Factors influencing the immune response after a single-dose 3-visit pre-exposure rabies intradermal vaccination schedule: a retrospective multivariate analysis

Benjamin Damanet, Diana Isabela Costescu Strachinaru, Mathias Van Nieuwenhove, Patrick Soentjens

    Research output: Contribution to journalA1: Web of Science-articlepeer-review

    Abstract

    Background: The World Health Organization (WHO) recommends intradermal (ID) rabies vaccination as a safe and immunogenic alternative to intramuscular administration. The aim of this study is to determine which factors influence the levels of rabies virus neutralizing antibodies (RVNA) after a 3-visit ID rabies vaccination.

    Methods: This is a retrospective secondary data analysis study based on electronic health record vaccination data of Belgian military subjects who received ID rabies Pre-exposure prophylaxis (PrEP) with a single-dose 3-visit regimen during the period 2014-2017. Logistic regression was performed to identify predictive factors of RVNA level >= 3.0 IU/mL and >10 IU/mL.

    Results: The second analysis performed on the 2025 subjects (100% seroconverted with a RVNA >= 0.5 IU/mL) shows a significantly better immune response in subjects younger than 30 years compared to all other age-groups, a gender-difference to predict RVNA >= 3.0 IU/mL (OR 2.30 [1.26-4.22] comparing "female" to "male") and the influence of the vaccination schedule (OR 2.28 [1.15-4.53] comparing "late - very variable" to "correct" schedule) to predict > 10 IU/ml. Multivariate analysis also demonstrates that a postponed serology control significantly influences the Rapid Fluorescent Focus Inhibition Test (RFFIT).

    Conclusion: Gender and age significantly influence the response to ID rabies vaccine. Timing of RVNA determination is important to correctly assess the response to vaccination. A single-dose 3-visit ID rabies PrEP schedule is a dose-sparing effective alternative to the double-dose 2-visit ID schedule. When the minimum time interval between doses is respected, RVNA determination is not necessary.

    Original languageEnglish
    Article number101867
    JournalTravel Medicine and Infectious Disease
    Volume37
    Number of pages6
    ISSN1477-8939
    DOIs
    Publication statusPublished - 2020

    Keywords

    • Rabies
    • Neglected preventable disease
    • Vaccines
    • Vaccination schedule
    • IMMUNOGENICITY

    Fingerprint

    Dive into the research topics of 'Factors influencing the immune response after a single-dose 3-visit pre-exposure rabies intradermal vaccination schedule: a retrospective multivariate analysis'. Together they form a unique fingerprint.

    Cite this