Rabies antibody response after two intradermal pre-exposure prophylaxis immunizations: An observational cohort study.
BACKGROUND
Rabies is a lethal, but vaccine preventable disease. Vaccination uptake is however hampered by the time-consuming three-dose, 21/28-day schedule. The aim of this study was to examine whether adequate rabies antibody titers are reached after two intradermal (ID) doses of rabies vaccine, with a seven-day window.


METHOD
We conducted an observational cohort study with military personnel. A titer was assessed by RFFIT, on the day of the third vaccination, to ensure an adequate rabies antibody response after ID immunization.


RESULTS
After this abbreviated two-dose, seven-day ID schedule, seroconversion was reached in 99.3% (427/430) with a geometric mean titer of 7.59 IU/mL (95% CI 7.04-8.17).


CONCLUSIONS
Implementation of this two-dose schedule will protect more people against Rabies. Travelers and military personnel under time constraints, who otherwise would remain unvaccinated, can be considered adequately protected after this two-dose schedule. For populations in endemic areas, local application of a two-dose schedule could provide an opportunity to vaccinate more people with less vaccine. Given the paucity of published data, this study adds relevant evidence in support of the new policy (2017) of WHO, concerning a two-dose, seven-day schedule is approved for all healthy individuals.
['De Pijper|Cornelis Adrianus|CA|', 'Boersma|Jimmy|J|', 'Terryn|Sanne|S|', 'Van Gucht|Steven|S|', 'Goorhuis|Abraham|A|', 'Grobusch|Martin Peter|MP|', 'Stijnis|Cornelis|C|']
D000293:Adolescent D000328:Adult D000914:Antibodies, Viral D015331:Cohort Studies D005260:Female D006801:Humans D007115:Immunization Schedule D000071497:Immunogenicity, Vaccine D007271:Injections, Intradermal D008297:Male D008875:Middle Aged D008889:Military Personnel D065129:Pre-Exposure Prophylaxis D011818:Rabies D011819:Rabies Vaccines D013997:Time Factors D014611:Vaccination D055815:Young Adult
Rabies Intradermal Vaccination Two-dose Abbreviated schedule Pre-exposure prophylaxis (PrEP)