Rabies Immune Globulin Shortage Update: What Patients Need to Know in 2026

When you hear that a critical medication is difficult to find, your first thought might be: is there a shortage? For rabies immune globulin, human (HRIG) — the biologic used in the first step of rabies post-exposure prophylaxis (PEP) — the answer requires nuance.

Is There a Shortage of Rabies Immune Globulin in 2026?

No — there is currently no national shortage of human rabies immune globulin in the United States. The CDC confirms this explicitly. Three brands are licensed, available, and actively distributed:

HyperRAB (Grifols, 300 IU/mL) — available in 1 mL/300 IU and 5 mL/1,500 IU vials

KedRAB (Kedrion/Kamada, 150 IU/mL) — FDA-approved in 2017, pediatric label expanded in 2021

Imogam Rabies-HT (Sanofi, 150 IU/mL) — heat-treated formulation, available since 1974

Then Why Is HRIG So Hard to Find?

The supply exists — the problem is distribution and access. HRIG is a specialized biologic that requires cold-chain storage and must be administered by injection into wound sites by a trained clinician. This means it is stocked only in clinical settings that routinely manage trauma and emergency cases.

This is not a new problem. There have been historical reports of patients in rural or underserved areas struggling to receive PEP in a timely manner, not because no HRIG existed nationally, but because the nearest stocking facility was far away. The CDC advises patients or providers having difficulty obtaining HRIG to contact their supplier directly for ordering guidance.

Historical Context: Has There Ever Been a True HRIG Shortage?

The US has seen periods where individual brands or specific HRIG formulations have faced production or availability challenges. For example, the older HyperRAB S/D (150 IU/mL) formulation was discontinued in favor of the higher-potency HyperRAB (300 IU/mL), which could have briefly affected facilities accustomed to the older product and dosing.

Unlike chronic medications such as ADHD drugs or certain antibiotics, HRIG is not subject to the surges in consumer demand that trigger the shortages you might see on a national drug shortage list. Its use is limited to post-exposure situations, and approximately 50,000 to 60,000 Americans receive it each year.

What Is the Biggest Access Challenge for HRIG in 2026?

The primary challenge is cost and geographic access:

Cost: HRIG is expensive. A single KedRAB vial starts at approximately $736 for 2 mL, and the full PEP course — HRIG plus four vaccine doses — can cost $2,500 to $7,000 out of pocket. High costs have caused some patients to hesitate before seeking treatment — a dangerous decision given that untreated rabies is almost always fatal.

Rural access: Smaller rural hospitals and clinics may not routinely stock HRIG. Patients in remote areas may need to travel significant distances to reach a facility with HRIG on hand.

Insurance delays: Some insurance plans may require prior authorization for PEP in outpatient settings, creating bureaucratic barriers to timely treatment.

How to Get HRIG If You've Been Potentially Exposed

If you believe you have been exposed to a potentially rabid animal:

Wash the wound with soap and water for at least 15 minutes immediately.

Go to the nearest hospital emergency department — do not call pharmacies.

If cost is a concern, ask the treating facility about patient assistance programs from Sanofi, Grifols, or Kedrion.

Ask your local or state health department if you are in a rural area — they often have a rabies response protocol.

Will HRIG Coverage and Access Improve?

Advances in monoclonal antibody technology may eventually provide a more accessible alternative. Researchers are studying synthetic mAb cocktails (like TwinRab) that would not require human donor plasma and could potentially be produced at lower cost and distributed more widely. However, as of 2026, these products are not FDA-approved in the US.

In the meantime, medfinder can help patients identify which clinical facilities near them stock HRIG — removing one of the key friction points in accessing this life-saving treatment quickly.

Also read: Why Is Rabies Immune Globulin So Hard to Find?