A 21-year-old woman died of rabies despite completing all five anti-rabies vaccine doses and receiving rabies immunoglobulin (RIG) after a dog bite, according to a social media post by an ex-Army doctor. The doctor used the case to explain that while rabies is almost always preventable, the treatment can fail if even one critical step is missed during wound care or vaccination. The post has drawn attention because many people believe taking all vaccine doses guarantees protection. The doctor said that is not always true. From improper wound washing to incorrect use of rabies immunoglobulin, several mistakes can reduce the effectiveness of treatment. Why can anti-rabies treatment fail? The ex-Army doctor said one of the biggest mistakes is stitching a dog bite wound too early. According to the post, "Stitching a dog bite without first injecting serum (Rabies immunoglobulin/RIG) inside can trap the virus. Doctors should avoid stitching deep dog bites whenever possible."— docakx (@docakx) Also Read: Singapore student told her mother she was going to college. She actually flew to Cambodia to meet an online gaming friend The doctor also warned that rabies vaccines are highly sensitive to temperature. If they are exposed to excessive heat or freezing, they may lose their effectiveness. The post added that many hospitals and clinics still face problems with cold storage and called for strict temperature monitoring. Why rabies immunoglobulin matters The doctor stressed that rabies immunoglobulin should be injected directly into and around the bite wound. The post said, "The first RIG injection (serum) must go directly into and around the bite. Just giving it in the arm is not enough. Virus is sitting in the wound. It needs to be killed there first." Another key step, according to the doctor, is washing the wound immediately after the bite. The former Army doctor stated, "The most important step is washing the bite with soap and running water for 15 full minutes. This alone removes a huge amount of virus. Most people and even some hospitals skip this." Vaccine must be given correctly The doctor also highlighted that the vaccine should never be injected into the buttocks. The post said, "Never inject in the buttocks. It must be given in the upper arm (deltoid). Wrong place = poor protection." The doctor added that people must receive all five doses on the recommended dates without delays. According to the post, "All 5 doses must be taken on exact days. Even one delay can create a dangerous gap. Never skip or postpone." Severe bites and missed wounds can increase the risk The post noted that some dog bites carry a much higher viral load, especially if the same infected dog bites several people in a short period. Such cases require extra care during treatment. The doctor also warned that tiny scratches or puncture wounds are sometimes overlooked. According to the post, "Tiny punctures or scratches are overlooked and left without RIG. Full-body exam under good light is mandatory in every dog-bite case. Every single break in the skin must be cleaned and treated with RIG."Other factors that may reduce protection The doctor said some people may have an undiagnosed immune condition or may not produce enough protective antibodies even after completing the vaccination schedule. The post also raised concerns about vaccine quality and storage. According to the doctor, "Sub-potent, expired or poorly handled vials can look normal but fail. Substandard batches and untrained staff can lead to failure. Continuous training, real-time stock monitoring & public accountability can fix this."The doctor's message The ex-Army doctor ended the post by reminding people that rabies remains one of the most preventable infectious diseases when every step is followed correctly. He concluded: "Rabies is 100% preventable if every step is done right." "Wash the wound with soap for 15 minutes." "Insist on serum inside the wound." "Complete all 5 doses on time." "Never ignore even a small dog bite."