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Post-Exposure Prophylactic Vaccination against Rabies: A Systematic Review
Norfazilah Ahmad1, Azmawati Mohammed Nawi1, Mohd Nazrin Jamhari1,2
1Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia.
Iranian Journal of Public Health
|November 21, 2022
Summary
Post-exposure prophylaxis (PEP) for rabies is effective. This review found purified Vero cell rabies vaccine (PVRV) and Peking Union Medical College
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Post-exposure prophylaxis (PEP) is crucial for preventing rabies, a fatal zoonotic disease.
- Malaysia utilizes purified Vero cell rabies vaccine (PVRV), but other vaccines and regimens exist.
- Effectiveness of different PEP vaccines, regimens, and administration routes in Asian populations requires comparison.
Purpose of the Study:
- To systematically review and compare the effectiveness of various rabies PEP vaccines, regimens, and administration routes.
- To evaluate rabies PEP strategies specifically within Asian populations.
Main Methods:
- Systematic review of PubMed and Web of Science databases.
- Inclusion of studies published between 2015 and 2019.
- Focus on effectiveness of PEP vaccination against rabies in Asian populations.
Main Results:
- Eleven relevant studies were identified, primarily using purified chick embryo cell rabies vaccine (PCECV) or PVRV with varied regimens.
- All compared vaccines demonstrated non-inferiority, with adequate immune responses by Day 14.
- Intradermal (ID) vaccination showed cost-effectiveness due to minimal vaccine volume, and concurrent rabies immunoglobulin (RIG) administration did not impact neutralizing antibody geometric mean titer (GMT) response.
Conclusions:
- PCECV with Essen or Zagreb regimens can be an alternative to PVRV, especially during shortages or outbreaks.
- Zagreb or Thai Red Cross (TRC) regimens, using either PVRV or PCECV, are recommended for good immunogenic outcomes in Asian populations.
