

Again, the article doesn't say otherwise. It doesn't say "40,000 people aren't vaccinated," it says "40,000 people (who aren't vaccinated) get rabies shots after a dog/cat bite."

The article does specifically say "a person usually has some time," which is why I put it in quotes. There's no value to the article downgrading an urgent medical situation, and the author lists herself only as a journalist. The standard of care is urgent, ERs are equipped to give the shots. This is USA.

"An estimated 40,000 people in the United States who might not be up-to-date on vaccinations," again, I used quotes specifically because that is how it is worded, "people who might not be up-to-date on vaccinations," as it is less usual for someone to be up to date on rabies vaccinations.

The science was badly worded, as if it was copied without understanding the context, and this is a legitimate concern when the press misstates medical advice. The number is probably from the CDC information page,

"Every year, about 40,000 people receive a rabies prevention treatment called post-exposure prophylaxis (PEP) because they had contact with potentially rabid animal."

CDC also doesn't say dog/cat bite or scratch, just potentially rabid animal, mostly dogs or cats.

I read the article, notices her carelessness, checked sources. There are more errors. It's badly done.

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