Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring
DOI:
https://doi.org/10.1590/S0034-89102010005000005Keywords:
Rabies Vaccines^i2^simmunol, Serology, Immunity, Humoral, Intervention Studies, Rabies^i2^sprevent, Rabies^i2^scontAbstract
OBJECTIVE: To evaluate the humoral immune response to the pre-exposure schedule of human rabies vaccination through intradermal and intramuscular routes, as well as the need for serological monitoring. METHODS: A randomized and controlled intervention study was carried out in São Paulo, Southeastern Brazil, from 2004-2005. There were 149 volunteers, of which 127 completed the vaccination schedule (65 intradermal and 62 intramuscular) and underwent humoral immune response evaluation at ten, 90 and 180 days post-vaccination. Two outcomes were considered for comparing the two routes of administration: the geometric average of neutralizing antibody titers and the proportion of individuals with satisfactory titers (>; 0.5 IU/mL) at each evaluation point. The association of the humoral immune response with anthropometric and demographic data was analyzed through a normal distribution test and a chi-square test with a Yates correction. After completion of the vaccination schedule, the proportion of seropositive results was compared by the Kruskall Wallis test, and the average titers were compared by variance analysis. RESULTS: the average antibody titers were higher in patients who were vaccinated intramuscularly. The percentage of volunteers with satisfactory titers (>; 0.5% IU/mL) decreased over time in both groups. However, in the group vaccinated intradermally the rate of satisfactory titers on day 180 ranged from 20% to 25%, while the intramuscular route varied from 63% to 65%. An association between the humoral immune response and the demographic and anthropometric variables was not observed. CONCLUSIONS: Serology after the third dose can be considered unnecessary in unexposed patients, since 97% and 100% of volunteers respectively vaccinated by the intradermal and intramuscular route presented satisfactory antibody levels (>; 0.5% IU/mL).Downloads
Published
2010-06-01
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Section
Original Articles
How to Cite
Cunha, R. S., Silva, A. de C. R. da, Batista, A. M., Chaves, L. B., & Barata, R. B. (2010). Equivalence between pre-exposure schemes for human rabies and evaluation of the need for serological monitoring . Revista De Saúde Pública, 44(3), 548-554. https://doi.org/10.1590/S0034-89102010005000005