Abstract
Objectives. To assess the immunogenicity of intradermal (ID) booster doses of Purified Chick Embryo Cell rabies vaccine (PCECV, Rabipur) administered to Thai schoolchildren one, three and five years after a primary ID pre-exposure (PrEP) vaccination series. Methods. In this follow-up study of a randomized, open-label, phase II clinical trial, two simulated post-exposure booster doses of PCECV were administered on days 0 and 3 intradermally to 703 healthy schoolchildren, one, three or five years after primary vaccination with either two or three ID doses of 0.1 mL PCECV. Blood was drawn immediately before and 7, 14 and 365 days after the first booster dose to determine rabies virus neutralizing antibody (RVNA) concentrations. Results. An anamnestic response of approximately 30-fold increase in RVNA concentrations was demonstrated within 14 days after booster. All children (100%) developed adequate RVNA concentrations above 0.5 IU/mL. No vaccine related serious adverse events were seen in any of the vaccinees. Conclusion. ID rabies PrEP with PCECV is safe and immunogenic in schoolchildren and the anamnestic response to a two booster dose vaccination series was found to be adequate one, three, and five years after a two- or three-dose primary PrEP vaccination series.
Highlights
Rabies post-exposure prophylaxis (PEP) after an exposure to a rabid animal has been demonstrated to be efficacious using tissue culture vaccines (TCV) including purified chick embryo cell vaccine (PCECV), administered either intramuscularly (IM) or intradermally (ID) [1, 2]
The 2-dose regimen proved equivalent to the 3-dose regimen in eliciting adequate response (100% adequate rabies virus neutralizing antibody (RVNA) concentrations in all groups), while on day 7 after booster, the percentage was lower in the 2dose group
When a person has been previously immunized with a pre-exposure prophylaxis (PrEP) series of three doses of rabies vaccine, the current recommendations for PEP include the administration of two booster doses of a WHO-recommended tissue culture vaccine
Summary
Rabies post-exposure prophylaxis (PEP) after an exposure to a rabid animal has been demonstrated to be efficacious using tissue culture vaccines (TCV) including purified chick embryo cell vaccine (PCECV), administered either intramuscularly (IM) or intradermally (ID) [1, 2]. A significant number of bite exposures and rabies cases occur in children under 15 years of age [5,6,7,8]. It has been reported that in Thailand by the age of 15 years approximately one-third of all children will have experienced a dog bite, indicating the potential risk for children to be exposed to a rabid animal [9]. While PEP clearly saves lives, human rabies cases, especially in children, continue to occur despite the availability of vaccines and biologicals. Almost all of these human rabies cases could have been prevented, and almost all occurred due to a lack of receiving PEP. The use of PrEP in children living in Advances in Preventive Medicine
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
