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Guo Y, Mills DJ, Lau CL, Mills C, Furuya‐Kanamori L. Immune response after rabies pre-exposure prophylaxis and a booster dose in Australian bat carers. Zoonoses Public Health 2023; 70:465-472. [PMID: 37170441 PMCID: PMC10952468 DOI: 10.1111/zph.13048] [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: 10/07/2022] [Revised: 03/31/2023] [Accepted: 04/29/2023] [Indexed: 05/13/2023]
Abstract
Periodic vaccination against rabies is essential for individuals at continuing risk of rabies exposure. There is limited evidence on long-term immunogenicity after a 3-dose intramuscular (3IM) pre-exposure prophylaxis (PrEP) and single IM booster dose, thus current guideline recommendations differ in the interval for serology tests following PrEP and boosters. This study investigated post-PrEP and post-booster persistence of antibodies in Australian bat carers. Bat carers who received 3IM PrEP/booster doses and had post-PrEP/booster serology test results were included. The proportion of antibody-negative (<0.5 EU/mL) individuals after PrEP/booster dose were examined. Three hundred and five participants (65.6% females, median age at PrEP 43.1 years) were included. The proportion who were antibody-negative varied depending on the time between 3IM PrEP and the serology test: 8.0% <1 year, 29.8% 1-2 years, 21.2% 2-3 years and 7.7% >3 years. Ninety-one participants receiving booster doses were further assessed. Only one participant was antibody-negative at >3 years after receiving one IM booster dose. Our findings support that a serology test should be performed 1 year after 3IM PrEP, followed by first booster if required. Rabies antibodies persist for many years after receiving the booster doses. The interval between subsequent serology tests and the first booster dose should be no longer than 3 years. Future studies are required to provide more insight into the most appropriate timing of subsequent boosters.
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Affiliation(s)
- Yihan Guo
- School of Medicine, Faculty of MedicineThe University of QueenslandHerstonAustralia
| | - Deborah J. Mills
- Dr Deb The Travel DoctorTravel Medicine AllianceBrisbaneAustralia
| | - Colleen L. Lau
- Dr Deb The Travel DoctorTravel Medicine AllianceBrisbaneAustralia
- School of Public Health, Faculty of MedicineThe University of QueenslandHerstonAustralia
| | - Christine Mills
- Dr Deb The Travel DoctorTravel Medicine AllianceBrisbaneAustralia
| | - Luis Furuya‐Kanamori
- School of Public Health, Faculty of MedicineThe University of QueenslandHerstonAustralia
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Parize P, Sommé J, Schaeffer L, Ribadeau-Dumas F, Benabdelkader S, Durand A, Tarantola A, Cailhol J, Goesch J, Kergoat L, Le Guern AS, Mousel ML, Dacheux L, Consigny PH, Fontanet A, Francuz B, Bourhy H. Systematic Booster after Rabies Pre-Exposure Prophylaxis to Alleviate Rabies Antibody Monitoring in Individuals at Risk of Occupational Exposure. Vaccines (Basel) 2021; 9:309. [PMID: 33805019 PMCID: PMC8063951 DOI: 10.3390/vaccines9040309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022] Open
Abstract
Pre-exposure rabies prophylaxis (PrEP) is recommended for people at frequent or increased risk of professional exposure to lyssavirus (including rabies virus). PrEP provides protection against unrecognized exposure. After the primary vaccination, one's immune response against rabies may decline over time. We aimed to evaluate the immune response to rabies in individuals immunized for occupational reasons before and after a booster dose of the rabies vaccine. With this aim, we retrospectively documented factors associated with an inadequate response in individuals vaccinated for occupational purposes. Our findings analyzed data from 498 vaccinated individuals and found that 17.2% of participants had an inadequate antibody titration documented after their primary vaccination without the booster, while inadequate response after an additional booster of the vaccine was evidenced in 0.5% of tested participants. This study showed that a single booster dose of vaccine after PrEP conferred a high and long-term immune response in nearly all individuals except for rare, low responders. A systematic rabies booster after primary vaccination may result in alleviating the monitoring strategy of post-PrEP antibody titers among exposed professionals.
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Affiliation(s)
- Perrine Parize
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Jérémie Sommé
- Institut Pasteur, Occupational Health Department, 75015 Paris, France; (J.S.); (M.-L.M.); (B.F.)
| | - Laura Schaeffer
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Centre for Global Health Research and Education, 75015 Paris, France; (L.S.); (A.F.)
| | - Florence Ribadeau-Dumas
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Sheherazade Benabdelkader
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | | | - Arnaud Tarantola
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Johann Cailhol
- Institut Pasteur, Centre Médical, Centre d’Infectiologie Necker-Pasteur, 75015 Paris, France; (J.C.); (J.G.); (P.-H.C.)
| | - Julia Goesch
- Institut Pasteur, Centre Médical, Centre d’Infectiologie Necker-Pasteur, 75015 Paris, France; (J.C.); (J.G.); (P.-H.C.)
| | - Lauriane Kergoat
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | | | - Marie-Laurence Mousel
- Institut Pasteur, Occupational Health Department, 75015 Paris, France; (J.S.); (M.-L.M.); (B.F.)
| | - Laurent Dacheux
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Paul-Henri Consigny
- Institut Pasteur, Centre Médical, Centre d’Infectiologie Necker-Pasteur, 75015 Paris, France; (J.C.); (J.G.); (P.-H.C.)
| | - Arnaud Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Centre for Global Health Research and Education, 75015 Paris, France; (L.S.); (A.F.)
- Conservatoire National des Arts et Métiers, 75003 Paris, France
| | - Beata Francuz
- Institut Pasteur, Occupational Health Department, 75015 Paris, France; (J.S.); (M.-L.M.); (B.F.)
| | - Hervé Bourhy
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
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