Rabies Antibody Response After Booster Immunization: A Systematic Review and Meta-analysis

Langedijk, Annefleur C; Pijper, Cornelis Adrianus De; Spijker, René; Holman, Rebecca; Grobusch, Martin P.; Stijnis, Cornelis

doi:10.1093/cid/ciy420

Cited by 35 publications

(24 citation statements)

References 51 publications

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“…Indeed, one dose may be sufficient to prime for rapid anamnestic antibody response to booster vaccination within 7 days, even among those who do not achieve or whose RVNA levels fell below the 0.5 IU/ml threshold [16]. Moreover, adequate booster responses can still be achieved after a long interval [58]. Thus, the WHO also now acknowledges that no further boosters are required following primary series of PrEP or PEP [55].…”

Section: Discussionmentioning

confidence: 99%

Purified Vero Cell Rabies Vaccine (PVRV, Verorab®): A Systematic Review of Intradermal Use Between 1985 and 2019

et al. 2020

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The purified Vero cell rabies vaccine (PVRV; Verorab ® , Sanofi Pasteur) has been used in rabies prevention since 1985. Evolving rabies vaccination trends, including shorter intradermal (ID) regimens with reduced volume, along with WHO recommendation for ID administration has driven recent ID PVRV regimen assessments. Thus, a consolidated review comparing immunogenicity of PVRV ID regimens during pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) is timely and beneficial in identifying gaps in current research. A search of seven databases for studies published from 1985 to November 2019 identified 35 studies. PrEP was assessed in 10 studies (n = 926) with 1-3-site, 1-3-visit regimens of up to 3-months duration. Seroconversion (rabies virus neutralizing antibodies [RVNA] ≥ 0.5 IU/mL) rates of 90-100% were reported within weeks, irrespective of regimen, with robust booster responses at 1 year (100% seroconversion rates by day 14 post-booster). However, data are lacking for the current WHO-recommended, 2-site, 1-week ID PrEP regimen. PEP was assessed in 25 studies (n = 2136) across regimens of 1-week to 90-day duration. All ID PEP regimens assessed induced ≥ 99% seroconversion rates (except in HIV participants) by day 14-28. This review confirms ID PVRV suitability for rabies prophylaxis and highlights the heterogeneity of use in the field.

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Section: Discussionmentioning

confidence: 99%

Purified Vero Cell Rabies Vaccine (PVRV, Verorab®): A Systematic Review of Intradermal Use Between 1985 and 2019

et al. 2020

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“…Pre-exposure rabies prophylaxis (PrEP) consists of a series of intramuscular or intradermal injections of rabies vaccine that primes the immune system and enables a prompt and robust anamnestic immune response after the booster doses [5]. PrEP may protect against rabies for individuals with unrecognized exposure and simplifies the postexposure regimen in case of documented exposure.…”

Section: Introductionmentioning

confidence: 99%

Systematic Booster after Rabies Pre-Exposure Prophylaxis to Alleviate Rabies Antibody Monitoring in Individuals at Risk of Occupational Exposure

et al. 2021

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Pre-exposure rabies prophylaxis (PrEP) is recommended for people at frequent or increased risk of professional exposure to lyssavirus (including rabies virus). PrEP provides protection against unrecognized exposure. After the primary vaccination, one’s immune response against rabies may decline over time. We aimed to evaluate the immune response to rabies in individuals immunized for occupational reasons before and after a booster dose of the rabies vaccine. With this aim, we retrospectively documented factors associated with an inadequate response in individuals vaccinated for occupational purposes. Our findings analyzed data from 498 vaccinated individuals and found that 17.2% of participants had an inadequate antibody titration documented after their primary vaccination without the booster, while inadequate response after an additional booster of the vaccine was evidenced in 0.5% of tested participants. This study showed that a single booster dose of vaccine after PrEP conferred a high and long-term immune response in nearly all individuals except for rare, low responders. A systematic rabies booster after primary vaccination may result in alleviating the monitoring strategy of post-PrEP antibody titers among exposed professionals.

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“…For both strategies, vaccination with a modern inactivated cell-culture or embryonated egg-based rabies vaccine (CCEERV) is recommended [3]. Both intramuscular and intradermal administration routes have been proven to be equally effective [4,5].…”

Section: Introductionmentioning

confidence: 99%

The Cellular Immune Response to Rabies Vaccination: A Systematic Review

2019

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The effectiveness of rabies vaccines is conventionally determined by serological testing. In addition to this assessment of humoral immunity, cellular immunity could help assess effectiveness and protection through a broad range of parameters. Therefore, this study aimed to systematically review all literature on the kinetics and composition of the cellular immune response to rabies vaccination in humans. A total of 1360 studies were identified in an extensive literature search. Twenty studies were selected for inclusion. In a primary response, plasma cells are detectable from day 7 to day 14, peaking at day 10. Memory B-cells appear from day 10 up to at least day 28. After revaccination, natural killer (NK) cells are the first detectable cellular parameters. Further research is required to assess cellular parameters in relation to long-term (serological) immunity. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42019134416.

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Rabies Antibody Response After Booster Immunization: A Systematic Review and Meta-analysis

Cited by 35 publications

References 51 publications

Purified Vero Cell Rabies Vaccine (PVRV, Verorab®): A Systematic Review of Intradermal Use Between 1985 and 2019

Purified Vero Cell Rabies Vaccine (PVRV, Verorab®): A Systematic Review of Intradermal Use Between 1985 and 2019

Systematic Booster after Rabies Pre-Exposure Prophylaxis to Alleviate Rabies Antibody Monitoring in Individuals at Risk of Occupational Exposure

The Cellular Immune Response to Rabies Vaccination: A Systematic Review

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