Intradermal immunization with rabies vaccine. Inactivated Wistar strain cultivated in human diploid cells

Ajjan, N.; Soulebot, Jean P.; Triau, R; Biron, G

doi:10.1001/jama.244.22.2528

Cited by 19 publications

(4 citation statements)

References 4 publications

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“…Thirty-two studies compared ID immunisation to SC immunisation, and two studies compared ID immunisation to both. The majority of studies was conducted on influenza (n = 5 1) [39–89], HBV (n = 43) [ 17 , [90] , [131] ] and rabies (n = 37) [ 14 , 15 , [132] , [133] , [134] , [135] , [136] , [137] , [138] , [139] , [140] , [141] , [142] , [143] , [144] , [145] , [146] , [147] , [148] , [149] , [150] , [151] , [152] , [153] , [154] , [155] , [156] , [157] , [158] , [159] , [160] , [161] , [162] , [163] , [164] , [165] , [166] ] vaccines. The remaining studies were conducted on IPV [ [167] , [168] , [169] , [170] , [171] , [172] , [173] ], measles [ 10 , [174] , [175] , [176] , [177] , [178] ], hepatitis A (HAV) [ [179] , [180] , [181] , [182] ], diphtheria-tetanus-pertussis (DTP) [ 183 , 184 ], Japanese encephalitis (JE) [ 185 ,…”

Section: Resultsmentioning

confidence: 99%

“…A total of 37 studies were conducted on rabies vaccines [ 14 , 15 , [132] , [133] , [134] , [135] , [136] , [137] , [138] , [139] , [140] , [141] , [142] , [143] , [144] , [145] , [146] , [147] , [148] , [149] , [150] , [151] , [152] , [153] , [154] , [155] , [156] , [157] , [158] , [159] , [160] , [161] , [162] , [163] , [164] , [165] , [166] ]. Since we only considered licensed and available vaccines in this review, only human diploid cell vaccines (HDCV), purified Vero cell rabies vaccines (PVRV) and purified chick embryo cell vaccines (PCECV) were included.…”

Section: Resultsmentioning

confidence: 99%

“…Participants of pre-exposure prophylaxis (PrEP) studies were immune naïve predominantly healthy adults. Twenty-two PrEP studies compared ID to IM immunisation [ 14 , 136 , [138] , [139] , [140] , [143] , [144] , [145] , [146] , [147] , [149] , [150] , [151] , [153] , [154] , [155] , 157 , 158 , [161] , [162] , [163] , 166 ]; two studies [ 132 , 141 ] compared ID to SC immunisation, and one study [ 15 ] compared ID with both IM and SC immunisation. ID doses consisted of either one injection of 0.1 ml or, in eight studies [ [143] , [144] , [145] , [146] , 160 , [164] , [165] , [166] ], of multiple injections of 0.1 ml.…”

Section: Resultsmentioning

confidence: 99%

“…The vast majority of cohort studies was considered of fair or low quality, mainly due to a lack of certainty of vaccine being exclusively delivered to the dermis (e.g. no inspection for wheal formation) n = 40 [ 14 , 42 , 44 , [52] , [54] , 57 , 58 , 61 , [66] , [70] , 72 , 73 , 95 , 107 , 117 , 132 , 135 , 137 , 141 , 145 , [151] , [153] , 159 , 162 , [174] , [178] , [180] , [184] , 188 ], and a lack of blinding of outcome assessors. Results of the critical appraisal of the included randomised clinical trials and cohort studies are shown in Supplementary Table 4 .…”

Section: Resultsmentioning

confidence: 99%

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Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

Schnyder

Pijper

Garrido

et al. 2020

Travel Medicine and Infectious Disease

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Background Vaccine supply shortages are of global concern. We hypothesise that intradermal (ID) immunisation as an alternative to standard routes might augment vaccine supply utilisation without loss of vaccine immunogenicity and efficacy. Methods We conducted a systematic review and meta-analysis searching Medline, Embase and Web of Science databases. Studies were included if: licensed, currently available vaccines were used; fractional dose of ID was compared to IM or SC immunisation; primary immunisation schedules were evaluated; immunogenicity, safety data and/or cost were reported. We calculated risk differences (RD). Studies were included in meta-analysis if: a pre-defined immune correlate of protection was assessed; WHO-recommend schedules and antigen doses were used in the control group; the same schedule was applied to both ID and control groups (PROSPERO registration no. CRD42020151725). Results The primary search yielded 5,873 articles, of which 156 articles were included; covering 12 vaccines. Non-inferiority of immunogenicity with 20–60% of antigen used with ID vaccines was demonstrated for influenza (H1N1: RD -0·01; 95% CI -0·02, 0·01; I 2 = 55%, H2N3: RD 0·00; 95% CI -0·01, 0·01; I 2 = 0%, B: RD -0·00; 95% CI -0·02, 0·01; I 2 = 72%), rabies (RD 0·00; 95% CI -0·02, 0·02; I 2 = 0%), and hepatitis B vaccines (RD -0·01; 95% CI -0·04, 0·02; I 2 = 20%). Clinical trials on the remaining vaccines yielded promising results, but are scarce. Conclusions There is potential for inoculum/antigen dose-reduction by using ID immunisation as compared to standard routes of administration for some vaccines (e.g. influenza, rabies). When suitable, vaccine trials should include an ID arm.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

Schnyder

Pijper

Garrido

et al. 2020

Travel Medicine and Infectious Disease

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Intradermal Immunization With Human Diploid Cell Rabies Vaccine

Burridge¹

1982

JAMA

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Human diploid cell rabies vaccine. Effectiveness of immunization with small intradermal or subcutaneous doses

Bernard¹

1982

JAMA: The Journal of the American Medical Association

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To determine antibody responses to small doses of human diploid cell rabies vaccine (HDCV), we determined rabies antibody titers in 124 volunteers who had been vaccinated with one of five primary preexposure regimens. In a sixth group of 47 persons previously vaccinated with duck embryo rabies vaccine (DEV), we evaluated the booster responses after a 0.1-mL dose of intradermal (ID) HDCV. Persons in all five groups undergoing primary immunization received three doses of vaccine, one each on days 0, 7, and 28. The dose and route of vaccination for the five groups included 1 mL intramuscular (IM), 0.1 mL ID (two subgroups), 0.1 mL subcutaneous (SC), and 0.25 mL SC. Adequate titers developed in all persons, irrespective of the route or quantity of vaccine. The geometric mean titers (IU/mL) on day 49 in those receiving primary regimens were 12.87 (1.0 mL IM), 7.44 (0.1 mL ID by syringe), 3.05 (0.1 mL by jet injector), 3.17 (0.1 mL SC), and 6.47 (0.25 mL SC). Titers on day 90, while lower, were still acceptable. Adequate antibody titers developed in all persons previously vaccinated with DEV after a single 0.1-mL ID dose of HDCV; however, higher titers developed at day 7 in those who had shown an adequate response to DEV in the past. Results of this study suggest that HDCV may be used ID or SC for primary preexposure rabies prophylaxis and ID for booster immunization.

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Intradermal immunization with rabies vaccine. Inactivated Wistar strain cultivated in human diploid cells

Cited by 19 publications

References 4 publications

Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

Fractional dose of intradermal compared to intramuscular and subcutaneous vaccination - A systematic review and meta-analysis

Intradermal Immunization With Human Diploid Cell Rabies Vaccine

Human diploid cell rabies vaccine. Effectiveness of immunization with small intradermal or subcutaneous doses

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