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Seroconversion following incomplete human rabies postexposure prophylaxis.

Kis Robertson1, Sergio Recuenco, Michael Niezgoda

  • 1Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, United States. kir6@cdc.gov

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This study found that many patients who stopped rabies postexposure prophylaxis (PEP) early still showed adequate antibody levels. This suggests a reduced vaccine schedule may be sufficient for rabies immunity.

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Area of Science:

  • Immunology
  • Vaccinology
  • Public Health

Background:

  • Rabies postexposure prophylaxis (PEP) typically involves a five-dose vaccine schedule.
  • Some patients discontinue PEP before completing the full schedule.
  • Assessing immunogenicity in these patients is crucial for public health.

Purpose of the Study:

  • To evaluate rabies virus neutralizing antibody levels in patients who discontinued PEP early.
  • To determine if further vaccination is necessary based on serological findings.
  • To assess the adequacy of reduced rabies vaccine regimens.

Main Methods:

  • A serosurvey was conducted on patients who discontinued rabies PEP early.
  • Serum rabies neutralizing antibody levels were measured using the rapid fluorescent focus inhibition test.
  • Samples were analyzed based on World Health Organization (WHO) and Advisory Committee for Immunization Practices (ACIP) recommendations.

Main Results:

  • Antibody titers were assessed a median of 147 days after the last vaccine dose.
  • While 10 patients had titers below the WHO cutoff of 0.5 IU/mL, significant seroconversion was observed.
  • 100% of patients receiving 3 or 4 vaccine doses demonstrated seroconversion.

Conclusions:

  • A rabies vaccine regimen of fewer than five doses may elicit adequate immunogenicity.
  • Findings support previous studies suggesting reduced PEP schedules could be effective.
  • Further research may inform optimized rabies prophylaxis protocols.