Post-Exposure Prophylactic Vaccination against Rabies: A Systematic Review

Abstract

Background: Post-exposure prophylaxis (PEP) is an effective method for preventing rabies, a highly fatal infection in exposed persons. Malaysia is currently using the purified Vero cell rabies vaccine (PVRV). Nonetheless, there are other commercially available vaccine types and regimens. This systematic review aimed at comparing the effectiveness of the different PEP vaccines, regimens and routes of administration among Asian populations.
 Methods: We systematically reviewed the PubMed and Web of Science databases for articles reporting on the effectiveness of PEP vaccination against rabies among Asian populations between 2015 and 2019.
 Results: Our search identified 11 relevant studies. Majority of study either used PCECV or PVRV type of vaccine, with different regimes and method. All are non-inferior to the other. Most of the studies recorded adequate response by Day 14 of vaccination. Nonetheless, the intradermal (ID) vaccination used minimal volume of vaccine used in all settings, thus cost less and the concurrent administration of RIG to the wound(s) doesn’t affect the RVNA GMT response.
 Conclusion: PCECV, using either the Essen or Zagreb regimen, might be a useful alternative for the healthy population in the context of PVRV shortage, especially during an outbreak. Use of the Zagreb or Thai Red Cross (TRC) regimens can be considered (either PVRV or PCECV), as both demonstrate good immunogenic outcomes in Asian populations.

Human Rabies Treatment—From Palliation to Promise

“…Celsus, in the first century, described wound cautery as a treatment after a rabid dog bite [3]; today, this intervention would be described as post-exposure prophylaxis (PEP). Since the revolutionary breakthrough of a rabies vaccine by Dr. Louis Pasteur in the late 19th century, PEP has proved effective when instituted correctly and in a timely fashion [5]. However, no therapy has consistently demonstrated efficacy in treating disease once symptoms develop.…”

Study of Factors Associated with Knowledge, Attitudes and Practices Regarding Rabies in the Commune of <i>Niakhéne</i> in Senegal, in 2022

“…With 25,000 deaths, Africa is one of continents most affected by rabies [2]. Established vaccination coverage in the dog population (30% to 50%) in many African countries is not high enough to break the transmission cycle of the disease [5].…”