Editorial Commentary: Rabies Postexposure Vaccination: Are Antibody Responses Adequate?

Abstract

responses are expected to result in titers >0.5 IU/mL on day 14 and to remain detectable for at least 1 year. Studies have also shown that World Health Organization (WHO)–recognized tissue culture rabies vaccines will maintain detectable levels of antibody for at least 21 years in most healthy subjects [2]. Receipt of intramuscular or intradermal boosters is expected to result in a rapidly accelerated antibody response that eliminates the need for immunoglobulin. We are aware of very rare cases of poor response to rabies vaccination in hosts who appeared to be healthy. A laboratory technician who was expected to work with rabies virus was found to be a nonresponder and had to be shifted to another position when several boosters failed to induce antibody (G. M. Baer, personal communication). Very poor or no response to preexposure and postexposure rabies vaccination has been well documented in human immunodeficiency virus (HIV)–infected subjects [3] and is very likely with immunosuppressive drugs; though definitive studies are lacking. Poor or no responses to other vaccines, particularly hepatitis B virus vaccine, are also known [4] and are