Rabies PEP Preparedness and Vaccine Inventory

Dear Local Health Departments,

We are reaching out regarding the recent confirmation of multiple rabies cases in baby goats associated with a mobile petting zoo operating out of Iredell County. These animals may have been in contact with people at private and public events across several counties between July 28 and August 27, 2026. Individuals who may have been exposed are being directed to contact their local health department to assess their need for post-exposure prophylaxis (PEP).

To support planning efforts, we want to ensure that all local health departments are prepared and aligned on access to PEP. As part of these efforts, it is important that we maintain an accurate understanding of available rabies vaccine inventory across North Carolina, including both publicly funded and privately purchased vaccine.  

Vaccine Inventory Guidance 

• Please ensure that all rabies vaccine inventory is accurately recorded in NCIR and reflects the current inventory at your facility. Providing inventory information does not obligate your facility to share your supply.  
   
• All rabies vaccine administrations should be recorded in NCIR at the time of administration or by the close of business on the day of administration.  
  • In NCIR, select the client comment “Client has been exposed to rabies” to switch the tracking schedule to post-exposure prophylaxis. For instructions on adding a client comment, please refer to the “How to Add a Client Comment” section on page 4 of the NCIR Quick Reference Guide.

PEP Preparedness Actions 

It is recommended health departments take the following preparedness actions, if they have not done so already.  

• Determine which partners (i.e. hospitals, urgent care facilities) within your jurisdiction have the ability to administer PEP. 
  • Note: When administering PEP never administer the first vaccine dose in the same syringe or in the same anatomical site as human rabies immune globulin (HRIG)
     
• Contact those partners and determine what process they would like you to follow when referring patients to them for PEP.  Some health systems have already established designated rabies PEP locations to prevent emergency departments from becoming overcrowded. 
   
• Coordinate with PEP partners to ensure there is a smooth and efficient process for individuals to complete the full rabies vaccination series.  
  • All local health departments should have the capability to provide the follow-up rabies vaccine doses on days 3, 7, and 14 and are encouraged to be a part of that process. 
  • Use the CDC Rabies PEP Calculator to calculate follow-up rabies vaccine dosing dates.
  • All local health departments can order rabies vaccine using their Cardinal Health accounts. We have been assured there is plenty of inventory in the supply chain. 
     
• Individuals who are uninsured and meet certain income requirements may be eligible for free PEP through either the state’s Patient Assistance Program or manufacturer patient assistance programs for HyperRAB and KEDRAB. Please ensure that you and your partners are familiar with these programs to reduce barriers to payment for PEP. NCDHHS maintains the expectation that no individual will be denied service due to the inability to pay.  

As this investigation continues and as additional exposure locations may be identified, having clarity on local resources and coordination plans will be essential. For more information, visit the NCDHHS Rabies webpage and Rabies Information for Health Care Providers webpage.

How to contact us: 

For questions or concerns, please contact the NCIP Help Desk by phone at 1.877.USE.NCIR (873-6247), by email, or submit a ticket through the NCIP Help Desk Portal. 

Thank you for your partnership and your ongoing commitment to protecting public health. 

In Health, 
NC Department of Health and Human Services