Immunogenicity and booster efficacy of pre-exposure rabies vaccination.
A multivariate analysis was used to identify factors influencing the immunogenicity of rabies vaccine and to assess the efficacy of booster injections in a cohort of 407 people monitored prospectively for 10 years after primary vaccination. Rabies vaccine (HDCV or PVRV) was injected by intramuscular route either on days 0 and 28 or on days 0, 7 and 28. All the participants received a booster injection on day 365. At the end of follow-up (year 10), 163 subjects had titers >0.5IU/ml (group A) and 59 subjects had titers <0.5IU/ml (group B: poor responders). The number of injections had a significant influence (P<0.001) on the magnitude of the serological response to rabies vaccine, but the type of vaccine and the potency of the batches did not (P=0.07 and P=0.06, respectively). The difference between GMTs on day 365 and day 379 was significantly lower in group B than in group A (13 and 50.70IU/ml, respectively; P<0.001). In conclusion, our study confirms that the rabies pre-exposure vaccination protocol of three intramuscular injections significantly decreases the proportion of poor responders at 10 years. Moreover, our findings indicate that a routine booster injection at 1 year could significantly increase the levels and duration of antibody titers.
Centre Antirabique, Service de Médicine Interne et des Maladies Infectieuses, Hôpital Robert Debré, CHU Reims, Avenue du général Koenig, 51093 Reims Cedex, France. cstrady@chu-reims.fr
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Strady
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Andreoletti
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Baumard
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Servettaz
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Jaussaud
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Strady
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000914:Antibodies, Viral / Q000276:immunology*; D002648:Child; D005260:Female; D006801:Humans; D007114:Immunization; D007117:Immunization, Secondary; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011818:Rabies / Q000276:immunology* / Q000517:prevention & control; D011819:Rabies Vaccines / Q000276:immunology*; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D000914:Antibodies, Viral; D011819:Rabies Vaccines