Ok. It may be because of the rabies incidence in the area you work. Again, I work in an increased risk environment, but in the US, which has a lower incidence than other countries. Still, my titers, which I do have to do every other year, show strong response.
Granted, there is not a good cutoff on what a good “titer” is, and I’d still get treated for rabies if exposure is shown. Again, the difference in my case will be both the urgency of the treatment and the total amount of shots needed, compared with someone who has not been vaccinated.
In that note, I want to clarify the difference in the rabies shots. There are the vaccine series (which for pre-exposure, at least, total 3 over month), and then there are the immunoglobulin shot. The immunoglobulin shot (RIG) is already formed antibodies against rabies. They will not help you with your own immunity, but will neutralize the virus while your own body defences gear up. The vaccines are the ones that prompt your body into “antibody production mode”.
I refer to these charts from the CDC about post-exposure protocols. Again, the difference between the previously vaccinated and unvaccinated are in the use of the immunoglobulin and the total amount of boosters needed.
Is the $5000 figure cited in the OP the charge that was presented to the OP’s insurance (if any), or the cost that was actually paid (by the OP or the insurer)?
I was told every 10 years, and rabies is definitely endemic here. (Plus one shot post-exposure if any.) Looking around on the Internet, I’m seeing all sorts of numbers including 2-3 years. One site says the three-shot series + a booster after one year is good for 10 years.
It’s clear I’m due for one anyway, be it two years or 10. When I get it, I’ll ask.
Typically, the insurance companies will have contracts in place whereby they pay much less. For instance, I got a notice today of a recent doctor’s appointment being charged at $160, and the insurance company’s contract disallowed all but $63.
If these shots were covered by insurance, you would typically get an “Explanation of Benefits” in the mail, showing the charge, the amount paid by the insurer and the amount (if any) that the patient owes.