Serologic Response of 2 Versus 3 Doses and Intradermal Versus Intramuscular Administration of a Licensed Rabies Vaccine for Preexposure Prophylaxis

J Infect Dis. 2020 Apr 7;221(9):1494-1498. doi: 10.1093/infdis/jiz645.

Abstract

Background: The World Health Organization recommends intradermal (ID) administration of rabies vaccine for preexposure prophylaxis.

Methods: In a randomized trial in adults assigned to 1 of 6 treatment groups (ID vs intramuscular [IM], 2 vs 3 doses, and controls), rabies neutralizing antibody titers were measured to 1 year postvaccination.

Results: ID vaccination produced acceptable antibody levels in all subjects (2- and 3-dose groups). At day 365, acceptable levels were 40% for IM and 50% for ID 2-dose schedule, and 70% for IM and 60% for ID 3-dose schedule.

Conclusions: ID rabies vaccination induces acceptable antibody titers at a fraction of the dose.

Clinical trials registration: NCT02374814.

Keywords: immunogenicity; intradermal; intramuscular; rabies; vaccine.

Publication types

  • Clinical Trial, Phase IV
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Neutralizing / blood*
  • Antibodies, Viral / immunology
  • Female
  • Humans
  • Immunization Schedule
  • Immunization, Secondary
  • Immunogenicity, Vaccine*
  • Injections, Intradermal
  • Injections, Intramuscular
  • Linear Models
  • Male
  • Middle Aged
  • Post-Exposure Prophylaxis
  • Pre-Exposure Prophylaxis / methods
  • Rabies / prevention & control*
  • Rabies Vaccines / administration & dosage*
  • Rabies Vaccines / adverse effects
  • Rabies Vaccines / immunology*
  • Rabies virus / immunology
  • Vaccination
  • Young Adult

Substances

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Rabies Vaccines

Associated data

  • ClinicalTrials.gov/NCT02374814