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Economical multiple-site intradermal immunisation with human diploid-cell-strain vaccine is effective for
Abstract:
An economical post-exposure regimen of Mérieux human diploid-cell-strain vaccine (HDCSV) was compared with Semple vaccine (SV), the most widely used vaccine in Asia. 155 patients bitten by animals proved to be rabid received either conventional courses of SV (34 severe and 43 mild cases) or HDCSV, 0.1 ml intradermally, at eight sites on day 0, at four sites on day 7, and at one site on days 28 and 91 (36 severe and 42 mild cases). All severely bitten patients were given equine anti-rabies serum (EARS), 80 IU/kg on day 0. There were no deaths from rabies in either group. Follow-up was 97.5% at 1 year and 93% at 2 years. 88% of patients given HDCSV alone had detectable neutralising antibody on day 7 in contrast to 2% given SV alone. Antibody persisted until 1 year in all sera tested from HDCSV patients in contrast to only 48% of SV sera. The high dose of EARS resulted in pronounced suppression of response to HDCSV. There were no serious systemic side-effects but local side-effects were significantly more common in the SV group. The multiple-site intradermal HDCSV regimen was at least as effective as SV. The amount of HDCSV used was 30% of the conventional dose.
Insights
A new economical rabies vaccine regimen using Mérieux human diploid-cell-strain vaccine (HDCSV) showed comparable effectiveness to Semple vaccine (SV) with reduced dosage. This HDCSV regimen induced higher antibody levels and fewer local side-effects in patients post-rabid animal exposure.
Area of Science:
- * Virology and Immunology
- * Public Health and Epidemiology
- * Vaccine Development and Efficacy
Background:
- * Semple vaccine (SV) is the predominant rabies vaccine in Asia.
- * There is a need for more economical and effective post-exposure rabies prophylaxis.
Purpose of the Study:
- * To compare the efficacy and safety of an economical human diploid-cell-strain vaccine (HDCSV) regimen against the conventional Semple vaccine (SV).
- * To evaluate antibody response and side-effects in patients receiving post-exposure rabies prophylaxis.
Main Methods:
- * A comparative study involving 155 patients bitten by rabid animals.
- * Patients received either conventional Semple vaccine (SV) or a reduced-dose, multi-site intradermal HDCSV regimen.
- * Equine anti-rabies serum (EARS) was administered to severely bitten patients.
Main Results:
- * No rabies deaths occurred in either the HDCSV or SV groups.
- * HDCSV induced significantly higher neutralizing antibody levels by day 7 and sustained antibody presence at 1 year compared to SV.
- * The HDCSV regimen used 30% less vaccine and resulted in fewer local side-effects than SV, though EARS suppressed antibody response.
Conclusions:
- * The multi-site intradermal HDCSV regimen is a safe and effective alternative to SV for rabies post-exposure prophylaxis.
- * HDCSV offers an economical advantage with reduced vaccine quantity and fewer local adverse events.
- * Further research may be needed to optimize EARS co-administration with HDCSV to maximize immunogenicity.