1
|
Jin F, Zhu L, Wang Y, Qin G, Tian Y, Xie Y, Jin H, Zhang Y, Wang L, Li J, Wu Z, Sheng Y, Shi L, Yang G, Zhao Z, Chen L, Chen P, Jiang Z, Yu J, Gao Z, Li Q, Wu X, Miao L. Randomized, blind, controlled phase III clinical trial: Assessing the immunogenicity and safety of freeze-dried human rabies vaccine (vero cell) with a 4-dose regimen (2-1-1) in a 10-60 year-old demographic. Vaccine 2024; 42:126059. [PMID: 38937182 DOI: 10.1016/j.vaccine.2024.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/29/2024] [Accepted: 06/09/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVE The aim of this study is to demonstrate that the freeze-dried human rabies vaccine (Vero cell), administered in a four-dose schedule (2-1-1) to the 10-60 years old population, has immunogenicity that is not inferior to the approved five-dose schedule and similar vaccines with a four-dose schedule, and to evaluate its safety. METHOD A total of 1800 individuals were enrolled and divided into three groups: four-dose test group, four-dose control group, and five-dose control group. The rabies virus neutralizing antibodies were measured using the Rapid Fluorescent Focus Inhibition Test to assess immunogenicity, and the incidence of adverse events and serious adverse events were statistically analyzed. RESULTS The seroconversion rates 14 days after the first dose and 14 days after the complete course of vaccination were 100% in all three groups. The antibody GMC of the four-dose test group was higher than that of the five-dose control group, but slightly lower than the four-dose control group. Seven days after the first dose, both four-dose regimen groups showed higher seroconversion rates and antibody GMCs compared to the five-dose regimen group, proving that the immunogenic effect of the four-dose regimen seven days post-first vaccination is superior to the five-dose regimen. The overall incidence of adverse events showed no significant difference between the four-dose test group and the five-dose control group, but was significantly lower in the four-dose test group compared to the four-dose control group. CONCLUSION The vaccine in the four-dose test group is equivalent in immunogenic effect to the four-dose control group vaccine and superior to the five-dose control group vaccine; the safety of the vaccine in the four-dose test group is equivalent to the five-dose control group vaccine and superior to the four-dose control group vaccine. CLINICALTRIALS gov number: NCT05549908.
Collapse
Affiliation(s)
- Fei Jin
- Hebei Province Center for Disease Prevention and Control, No.97, Huaian East Road, Hebei, 050011, China
| | - Lei Zhu
- Changchun Zhuoyi Biological Co., Ltd, No.2 Yongxin Road, Changchun 130000, China
| | - Yunpeng Wang
- National Institutes for Food and Drug Control, No. 29, Huatuo Road, Beijing 100010, China
| | - Guoqiang Qin
- Simoon Record Beijing Co., Ltd., No. 56 Dongsihuanzhong Road, Beijing 100000, China
| | - Ye Tian
- Beijing Key Tech Statistical Consulting Co., Ltd, No. 1008 Huihenan Street, Building, Beijing 100000, China
| | - Yanhua Xie
- Dingxing County Center for Disease Prevention and Control, Tianma Street, Hebei 072650, China
| | - Hui Jin
- Renqiu City Center for Disease Prevention and Control, Mount Taishan North Road, Hebei 062550, China
| | - Yanqing Zhang
- Gaoyang County Center for Disease Prevention and Control, No. 3 Tonglinge Street, Hebei 071500, China
| | - Lidong Wang
- Changchun Zhuoyi Biological Co., Ltd, No.2 Yongxin Road, Changchun 130000, China
| | - Jia Li
- National Institutes for Food and Drug Control, No. 29, Huatuo Road, Beijing 100010, China
| | - Zhiwei Wu
- Hebei Province Center for Disease Prevention and Control, No.97, Huaian East Road, Hebei, 050011, China
| | - Ying Sheng
- Changchun Zhuoyi Biological Co., Ltd, No.2 Yongxin Road, Changchun 130000, China
| | - Leitai Shi
- National Institutes for Food and Drug Control, No. 29, Huatuo Road, Beijing 100010, China
| | - Guoling Yang
- Changchun Zhuoyi Biological Co., Ltd, No.2 Yongxin Road, Changchun 130000, China
| | - Ziyan Zhao
- Changchun Zhuoyi Biological Co., Ltd, No.2 Yongxin Road, Changchun 130000, China
| | - Lei Chen
- Dingxing County Center for Disease Prevention and Control, Tianma Street, Hebei 072650, China
| | - Panpan Chen
- Renqiu City Center for Disease Prevention and Control, Mount Taishan North Road, Hebei 062550, China
| | - Zhiwei Jiang
- Beijing Key Tech Statistical Consulting Co., Ltd, No. 1008 Huihenan Street, Building, Beijing 100000, China.
| | - Jiajie Yu
- Simoon Record Beijing Co., Ltd., No. 56 Dongsihuanzhong Road, Beijing 100000, China.
| | - Zhao Gao
- Hebei Province Center for Disease Prevention and Control, No.97, Huaian East Road, Hebei, 050011, China.
| | - Qi Li
- Hebei Province Center for Disease Prevention and Control, No.97, Huaian East Road, Hebei, 050011, China.
| | - Xiaohong Wu
- National Institutes for Food and Drug Control, No. 29, Huatuo Road, Beijing 100010, China.
| | - Li Miao
- Changchun Zhuoyi Biological Co., Ltd, No.2 Yongxin Road, Changchun 130000, China.
| |
Collapse
|
2
|
Wu X, Li J, Zhou L, Chen J, Jin Z, Meng Q, Chai J, Gao H, Wang Y, Zhao D, Wu H, Yu J, Chen N, Wang Y, Lin Y, Huang P, Li Y, Zhang Y. A Randomized, Double-Blind, Controlled Phase III Clinical Trial to Evaluate the Immunogenicity and Safety of a Lyophilized Human Rabies Vaccine (Vero Cells) in Healthy Participants Aged 10-60 Years Following Essen and Zagreb Vaccination Procedures. Vaccines (Basel) 2023; 11:1311. [PMID: 37631879 PMCID: PMC10458047 DOI: 10.3390/vaccines11081311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE In this paper, we aim to show that the immunogenicity of the lyophilized human rabies vaccine (Vero cells) (investigational vaccine) developed by Dalian Aleph Biomedical Co., Ltd. in healthy participants aged 10-60 years old is non-inferior to the lyophilized PVRV (positive control) manufactured by Liaoning Chengda Biotechnology Co., Ltd. (Shenyang, China), and that its safety is clinically acceptable. METHOD A total of 2776 participants were enrolled in this study and divided into four groups: a five-dose test group, a five-dose control group, a four-dose test group, and a four-dose control group. The patients in the four-dose groups (Zagreb) were vaccinated on Days 0 (two doses), 7 (one dose), and 21 (one dose), and those in the five-dose groups (Essen) were vaccinated on Days 0, 3, 7, 14, and 28 (one dose each). The rabies-virus-neutralizing antibody assay with the RFFIT was used to assess the immunogenicity, and the adverse events (AEs) and serious adverse events (SAEs) were identified and collated. RESULTS The positive seroconversion rate was up to 100% on Days 14 and 35/42 after vaccination following any procedures in pre-immunization antibody-negative participants, and the positive seroconversion rate and geometric mean concentration (GMC) of the test groups (Zagreb and Essen vaccination procedures) was not inferior to that of the control groups. On Day 7 after vaccination, the immunogenicity of the Zagreb procedure with two doses of the vaccine on Day 0 was superior to the Essen procedure with one dose of vaccine, that is, the former had a higher seroconversion rate and RVNA titer. The non-inferiority criterion of immunogenicity was met for the whole population, the population aged 10-18 years and ≥18 years, and the pre-immunization antibody-positive population. The incidences of all AEs, solicited AEs, and unsolicited AEs in both groups were not statistically significant, and no vaccination-related SAEs were observed. CONCLUSION The investigated vaccine is safe, its immunogenicity is non-inferior to that of the control vaccine, and the efficacy of the Zagreb procedure is superior to that of the Essen procedure 7 days after the first dose.
Collapse
Affiliation(s)
- Xiaohong Wu
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing 102629, China
| | - Jia Li
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing 102629, China
| | - Lei Zhou
- School of Chemical Engineering, Dalian University of Technology, Dalian 116023, China
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Jianmin Chen
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Zhongqiang Jin
- Vaccine Clinical Research Center of Sichuan Center for Disease Control and Prevention, Chengdu 610044, China
| | - Qingwei Meng
- School of Chemical Engineering, Dalian University of Technology, Dalian 116023, China
| | - Jing Chai
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Hongxia Gao
- Quality Control Department, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Yunpeng Wang
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing 102629, China
| | - Danhua Zhao
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing 102629, China
| | - Heng Wu
- Rabies Vaccine Production Workshop, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Jieran Yu
- Filling and Packaging Workshop, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Nan Chen
- Quality Control Department, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Yanan Wang
- R&D Department, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| | - Yuan Lin
- Department of Scientific Affairs, Simoon Record Beijing Co., Ltd., Beijing 100025, China
| | - Peifang Huang
- Department of Project Management, Simoon Record Beijing Co., Ltd., Beijing 100025, China
| | - Yuhua Li
- Arbovirus Vaccine Department, National Institutes for Food and Drug Control, Beijing 102629, China
| | - Yuhui Zhang
- General Manager Office, Dalian Aleph Biomedical Co., Ltd., Dalian 116620, China
| |
Collapse
|
3
|
Wang SY, Sun JF, Liu P, Luo L, Li JX, Zhu FC, Shen XX, Meng FY. Immunogenicity and safety of human diploid cell vaccine (HDCV) vs. purified Vero cell vaccine (PVRV) vs. purified chick embryo cell vaccine (PCECV) used in post-exposure prophylaxis: a systematic review and meta-analysis. Hum Vaccin Immunother 2022; 18:2027714. [PMID: 35192787 PMCID: PMC8993064 DOI: 10.1080/21645515.2022.2027714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 11/04/2022] Open
Abstract
This study comprehensively evaluated and compared three human rabies vaccines. Seven electronic databases were systematically searched. The Cochrane Handbook v5.1.0 was used to assess the risk of bias. A random-effects model was used to combine individual rates, and network meta-analysis was used for pairwise comparisons. Twenty-seven articles were included, with a total of 18,630 participants. The pooled incidence of the total adverse reaction to HDCV was significantly lower than that of PCECV. HDCV administration resulted in a lower incidence of local pain, fever, and weakness than purified Vero cell vaccine. HDCV caused a lower incidence of local pain and fever than PCECV. No significant difference was observed in terms of the seroconversion rate on day 7 or the rabies virus-neutralizing antibody titer on day 14. HDCV demonstrated superiority in terms of safety compared with the other two rabies vaccines, while the same was not observed in terms of immunogenicity.
Collapse
Affiliation(s)
- Shi-Yuan Wang
- School of Public Health, Southeast University, Nanjing, PR China
| | - Jin-Fang Sun
- School of Public Health, Southeast University, Nanjing, PR China
| | - Pei Liu
- School of Public Health, Southeast University, Nanjing, PR China
| | - Li Luo
- School of Public Health, Southeast University, Nanjing, PR China
| | - Jing-Xin Li
- Department of Vaccine Clinical Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| | - Feng-Cai Zhu
- School of Public Health, Southeast University, Nanjing, PR China
- Department of Vaccine Clinical Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
- NHC Key laboratory of Enteric Pathogenic Microbiology, Nanjing, China
| | - Xu-Xiang Shen
- School of Public Health, Southeast University, Nanjing, PR China
| | - Fan-Yue Meng
- Department of Vaccine Clinical Evaluation, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, PR China
| |
Collapse
|
4
|
Safety and immunogenicity of human rabies vaccine for the Chinese population after PEP: A systematic review and meta-analysis. Vaccine 2022; 40:4371-4379. [PMID: 35750539 DOI: 10.1016/j.vaccine.2022.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/29/2022] [Accepted: 06/01/2022] [Indexed: 11/22/2022]
Abstract
AIM To evaluate the safety and immunogenicity of rabies vaccine for human use after post-exposure in China. METHODS A systematic search was performed from PubMed, EMBASE, CNKI and Cochrane Library database, supplemented by manual retrieval. According to the inclusion and exclusion criteria, a meta-analysis was performed using Stata 16.0 software after independent literature screening, data extraction and quality assessment by two evaluators. RESULTS A total of 32 studies were included. It was found that rabies vaccination after PEP could induce the body to produce sufficient RVNA. Both Essen and Zagreb regimens showed good immunogenicity, with no significant difference in systemic events and local events after PEP, but a relatively high incidence of local and systemic events after PEP under the Zagreb regimen. CONCLUSION For the Chinese population, rabies vaccination after PEP has shown relatively a good immune efficacy and acceptable safety for preventing human rabies. The survey also found that the Zagreb regimen was comparable to the Essen regimen in terms of rabies prophylaxis with an acceptable safety profile.
Collapse
|
5
|
Zhang L, Huang S, Cai L, Zhu Z, Chen J, Lu S, Zhu Z, Zhang M, Fang Y, Hu Q. Safety, immunogenicity of lyophilized purified vero cell cultured rabies vaccine administered in Zagreb and Essen regimen in post-exposure subjects: A post-marketing, parallel control clinical trial. Hum Vaccin Immunother 2021; 17:2547-2553. [PMID: 33631078 PMCID: PMC8475608 DOI: 10.1080/21645515.2021.1880200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022] Open
Abstract
To compare the safety and immunogenicity of lyophilized PVRV under Zagreb and Essen regimen.A post-marketing parallel control clinical trial was conducted. Totally 240 subjects were assigned to two groups randomly, immunized with lyophilized PVRV under Zagreb and Essen schedule. Solicited adverse events were observed after each dose and unsolicited adverse events were collected. Serum samples were collected on days 0, 7, 14, 42, 180 and 365 to be used to determine immunogenicity level. No severe adverse events (SAE) were observed. The incidence of adverse events under Zagreb and Essen were similar and there was no significant difference between the two groups and within all age groups. Fever and pain were the most frequently reported systemic and local adverse events (AEs) respectively. There were no differences in the GMT and the positive seroconversion rate between these two groups. All participants in the Zagreb group obtained protective effect on day 14, while 99.16% of the subjects obtained in the Essen group. Both groups showed similar enduring immunity. Immunizations under Zagreb and Essen regimens showed similar safety and immunogenicity. For lyophilized PVRV, Zagreb was non-inferior to Essen to patients of all age groups.
Collapse
Affiliation(s)
- Lei Zhang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shichun Huang
- Department of Academic Research, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Li Cai
- Institute of Infectious Disease, Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Zhenggang Zhu
- Department of Immunization, Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Jian Chen
- Institute of Infectious Disease, Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Sha Lu
- Department of Immunization, Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Zerong Zhu
- Pathogen Biology Laboratory, Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Man Zhang
- Department of Immunization, Wuhan Center for Disease Control and Prevention, Wuhan, China
| | - Yuan Fang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Quan Hu
- Department of Public Health, Wuhan Institute of Dermatology and Venereology, Wuhan, China
| |
Collapse
|
6
|
Shen H, Wang Z, Yang B, Cai K, Jiang C, Xie R, Xiao H, Ren Q, Qi Z, Li J, Li Q, Ye J, Zhan F. Immunogenicity and safety of purified vero cell-cultured rabies vaccine under Zagreb 2-1-1 or 5-dose Essen regimen in the healthy Chinese subjects: a randomized, double-blind, positive controlled phase 3 clinical trial. Hum Vaccin Immunother 2020; 17:351-357. [PMID: 32783769 DOI: 10.1080/21645515.2020.1778408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Aim: The aims of the study were to evaluate the non-inferiority of the safety and immunogenicity of a new trial purified vero cell-cultured rabies vaccine (trial vaccine) in healthy subjects comparing with the control purified vero cell-cultured rabies vaccine (control vaccine) following Essen regimen and to evaluate the non-inferiority of the safety and immunogenicity of the trial vaccine following two intramuscular regimens, between Zagreb and Essen regimen. Methods: Serum samples were collected before vaccination and on d 7, 14, 35/42 post vaccination. Adverse events (AEs) were recorded for 30 d following each vaccination. This study was registered in the Chinese Clinical Trial Registry (ChiCTR-PPR-15007057). Results: There was no significant difference in the incidence of AEs, local and systemic reactions, among Zagreb group, Essen group, and control group. But the incidence of solicited AEs was a significant difference among the three groups (p = 0.0498). The incidence of solicited AEs was higher in Essen group than that in control group and Zagreb group (p = 0.0278, p = 0.0248). In the subjects whose antibodies were seronegative before vaccination, the seroconversion rates of antibodies among three groups were all 100.0% on d 14 and d 35/42. The Essen group was not inferior to the control group, and the Zagreb group was not inferior to the Essen group on d 14. On d 14 and d 35/42, the geometric mean concentration of the three groups was much higher than the immune protection level of 0.5 IU/ml. Conclusions: The trial vaccine had good safety and immunogenicity, and the trial vaccine is not inferior to the control vaccine. Abbreviations: PVRV: purified vero cell-cultured rabies vaccine; AE: adverse event; CI: confidence interval; GMC: geometric mean concentration; IM: intramuscular; NIFDC: National Institutes for Food and Drug Control; PPS: per-protocol set; SS: safety set; REFIT: Rapid Fluorescent Focus Inhibition Test; RVNA: rabies virus neutralizing antibody; WHO: World Health Organization.
Collapse
Affiliation(s)
- Heng Shen
- Hubei Center for Disease Prevention and Control , Wuhan, China
| | - Zhao Wang
- Hubei Center for Disease Prevention and Control , Wuhan, China
| | - Beifang Yang
- Hubei Center for Disease Prevention and Control , Wuhan, China
| | - Kun Cai
- Hubei Center for Disease Prevention and Control , Wuhan, China
| | - Changjun Jiang
- Dangyang Center for Disease Prevention and Control , Dangyang, China
| | - Ronghua Xie
- Tuanfeng Center for Disease Prevention and Control , Huanggang, China
| | - Haitao Xiao
- Dangyang Center for Disease Prevention and Control , Dangyang, China
| | - Qunhui Ren
- Dangyang Center for Disease Prevention and Control , Dangyang, China
| | - Zhengxu Qi
- Tuanfeng Center for Disease Prevention and Control , Huanggang, China
| | - Jinghui Li
- Xianshengweike Biopharmaceutical Co., Ltd , Jiangsu, China
| | - Qiong Li
- Hubei Center for Disease Prevention and Control , Wuhan, China
| | - Jianjun Ye
- Hubei Center for Disease Prevention and Control , Wuhan, China
| | - Faxian Zhan
- Hubei Center for Disease Prevention and Control , Wuhan, China
| |
Collapse
|
7
|
Li T, Wang X, Cheng H. Meta-analysis of immunogenicity and safety of human rabies vaccination under Zagreb and Essen regimens. J Comp Eff Res 2020; 9:459-468. [PMID: 32374178 DOI: 10.2217/cer-2019-0202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: To assess the immunogenicity and safety of rabies vaccination under the Zagreb and Essen regimens by performing a meta-analysis. Methods: Electronic databases were searched for eligible studies. Risk ratios and weighted mean differences with 95% CIs were used to calculate estimates. Results: A total of 18 studies were included. Rabies virus neutralizing antibody concentration was comparable between the two regimens at D7 and 14. No significant differences were observed in seroconversion rates from D14 and 42. Incidence of fever was higher in Zagreb group (risk ratio: 1.55 [1.37–1.76]); but no significant differences were present for other common adverse events. Conclusion: Rabies vaccination under the Zagreb regimen was noninferior to the Essen regimen in immunogenicity and had an acceptable safety profile.
Collapse
Affiliation(s)
- Ting Li
- Emergency Department, Tianjin 4th Center Hospital, No.1 Zhongshan Road, Hebei District, Tianjin 300142, China
| | - Xin Wang
- Emergency Department, Tianjin 4th Center Hospital, No.1 Zhongshan Road, Hebei District, Tianjin 300142, China
| | - Hongbin Cheng
- Emergency Department, Tianjin 4th Center Hospital, No.1 Zhongshan Road, Hebei District, Tianjin 300142, China
| |
Collapse
|
8
|
Evaluating new rabies post-exposure prophylaxis (PEP) regimens or vaccines. Vaccine 2018; 37 Suppl 1:A88-A93. [PMID: 30471958 DOI: 10.1016/j.vaccine.2018.10.103] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/12/2018] [Accepted: 10/31/2018] [Indexed: 12/25/2022]
Abstract
The development of human rabies vaccines has evolved dramatically from the first crude nerve tissue vaccine produced then administered in the presence of Louis Pasteur in 1885. New cell culture technology has enabled highly potent and well-tolerated rabies vaccines to be produced that have reduced the volume and number of doses required to save human lives after exposure. However, these highly potent vaccines are still unaffordable to many patients living at risk of exposure on a daily basis. The cost of post-exposure prophylaxis (PEP) is not only related to the direct cost of rabies biologicals and equipment but is also associated with indirect costs that patients incur as a result of travel, loss of work time (income loss), and accommodation over the period of time that a PEP regimen requires to be completed. This paper summarizes the particular criteria that the SAGE Working Group and WHO personnel reviewed as part of the evaluation process for recommending the new one-week intradermal vaccination regimen (2-2-2-0-0) for rabies post-exposure prophylaxis. These criteria included: Cost-effectiveness; evaluation of number of doses; seroconversion after vaccination; efficacy; safety; and patient follow-up.
Collapse
|