Immune Response to Rabies Booster Vaccination in Subjects Who Had Postexposure Treatment More Than 5 Years Previously

Abstract

Patients exposed to rabies, who had a history of having received a complete series of intramuscular or intradermal postexposure vaccine treatment 5 or more years previously, all developed an early anamnestic antibody response to two intradermal booster vaccine injections. I t is suggested that such subjects do not require a full five-dose postexposure series nor do they require administration of rabies immune globulin. These data confirm World Health Organization and US-CDC recommendations. Current World Health Organization (WHO) recommendations state that indi&duals,previously vaccinated against rabies with a potent tissue or avian culture vaccine, should be given two tissue or avian culture vaccine boosters on days 0 and 3 ifpostexposure vaccination is required. Boosters can be ahnis te red either intramuscularly as a full ampoule or i n t r a d e r d y as 0.1 mL if the ampoule is reconstituted in 0.5 mL solution or 0.2 mL. if the diluent provided with the vaccine is 1 .O mL.'** Previous studies supported this recommendation.' Investigators at this institution published a study of nerve tissue-derived vaccine recipients, reexposed to rabies up to 50 years after their original immunization, and found that most but not all had an accelerated immune response and thus showed immunological memory. This was not related to the time elapsed since the previous Semple or