ArticleInfection2025
Immunogenicity and safety of the accelerated 2-dose intradermal rabies pre exposure prophylaxis regimen in immunocompetent and immunocompromised pediatric populations: a comparative study.
Article in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeRabies is a fatal zoonotic disease, and India accounts for 35% of global rabies-related deaths. In 2018, the World Health Organization (WHO) revised its guidelines for pre-exposure prophylaxis (PrEP) from a 3-dose to a cost-saving 2-dose intradermal (ID) regimen. This study evaluates the immunogenicity and safety of this regimen in pediatric populations, including children exposed to immunosuppressant therapy.
methodsThis single-center, prospective, comparative follow-up study was conducted at a tertiary care hospital. Participants (5-18 years) were enrolled into two groups: (1) children with no known immunodeficiency (n = 31) and (2) children on immunosuppressant therapy (n = 10). All received Vero cell culture rabies vaccine (RABIVAX-S
resultsBy day 28, both groups achieved a 100% seroconversion rate (SCR). Geometric mean titers (GMT) were 2.168 EU/ml and 1.547 EU/ml in the no-known-immunodeficiency and immunosuppressant therapy groups, respectively. At day 90, SCRs were 90% and 70%, with GMTs of 1.358 EU/ml and 0.962 EU/ml, respectively. Booster doses restored titers in all participants with insufficient levels. Pain at the injection site was the only solicited adverse effect.
conclusionsThe 2-dose ID PrEP regimen is immunogenic and safe in pediatric populations, including immunosuppressed children. It offers a cost-effective alternative in rabies-endemic regions, enhancing compliance and accessibility.
trial registrationProspectively registered with the Clinical Trials Registry India with Trial Registration No. CTRI/2022/10/046777.
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