Intradermal pre-exposure rabies vaccination in a Canadian travel clinic: 6-year retrospective observational study

Kong, Ling Yuan; Vincelette, Jean; Laplante, Gaétan; Duchesne, Jo-Anne; Libman, Michael; Barkati, Sapha

doi:10.9778/cmajo.20170147

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…While ID use reduces the cost to travellers, the time to vaccinate and obtain serology can exceed 7 weeks. 42,43 The vial must be used within 6 hours of reconstitution, however, which creates challenges to maximize the number of patients vaccinated to reduce waste. 39,40,42,43 ID dosing should not be used in immunocompromised travellers or with concomitant chloroquine use.…”

Section: Rabies Vaccinementioning

confidence: 99%

Travel vaccines: Update for Canadian pharmacists

Bascom

2019

Can Pharm J

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Section: Rabies Vaccinementioning

confidence: 99%

Travel vaccines: Update for Canadian pharmacists

Bascom

2019

Can Pharm J

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“…In addition, intradermal administration of the rabies vaccine is an option ( Gongal and Sampath, 2019 ). The justification for providing intradermal vaccine injections is to attain increased immunization coverage at a lower cost, although intradermal vaccination has not yet been widely used ( Kong et al , 2018 ). Numerous investigations on the administration of the anti-rabies vaccine intradermally at doses less than half of those administered intramuscularly have been conducted in a number of nations ( Brown, 2011 ; Sudarshan et al , 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Tracking lethal threat: In-depth review of rabies

Khairullah,

Kurniawan,

Hasib

et al. 2023

Open Vet J

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An infectious disease known as rabies (family Rhabdoviridae, genus Lyssavirus) causes severe damage to mammals’ central nervous systems (CNS). This illness has been around for a very long time. The majority of human cases of rabies take place in underdeveloped regions of Africa and Asia. Following viral transmission, the Rhabdovirus enters the peripheral nervous system and proceeds to the CNS, where it targets the encephalon and produces encephalomyelitis. Postbite prophylaxis requires laboratory confirmation of rabies in both people and animals. All warm-blooded animals can transmit the Lyssavirus infection, while the virus can also develop in the cells of cold-blooded animals. In the 21st century, more than 3 billion people are in danger of contracting the rabies virus in more than 100 different nations, resulting in an annual death toll of 50,000–59,000. There are three important elements in handling rabies disease in post exposure prophylaxis (PEP), namely wound care, administration of anti-rabies serum, and anti-rabies vaccine. Social costs include death, lost productivity as a result of early death, illness as a result of vaccination side effects, and the psychological toll that exposure to these deadly diseases has on people. Humans are most frequently exposed to canine rabies, especially youngsters and the poor, and there are few resources available to treat or prevent exposure, making prevention of human rabies challenging.

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“…In the WHO recommendations, rabies vaccinations can be administered either IM or ID. One ID dose is 0.1 mL of vaccine, leading to an immune response comparable with IM administration but at a considerably lower dose, thus saving vaccine and costs [9,13]. A disadvantage is that vaccination staff must be well trained to guarantee full ID instillation of the vaccine and to avoid accidental subcutaneous injection.…”

Section: Introductionmentioning

confidence: 99%

Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation

et al. 2020

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Background: The risk of contracting rabies is low for travellers. However, the number of Dutch travellers potentially exposed abroad following an animal-associated injury and needing post-exposure prophylaxis (PEP) has increased, resulting in increased costs. Aim: Here, we evaluated the costs and the cost-effectiveness of different pre-and post-exposure interventions in the Netherlands, taking into account the 2018 World Health Organization (WHO) recommendations for the prevention of rabies. Methods: A decision tree-based economic model was constructed. We calculated and compared the cost of different WHO pre-exposure prophylaxis (PrEP) recommendations, intramuscular vs intradermal vaccination and PEP subsequent to increased vaccination coverage in risk groups. We estimated cost-effectiveness, expressed as incremental costs per rabies immunoglobulin (RIG) administration averted, using a societal perspective. Statistical uncertainty regarding number of travellers and vaccination coverage was assessed. Results: Total costs at the national level were highest using previous WHO recommendations from 2012, estimated at EUR 15.4 million annually. Intradermal vaccinations in combination with the current recommendations led to the lowest costs, estimated at EUR 10.3 million. Higher vaccination uptake resulted in higher overall costs. The incremental costs per RIG administration averted varied from EUR 21,300-46,800. Conclusions: The change in rabies PrEP and PEP recommendations in 2018 reduced total costs. Strategies with increased pre-travel vaccination uptake led to fewer RIG administrations and fewer vaccinations after exposure but also to higher total costs. Although larger scale intradermal administration of rabies vaccine can reduce total costs of PrEP and can positively influence vaccination uptake, it remains a costly intervention.

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Intradermal pre-exposure rabies vaccination in a Canadian travel clinic: 6-year retrospective observational study

Cited by 3 publications

References 15 publications

Travel vaccines: Update for Canadian pharmacists

Travel vaccines: Update for Canadian pharmacists

Tracking lethal threat: In-depth review of rabies

Rabies vaccination strategies in the Netherlands in 2018: a cost evaluation

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