Just want to point out that this is likely because the “initial” vaccine given when potentially exposed isn’t one vaccine. The vaccine itself can be given prophylactically and often for cheap/free at a local health department/doctors office. However, when you show up to an emergency room with an exposure, you get the vaccine (which is about half a cc injection) along with (the likely much more expensive) rabies immune globulin, which is first injected around the bite and any remainder given intramuscularly. The Immune globulin is weight based, so it can often be a much large volume. Given that you were “billed” 40k, this also likely means you went to an emergency department (which is the right call imo) in the US … this generally means that your bill exploded into a crazy number that is often mostly disregarded by the insurance company, either because it is viewed as a negotiation point, or because it is heavily subsidized by the government (EMTALA had subsidized all ER care, but less so after the ACA… people now must also pay a flat ER fee to the insurance company, typically a few hundred dollars)

[–] GnomeGodsGnomeMasters@hexbear.net 3 points 1 week ago

Yes this is a good write up, and you are correct: Immune Globulin is the real expensive piece.

For yall wondering, from what I understand, the immune globulin has a super short shelf life, which means it’s often discarded before use which inflates the price significantly. Further, since so much gets discarded and demand is relatively low, most supplies of the stuff are in more densely populated areas. As I mentioned below, I went to a middle-of-nowhere ER late at night which was a several hours drive away from the nearest available immune globulin which needed to be couriered to my location which also inflated the price tremendously, I’m sure.

And yes, ER is definitely the right call. Rabies is 100% gonna kill you, and the vaccine is 100% gonna save your ass. The sooner you can get to a hospital and get the immune globulin the better. If you can secure and/or dispatch the animal that bit you and have it tested for rabies, that would be ideal but that very often is simply not possible. My understanding is that many major state universities in the U.S. offer rabies testing, but uh, don’t quote me.