Australia Warns of Counterfeit Rabies Vaccine in India, Triggers Global Health Alerts

Australian health authorities have issued a public health advisory warning that counterfeit doses of the rabies vaccine Abhayrab may be circulating in India, raising concerns about the effectiveness of rabies protection for people vaccinated with fake vials. The alert has prompted responses from Indian health officials, international agencies, and the vaccine’s manufacturer, amid fears that poorly worded warnings could fuel vaccine hesitancy.

Australia Flags Risk of Inadequate Rabies Protection

The Australian Technical Advisory Group on Immunisation (ATAGI) said individuals who may have received counterfeit Abhayrab vaccines might not be fully protected against rabies, a disease that is almost always fatal once symptoms appear. ATAGI advised clinicians to carefully assess vaccination histories of travelers who received rabies shots in India and to consider revaccination or antibody testing where appropriate.

Abhayrab is manufactured by the Human Biologicals Institute, a subsidiary of Indian Immunologicals Limited (IIL), and is one of the most widely used rabies vaccines in India.

Global Health Agencies Raise Parallel Concerns

Australia’s advisory follows similar alerts from other countries. The United States Centers for Disease Control and Prevention (CDC) previously reported a rabies case involving a traveler from India and noted concerns over counterfeit Abhayrab vaccines in circulation. The CDC advised travelers exposed to potentially rabid animals in India to seek immediate medical attention rather than rely solely on vaccination records.

In the United Kingdom, health authorities undertook a retrospective review to identify travelers who had received rabies vaccinations in India since November 2023, assessing whether further medical follow-up was needed.

Public health experts say the coordinated international response reflects the seriousness of rabies exposure and the reliance of global travel medicine on vaccine supply chains in high-burden countries such as India.

Manufacturer Pushes Back, Seeks Review

Indian Immunologicals Limited strongly contested the tone of the Australian advisory, describing it as “over-cautious and misplaced.” In a formal response, the company said it had identified a counterfeiting incident involving a specific Abhayrab batch—KA24014—in early January 2025 and that the fake batch was no longer in circulation.

IIL emphasised that all legitimate Abhayrab vaccine batches are tested and released only after clearance by India’s Central Drugs Laboratory, in line with national regulatory standards. The company has requested a review of the advisory, arguing that it could create unnecessary alarm.

Market Impact and Expert Views

Abhayrab accounts for nearly 40% of India’s rabies vaccine market and is routinely used in government hospitals and private clinics. Senior company officials warned that broad international advisories could undermine public confidence in vaccines, particularly in countries where rabies remains endemic and vaccination is a critical public health tool.

Reeta Mani, a specialist from the National Institute of Mental Health and Neurosciences (NIMHANS) in Bengaluru, described Abhayrab as a well-established and reliable vaccine with a long history of safe use. She cautioned that public health advisories must be carefully worded to distinguish between isolated counterfeiting incidents and the overall quality of an approved vaccine.

Why the Issue Matters

India accounts for a significant proportion of the world’s rabies deaths, and timely vaccination after animal bites is essential to prevent fatalities. Experts note that counterfeit medicines pose a serious risk not only to individual patients but also to public trust in immunisation programmes.

Health authorities across countries are now walking a delicate line: ensuring patient safety through vigilance against counterfeit products, while avoiding broad messaging that could discourage people from seeking life-saving vaccines.