Pre-exposure rabies vaccination using purified chick embryo cell rabies vaccine intradermally is immunogenic and safe.
OBJECTIVE
To demonstrate the safety and immunogenicity of intradermal rabies pre-exposure prophylaxis with purified chick embryo cell vaccine (PCECV) in schoolchildren age 5 to 8 years in Thailand.


METHODS
In a randomized, open-label, phase II clinical trial, 2 or 3 intradermal doses of 0.1 mL PCECV (Rabipur) were administered to 703 schoolchildren on days 0 and 28 or on days 0, 7, and 28. In 206 children, 2 simulated post-exposure booster doses were given 1 year after the primary vaccination series. Rabies virus- neutralizing antibody (RVNA) titers were determined by the rapid fluorescent focus inhibition test.


RESULTS
In school-age children in Thailand, a pre-exposure immunization regimen of 3 intradermal doses of PCECV produced adequate immune responses. After primary vaccination, all subjects developed RVNA titers > or =0.5 IU/mL and demonstrated a rapid increase in RVNA titer after 2 simulated post-exposure booster immunizations 1 year after the primary vaccination series. No serious adverse drug reactions occurred.


CONCLUSIONS
Rabies pre-exposure immunization with PCECV is safe and immunogenic, and its implementation could save the lives of many children in rabies-endemic areas.
Kamoltham
Thavatchai
T
Provincial Health Office of Phetchabun, Ministry of Health, Phetchabun, Thailand.
Thinyounyong
Wirawan
W
Phongchamnaphai
Phana
P
Phraisuwan
Phran
P
Khawplod
Pakamatz
P
Banzhoff
Angelika
A
Malerczyk
Claudius
C
D000818:Animals; D002642:Chick Embryo; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007115:Immunization Schedule; D007271:Injections, Intradermal; D008297:Male; D011322:Primary Prevention; D011818:Rabies / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage* / Q000276:immunology* / Q000494:pharmacology; D011820:Rabies virus / Q000276:immunology; D012307:Risk Factors; D016037:Single-Blind Method; D013785:Thailand; D013997:Time Factors; D014611:Vaccination / Q000379:methods*
D011819:Rabies Vaccines