Low-Cost Intradermal Rabies Vaccination Is Indeed Very Promising

Soentjens, Patrick; Aerssens, Annelies; Gucht, Steven Van; Ravinetto, Raffaella; Gompel, A Van

doi:10.1093/cid/cit080

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…A 1²ID PrEP schedule, given only once or possibly repeated without a specific time window, may be appropriate for any type of healthy traveler. Further research is required to assess whether it would also be immunogenic in more vulnerable travelers or groups of populations (children, elderly, and immunosuppressed), particularly in low-income countries (28).…”

Section: Discussionmentioning

confidence: 99%

Comparative Immunogenicity and Safety Trial of 2 Different Schedules of Single-visit Intradermal Rabies Postexposure Vaccination

Soentjens

Koninck

Tsoumanis

et al. 2018

Clinical Infectious Diseases

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Background Effective and safe single-visit rabies vaccination for pre- and postexposure prophylaxis (PrEP and PEP) could substantially simplify rabies prevention and therefore increase compliance. Methods In a comparative trial, 303 healthy adults received a primary vaccination that consisted of 2 intradermal (ID) doses of 0.1 mL of the purified chicken embryo cell vaccine (PCEV) during a single visit. One year later, participants were randomly assigned to receive either 4 or 2 ID PEP booster doses of 0.1 mL PCEV during a single visit. The primary endpoint for immunogenicity was the percentage of participants with an adequate antibody level (>0.5 IU/mL) 7 days after the booster doses. The safety endpoint was the proportion of participants who developed adverse events (AEs) following primary and/or booster vaccination. Results All participants, except 1 (99.3%) in each study group, had a rabies antibody titer >0.5 IU/mL on day 7 following the booster schedules. Participants exposed to the 4-dose PEP schedule had a geometric mean titer of 20 IU/mL vs 14 IU/mL for the 2-dose PEP schedule (P = .0228). Local reactions at the injection site following PrEP and PEP were mild and transient and only seen in 14.9% and 49.6%–53% of the participants, respectively. No serious AEs were reported. Conclusions In healthy adults, a 2-dose (2 × 0.1 mL) single-visit ID PEP schedule was as immunologically adequate and safe as a 4-dose (4 × 0.1 mL) single-visit PEP schedule 7 to 28 months following a 2-dose (2 × 0.1 mL) single-visit ID PREP. Clinical Trials Registration EudraCT 2014-00183612.

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Section: Discussionmentioning

confidence: 99%

Comparative Immunogenicity and Safety Trial of 2 Different Schedules of Single-visit Intradermal Rabies Postexposure Vaccination

Soentjens

Koninck

Tsoumanis

et al. 2018

Clinical Infectious Diseases

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“…ID administration of 0.1 mL of rabies vaccine (0.1ID) has proven to be as immunogenic as the 1.0 mL IM dose (1IM) vaccination (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13), offering substantial cost savings when vaccine recipients can be clustered (14). In addition, ID injections induce a more rapid immune response compared to IM injections via stimulating cutaneous dendritic cells and their draining lymph nodes (15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%