Immune complex-like disease in 23 persons following a booster dose of rabies human diploid cell vaccine

Abstract

Following a routine 0.1 ml booster dose of Merieux rabies human diploid cell vaccine (HDCV), administered intradermally, 23 (10.2%) of 226 persons had signs and symptoms compatible with an immune complex-like disease. The disease had its onset from 3–13 days after the injection, lasted 1–5 days, and consisted primarily of urticaria (78.3%), macular rash (65.2%), angio-oedema (39.1%), and arthralgia (17.4%). None of the cases were considered severe, and all recovered with no sequelae. There were significant differences in attack rates between men (78.3% of all cases) and women, and between those receiving vaccinations on different days. Similar reactions have been reported following intramuscular booster doses of HDCV. Since the Merieux HDCV is used worldwide, physicians administering HDCV must be aware of these adverse reactions and warn patients. Appropriate therapy should be instituted as warranted by severity of reactions.