An overview of the immunogenicity and effectiveness of current human rabies vaccines administered by intradermal route

Denis, Martine; Knežević, Ivana; Wilde, Henry; Hemachudha, Thiravat; Briggs, Deborah J.; Knopf, Lea

doi:10.1016/j.vaccine.2018.11.072

Cited by 37 publications

(25 citation statements)

References 56 publications

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“…A recent review of the rabies vaccine 28 reported 338 publications in the period between 1997 and 2018, 40 of which were evaluated for immunogenicity, and 371 publications in the period between 2007 and 2018 of which 13 publications evaluated. The immunogenicity of rabies vaccines was analyzed according to 3 criteria: proportion of subjects reaching the antibody threshold of 0.5 IU mL after ID vaccination, relationship between potency and immunogenicity of the vaccine administered by ID route and comparison of antibody responses after vaccination IM or ID.…”

Section: Evidence From the Literaturementioning

confidence: 99%

“… Hung 2018 18 Influenza Review Considered in our article 4 Meta-analysis - intramuscular full-dose 15 μg - intradermal 3/5- one-fifth dose 9-3 μg Four meta-analysis suggested a non-inferior immunogenicity and efficacy with the reduced dose 3 mg or 9 mg ID vaccination, when compared with the full-dose 15 mg IM influenza vaccination regardless of age. Hettinga 2020 7 Influenza (and other disease) Review / / ID administration of vaccine at lower doses than the IM route may represent a valid alternative both in terms of safety and efficacy Anand 2017 19 Polio Review 9 - intramuscular full dose 0.5 mL - intradermal one fifth dose 0.1 mL ID administration of a fractionate dose showed better immunization than the IM dose Denis 2019 28 Rabies Review 41 (13 comparison ID/IM route) - intramuscular full dose 1-0.5 mL - intradermal 3/5-2/5- one-fifth – one tenth dose ID route were adequately immunogenic and post-exposure prophylaxis by ID route was equally immunogenic than by IM route. Pre-exposure prophylaxis by ID administration tended towards lower antibody titers compared to vaccination by IM (data not associated with clinical relevance) Egunsola 2021 29 Influenza Review and Meta-analysis (random effects model) 30 for Review and Meta-analasys - intramuscular full dose 15 μg - intradermal reduce dose 15-9-7.5-6-5-4-3 μg Similarity in immunogenicity was found between the reduced dose ID and full dose IM influenza vaccine.…”

Section: Evidence From the Literaturementioning

confidence: 99%

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Intradermal Vaccination: A Potential Tool in the Battle Against the COVID-19 Pandemic?

Migliore¹,

Gigliucci²,

Marzo³

et al. 2021

RMHP

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This narrative review is the final output of an initiative of the SIM (Italian Society of Mesotherapy). A narrative review of scientific literature on the efficacy of fractional intradermal vaccination in comparison with full doses has been conducted for the following pathogens: influenza virus, rabies virus, poliovirus (PV), hepatitis B virus (HBV), hepatitis A virus (HAV), diphtheria-tetanus-pertussis bacterias (DTP), human papillomavirus (HPV), Japanese encephalitis virus (JE), meningococcus, varicella zoster virus (VZV) and yellow fever virus. The findings suggest that the use of the intradermal route represents a valid strategy in terms of efficacy and efficiency for influenza, rabies and HBV vaccines. Some systematic reviews on influenza vaccines suggest the absence of a substantial difference between immunogenicity induced by a fractional ID dose of up to 20% and the IM dose in healthy adults, elderly, immunocompromised patients and children. Clinical studies of remaining vaccines against other pathogens (HAV, DTP bacterias, JE, meningococcal disease, VZV, and yellow fever virus) are scarce, but promising. In the context of a COVID-19 vaccine shortage, countries should investigate if a fractional dosing scheme may help to save doses and achieve herd immunity quickly. SIM urges the scientific community and health authorities to investigate the potentiality of fractionate intradermal administration in anti-COVID-19 vaccination.

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Section: Evidence From the Literaturementioning

confidence: 99%

Section: Evidence From the Literaturementioning

confidence: 99%

Intradermal Vaccination: A Potential Tool in the Battle Against the COVID-19 Pandemic?

Migliore¹,

Gigliucci²,

Marzo³

et al. 2021

RMHP

View full text Add to dashboard Cite

show abstract

“…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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“…The potency of each of the vaccines was ≥2.5 IU per vial, as per the set WHO standards. Numerous studies have shown that WHO-recommended vaccines (≥2.5 IU per intramuscular dose), when administered by the intradermal route for PEP, have efficacy equivalent to or higher than that of the same vaccine administered by the intramuscular route [11,18]. Hence, we considered both the vaccines to be of similar efficacy in our study.…”

Section: Methodsmentioning

confidence: 99%

Cost Savings of Using Updated Thai Red Cross Intradermal Regimen in a High-Throughput Anti-Rabies Clinic in New Delhi, India

et al. 2019

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Replacement of the Essen intramuscular (EIM) by the updated Thai Red Cross intradermal (UTRCID) regimen for rabies post-exposure prophylaxis (PEP), in high-throughput hospitals of India, has been advocated since 2006 thanks to its cost-effectiveness. However, several anti-rabies clinics in India and other parts of the world have not initiated this switchover of regimens because of the paucity of financial literature, generated in realistic settings, regarding the same. We calculated the procurement costs of various items required for providing rabies vaccinations via the EIM regimen and UTRCID regimen, on an annual basis, a year before and after the switchover. From a healthcare provider’s perspective, the cost of vaccination per patient was calculated to be 5.60 USD for the EIM regimen and 2.40 USD for the UTRCID regimen. The switchover to the UTRCID regimen from the EIM regimen reduced the financial burden of the rabies vaccination by almost 60%. Procurement of vaccine vials contributed to the majority of the cost (>94%) in both of the regimens. Procurement of syringes with fixed needles contributed negligibly (<6%) to the financial burden in both the regimens. A policy to progressively switch over to the UTRCID regimen from the EIM in all high-throughput anti-rabies centers of India would dramatically reduce the economic burden of running a successful anti-rabies program.

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An overview of the immunogenicity and effectiveness of current human rabies vaccines administered by intradermal route

Cited by 37 publications

References 56 publications

Intradermal Vaccination: A Potential Tool in the Battle Against the COVID-19 Pandemic?

Intradermal Vaccination: A Potential Tool in the Battle Against the COVID-19 Pandemic?

The Cellular Immune Response to Rabies Vaccination: A Systematic Review

Cost Savings of Using Updated Thai Red Cross Intradermal Regimen in a High-Throughput Anti-Rabies Clinic in New Delhi, India

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