title: Evidence for a 4-dose vaccine schedule for human rabies post-exposure prophylaxis in previously non-vaccinated individuals.
abstract: After exposure, human rabies is preventable by prompt application of post-exposure prophylaxis. Historically, the total number of rabies vaccine doses administered during human prophylaxis has decreased, as modern biologics have improved and scientific knowledge has grown. A review of the literature on rabies virus pathogenesis, experimental animal studies, clinical trials, epidemiological surveillance, and economic analyses was conducted to determine the potential utility of reducing the current 5-dose intramuscular series of human rabies vaccine administered in the United States. Based upon the available evidence, a reduced schedule of cell-culture rabies vaccine, administered on days 0, 3, 7, and 14, given in conjunction with rabies immune globulin, was supported and recommended by the United States Advisory Committee on Immunization Practices.
authors.affiliation: National Center for Zoonotic, Vector-Borne and Enteric Diseases, 1600 Clifton Road N.E., Atlanta, GA 30333, USA. cyr5@cdc.gov
authors.forename: Charles E
authors.initials: CE
authors.lastname: Rupprecht
authors.forename: Deborah
authors.initials: D
authors.lastname: Briggs
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Brown
authors.forename: Richard
authors.initials: R
authors.lastname: Franka
authors.forename: Samuel L
authors.initials: SL
authors.lastname: Katz
authors.forename: Harry D
authors.initials: HD
authors.lastname: Kerr
authors.forename: Susan
authors.initials: S
authors.lastname: Lett
authors.forename: Robin
authors.initials: R
authors.lastname: Levis
authors.forename: Martin I
authors.initials: MI
authors.lastname: Meltzer
authors.forename: William
authors.initials: W
authors.lastname: Schaffner
authors.forename: Paul R
authors.initials: PR
authors.lastname: Cieslak
mesh_terms: D006801:Humans; D007115:Immunization Schedule; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D056990:Post-Exposure Prophylaxis / Q000191:economics / Q000379:methods*; D011818:Rabies / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage* / Q000191:economics; D014481:United States
chemical_list: D016756:Immunoglobulins, Intravenous; D011819:Rabies Vaccines