Recent incidents in Kerala have cast a shadow of doubt on the effectiveness of rabies vaccines, following the deaths of three children who had received timely shots after being bitten by stray dogs. The deaths have sparked concerns among the public and prompted investigations into the quality and administration of the vaccines.

The most recent victim, seven-year-old Niya Faisal from Kollam district, died at SAT Hospital in Thiruvananthapuram after receiving three doses of the anti-rabies vaccine. Prior to this, a 12-year-old girl from Pathanamthitta district died on April 9, and a five-year-old girl from Malappuram succumbed to the disease on April 29, despite both receiving the rabies vaccine.

In response to the rising concerns, Kerala's Health Minister Veena George has assured the public that the vaccines used in the state undergo rigorous quality testing at the Central Drugs Laboratory in Kasauli before distribution. She also mentioned that an expert committee formed in 2022 found that vaccinated individuals had adequate antibody levels, suggesting the vaccines were effective. However, opposition leaders have voiced their concerns, alleging that the deaths are a result of government mismanagement and corruption, pointing out that, in the last five years, 20 out of 102 rabies fatalities in the state occurred in people who had been vaccinated.

Health experts suggest that several factors can influence the outcome of a rabies infection, even with vaccination. Deep wounds, particularly those on the head and hands where nerve density is high, pose a greater risk because the virus can reach the central nervous system more quickly. The effectiveness of the vaccine also depends on how quickly and thoroughly the wound is cleaned, and whether rabies immunoglobulin (RIG) is administered promptly to neutralize the virus before the vaccine takes effect. Doctors have also noted that administering vaccines intradermally to children can be challenging due to their thinner skin and restlessness.

The state has reported 13 rabies deaths till May 2, 2025. In 2024, there were 22 confirmed rabies deaths and 4 suspected ones, while in 2023, there were 17 confirmed and 8 suspected deaths. A 2023 article in The Lancet raised concerns about rabies deaths in vaccinated individuals in Kerala, attributing the deaths to the nature of the wounds and delays in seeking appropriate care.

The rising number of stray dog attacks in Kerala is also a major concern. In 2024, the state reported over 3.16 lakh dog bite cases, a significant increase from 1.35 lakh in 2017. Data indicates that 56% of dog samples tested in 2022 were positive for rabies, compared to 32% in 2016. The Kerala Pravasi Association has approached the Union Ministry of Health and Family Welfare, highlighting critical deficiencies in vaccine manufacturing and distribution protocols.