Pre-exposure rabies vaccination: strategies and cost-minimization study

Area of Science:

• Immunology
• Vaccinology
• Public Health

Background:

• Current pre-exposure rabies vaccination strategies by WHO and CDC involve specific schedules.
• Long-term follow-up data on post-vaccinal seroconversion rates are crucial for optimizing vaccination protocols.

Purpose of the Study:

• To compare the efficiency and cost-effectiveness of an alternative pre-exposure rabies vaccination strategy against institutional recommendations.
• To evaluate a novel vaccination schedule based on long-term seroconversion data.

Main Methods:

• A cost-minimization analysis was performed using data from published studies on long-term immunity after rabies vaccination.
• The alternative strategy includes a primary series (D0, D7, D28), a booster at D365, and serological testing (RFFIT) at D379 and 3 years later.
• Sensitivity analysis was conducted to confirm the robustness of the cost-effectiveness findings.

Main Results:

• The alternative rabies vaccination strategy was found to be 1.7 to 5.2 times less expensive than current institutional recommendations, assuming equivalent immunogenicity.
• The cost savings are primarily attributed to a potentially reduced need for subsequent booster injections based on serological monitoring.
• Sensitivity analysis supported the financial advantages of the proposed alternative strategy.

Conclusions:

• The proposed alternative pre-exposure rabies vaccination strategy presents a more cost-effective approach compared to existing WHO and CDC guidelines.
• Further validation of this strategy under real-world field conditions is recommended to confirm its practical efficiency.
• This cost-saving approach could improve accessibility to pre-exposure rabies prophylaxis.