Safety and immunogenicity of chromatographically purified Vero cell rabies vaccine for intradermal pre- and post-exposure rabies prophylaxis

Abstract

CPRV is safe and immunogenic when given for intradermal PrEP and PEP.

Purified Vero Cell Rabies Vaccine (PVRV, Verorab®): A Systematic Review of Intradermal Use Between 1985 and 2019

“…The RAC17 study reported GMTs for two PVRV ID regimens (0,3,7,14,28,90 [2-2-2-0-1-1] and 0,3,7,14,28,90 [2-2-2-0-2-0]) of 80.8 and 72.9 IU/mL at day 14, respectively, and 43.8 and 45.4 IU/mL at day 28 [52], which are outlying data compared to other studies and were therefore not included in the ranges reported overall. Seroconversion rates were maintained at 50-100% at 1 year, with GMTs decreasing to 0.42-1.37 IU/mL [37,42,46,48,50]. These results were, in general, slightly lower than those reported without RIG use in simulated PEP in otherwise healthy participants.…”

“…There were 26 citations identified that reported immunogenicity data following ID PVRV as part of PEP [25,26,28,; of these 14 studies were undertaken in Thailand [25,28,30,[32][33][34]37,39,42,44,[46][47][48]51], and 5 in India [35,36,38,43,45]. Three studies were undertaken in The Philippines [40,50,52], and one included long-term follow up to year 5 [31,50].…”

“…The studies that assessed regimens that included RIG reported 99-100% seroconversion rates from day 14 to 28 after the first vaccination (except for one study that reported 100% seroconversion at day 14 that decreased to 90% at day 28 [37]), with GMTs ranging from 2.7 to 19.7 IU/mL [42,45,46,48,50]. Figure 4 summarizes the RVNA GMTs reported across the studies that included concomitant RIG.…”

“…These results were, in general, slightly lower than those reported without RIG use in simulated PEP in otherwise healthy participants. Eleven studies assessed PEP that included rabies immune globulin (equine rabies immune globulin [ERIG] or human rabies immune globulin [HRIG]) [35,37,40,42,[45][46][47][48]50,52,53], excluding one study in HIV patients reported in greater detail below [51]. The ID PVRV PEP vaccination regimens concomitant with RIG are also summarized in Table 1 along with the type of patient/participants assessed.…”

“…Four studies assessed PEP followed by simulated (booster) PEP after 1 year [36,37,40] or 5 years [31]. Of these, two studies assessed simulated PEP in otherwise healthy participants after 1 year [36,37]. In the first study, participants with RVNA levels that fell to <0.5 IU per mL at day 365 received a 4-site booster at day 436 [36].…”