Single visit rabies pre-exposure priming induces a robust anamnestic antibody response after simulated post-exposure vaccination: results of a dose-finding study

Abstract

This dose finding study demonstrates that priming with a single dose of rabies vaccine was sufficient to induce an adequate anamnestic antibody response to rabies PEP in all subjects 1 year later, even in those in whom the RVNA threshold of 0.5 IU/ml was not reached after priming.

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

“…There were 11 citations identified that reported immunogenicity data following ID PVRV for PrEP [16,[20][21][22][23][24][25][26][27][28][29]; of these, 6 were undertaken in Thailand [20,23,25,[28][29][30]. The other studies were undertaken in Vietnam [24,27] (both these Vietnamese studies reported data on the same cohort of children), Brazil [22], and The Netherlands [16,21].…”

“…Seroconversion rates from day 14 to 56 after the first vaccination and at 1 year across the studies identified were 90-100% and 20-96%, respectively [16,[21][22][23]25,[27][28][29]. The RVNA GMTs reported across the studies irrespective of PrEP regimen (n = 926), including following booster vaccination after one year, are summarized in Figure 2 [16,[20][21][22][23][24][25][26][27][28][29].…”

“…The RVNA GMTs reported across the studies irrespective of PrEP regimen (n = 926), including following booster vaccination after one year, are summarized in Figure 2 [16,[20][21][22][23][24][25][26][27][28][29]. The GMT range across studies from day 14 to 56 after the first vaccination was 1.90-14.35 IU/mL decreasing to ≤1.9 IU/mL at 1 year [16,[20][21][22][23]26,29].…”

“…There were 11 citations identified that reported immunogenicity data following ID PVRV for PrEP [16,[20][21][22][23][24][25][26][27][28][29]; of these, 6 were undertaken in Thailand [20,23,25,[28][29][30]. The other studies were undertaken in Vietnam [24,27] (both these Vietnamese studies reported data on the same cohort of children), Brazil [22], and The Netherlands [16,21]. The study populations included: children aged < 1 year [24,27]; children aged 12-16 months [29]; children aged 5-12 years [23]; children and adults [25] or where age was not specified (assumed to be children and adults) [26]; and adults [16,[20][21][22]28].…”

“…Progressively shorter ID regimens requiring fewer injections and clinic visits (thus improving compliance) have been developed over the years without compromising efficacy [14,15]. Indeed, one dose of PVRV (ID or IM) may be sufficient PrEP as it can prime for an anamnestic antibody response to booster vaccination 1 year later [16]. Although ID administration requires specific experience to ensure correct vaccine administration technique, mainly to avoid accidental subcutaneous injection [14], arguably the skills are not difficult to acquire and are easily maintained as long as ID administration is done routinely.…”