Background: The United States of America (USA) does not have a national reporting system for rabies post-exposure prophylaxis (PEP). We describe the epidemiology of PEP in the USA so recommendations can be made during a PEP shortage.
Methods: A two-part questionnaire designed to evaluate PEP distribution practices and estimate PEP use was administered to state health department representatives.
Results: Seventy-five percent of participants responded that no public health guidance was needed to make a recommendation for PEP. The annual national average PEP use is 23,415 courses of PEP (range: 10,645-35,845).
Conclusion: PEP is loosely monitored and a precise estimate of PEP use is unknown. Improved national surveillance for PEP is needed.