Article

One clinic visit for pre-exposure rabies vaccination (a preliminary one year study). Vaccine

Queen Saovabha Memorial Institute, the Thai Red Cross Society, Bangkok 10330, Thailand.
Vaccine (Impact Factor: 3.62). 12/2011; 30(19):2918-20. DOI: 10.1016/j.vaccine.2011.12.028
Source: PubMed

ABSTRACT

We performed an abbreviated prospective study of rabies pre-exposure (PREP) vaccination in 109 volunteers. Group 1, the control group, received the conventional 3 intradermal injections on days 0, 7 and 21. Group 2 received one rabies vaccine injection (0.1 ml intradermally) at 2 sites on a single day. Group 3 was given one full ampule intramuscularly. One year later, all 3 groups received booster injections (0.1 ml at 4 sites) intradermally at one time or 2 injections intramuscularly on days 0 and 3. All subjects achieved a vigorous anamnestic antibody response 7 days after the boosters. These data suggest that one time immunization of one full dose intramuscularly or 2 site injections of 0.1 intradermally on a single day are adequate to prime immune memory and obtain an accelerated immune response one year later.

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    • "They stated that direct comparisons of various studies was not possible because of the different timing, dosing, routes of administration, and, in our opinion, also because of the small sample size and of the differences in serologic testing. The 2 most promising intradermal studies were designed by Khawplod [2, 3]: In 5 of the 10 study arms, exclusively intradermal regimens (0.1 mL) were used, with a total dose between 0.4 mL and 0.8 mL. In 2 other studies, authors declared that a total dose of 0.4 mL or 0.6 mL, respectively, of preexposure rabies vaccine administered over a minimum of 2 visits gives an adequate antibody response , irrespective of the time interval since the last dose [4, 5]. "

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    ABSTRACT: Using the principle of immunochromatography, we previously developed a method called RAPINA (Rapid Neutralizing Antibody detection test) that can measure the level of rabies virus -neutralizing antibody (VNA) in serum samples [Shiota S, Mannen K, Matsumoto T, Yamada K, Yasui T, Takayama K, et al. Development and evaluation of a rapid neutralizing antibody test for rabies. J Virol Methods 2009;161:58-62]. RAPINA is faster, simpler, and easier to perform compared with a virus-neutralizing test or enzyme-linked immunosorbent assay (ELISA). The improved version of RAPINA has greater positive and negative predictive values corresponding to a VNA level of 0.5 IU/mL, as recommended by the World Health Organization and the World Organization for Animal Health. To verify the efficacy of this improved method, serum samples were collected from humans and dogs before and after immunization against rabies and were tested in Japan, Sri Lanka, and Thailand. The results were compared between RAPINA and the true VNA levels measured by the Rapid Fluorescent Focus Inhibition Test (RFFIT). The improved RAPINA accurately predicted seropositivity for 182 of 183 seropositive human samples as assessed by RFFIT (99.5%) and for 138 of 140 RFFIT-negative human samples (98.6%). In dog serum samples, the positive and negative predictive values were 99.7% (345/355) and 95.6% (174/182), respectively. RAPINA was also used to estimate VNA levels in a semiquantitative manner by using serial dilution of serum samples. Our results show that RAPINA is an easy and rapid method for measuring VNA levels before and after immunization with the rabies vaccine and does not need a high skill level or sophisticated equipment. RAPINA can be used to monitor the success of preexposure prophylaxis in at-risk persons, vaccine coverage, and animal control. It can also be used in laboratories with modest facilities and where a large number of samples are screened.
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