One or three intradermal injections within one week for rabies pre-exposure immunization.

Pre-exposure rabies vaccination is recommended fortravellers to endemic countries and forselected populations in highly endemic regions. It consists of three injections administered over 3-4 weeks. Travellers often ignore or do not have enough time to receive a complete course prior to departure or leave with only one or two injections. In this study, the secondary antibody response in volunteers who received one or three injections within one week is evaluated. Results are compared to the recommended three injection regimen when administered with two booster vaccinations on days 0 and 3 one year later. Long-lasting immune memory in volunteers who received only one time vaccination of 0.1 ml (1 site) intradermally and then received two booster vaccinations of 0.1 ml (1 site) intradermally on days 0 and 3, one or three years later is also reported. All volunteers developed an accelerated and adequate neutralizing antibody response within seven days after they received two boosters. These data suggest that three injections within one week are as immunogenic as three injections within four weeks. One clinic visit with two-site 0.1 ml ID injections or a one-site single 0.1 ml pre-exposure rabies vaccination is enough to prime the host immune memory for at least one to three years.

Sex- and age-related differences in rabies immunoglobulin hypersensitivity.

We retrospectively reviewed 72132 patients who had received rabies immunoglobulin between 1987 and 2005 at the Queen Saovabha Memorial Institute, Bangkok. Purified equine rabies immunoglobulin (ERIG) was given to 42965 (59.56%) patients and human rabies immunoglobulin (HRIG) to 29167 (40.44%) patients. A total of 812 patients from both groups (1.13%) reported adverse reactions; among those who had received ERIG, 43.13% were male and 56.87% were female, and among those who had received HRIG, 34.62% were male and 65.38% were female. Females were at higher risk of exhibiting ERIG or HRIG hypersensitivity than males (P<0.01). None of the reactions was life-threatening. Serum sickness-like reactions to ERIG and HRIG were rare under the age of 10 years (0.05 and 0.01% among recipients in that age group).