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Randomised feasibility trial of pre-exposure rabies vaccination with DTP-IPV in infants
J Lang1, G H Duong, V G Nguyen
1Medical Department, Pasteur Mérieux Connaught, Lyon, France.
Insights
Administering pre-exposure rabies vaccine (PVRV) alongside routine infant vaccinations (DTP-IPV) in Vietnam was safe and effective. This combination provides protective rabies antibodies, simplifying treatment in enzootic regions.
Area of Science:
- Pediatric Infectious Diseases
- Vaccinology
- Public Health
Background:
- Rabies pre-exposure vaccination simplifies post-exposure treatment, particularly for children in enzootic areas.
- Investigating the feasibility of combined infant vaccinations is crucial for public health initiatives.
Purpose of the Study:
- To assess the safety and immunogenicity of co-administering purified Vero cell rabies vaccine (PVRV) with diphtheria, tetanus, whole-cell pertussis, and inactivated poliomyelitis vaccine (DTP-IPV) in infants.
Main Methods:
- 84 Vietnamese infants received either DTP-IPV alone or DTP-IPV combined with PVRV.
- Safety and antibody concentrations against diphtheria, tetanus, pertussis, polio, and rabies were compared between groups.
Main Results:
- All infants achieved protective antibody levels for all tested antigens, including rabies in the PVRV group.
- No serious adverse events were reported, and systemic reactions were similar between groups.
Conclusions:
- Combined PVRV and DTP-IPV vaccination is safe and immunogenic in infants.
- This strategy could be integrated into Expanded Programme on Immunisation (EPI) schedules in rabies-endemic countries.
Background:
Pre-exposure vaccination against rabies generally simplifies treatment and could be especially beneficial to children in countries where the disease is enzootic. We studied the feasibility of administering to infants pre-exposure rabies vaccination with combined diphtheria, tetanus, whole-cell pertussis, and inactivated poliomyelitis vaccine (DTP-IPV).
Methods:
84 Vietnamese infants were randomly assigned to groups that received three doses of DTP-IPV vaccine at 2, 3, and 4 months of age alone (n = 43) or with two doses of purified Vero cell rabies vaccine (PVRV) at 2 and 4 months (n = 41). The safety and immunogenicity data of the groups were compared.
Findings:
All infants in both groups developed protective antibody concentrations against diphtheria, tetanus, pertussis, and polio. All infants who received the PVRV vaccine developed protective antibody concentrations against rabies. No serious adverse effects were reported, nor did systemic reactions differ between groups.
Interpretation:
Administration of PVRV with DTP-IPV proved safe, and elicited what are presumed to be protective antibody concentrations to all antigens in all 41 infants. Confirmation of these results could lead to integration of pre-exposure rabies vaccination into Expanded Programme on Immunisation (EPI) sessions in selected countries where rabies is enzootic.