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Single dose for rabies pre-immunization P. Khawplod 1, H. Wilde 2,T. Kamolthum 3,Visith Sitprija 1. 1Queen Saovabha Memorial Institute, The Thai Red Cross.

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Presentation on theme: "Single dose for rabies pre-immunization P. Khawplod 1, H. Wilde 2,T. Kamolthum 3,Visith Sitprija 1. 1Queen Saovabha Memorial Institute, The Thai Red Cross."— Presentation transcript:

1 Single dose for rabies pre-immunization P. Khawplod 1, H. Wilde 2,T. Kamolthum 3,Visith Sitprija 1. 1Queen Saovabha Memorial Institute, The Thai Red Cross Society, Bangkok, Thailand. 2 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. 3 Provincial Public Health Office of Pitsanulok, Thailand.

2 The Ab response in incomplete PET cases (1 - 3 injections) Subjectsn Day 0 Day 7 Day 14 Day 28 I. No previous rabies rabies vaccination vaccination 10<0.030.06(<0.03–0.2)7.13(1.15-58.8)6.44(1.8-20.7) II. 1-3 injections injections previously previously200.26(<0.03-22.0)6.73(1.1-80.5)38.91(16.7-248.4)23.86(6.7-175.6) All subjects received TRC-ID 2-2-2-0-1-1 (PVRV lot.no. L1012, potency 8.7 IU/0.5mL)

3 Pre-exposure vaccination Shorten time & reduce cost

4 Objective : To evaluate the immune memory of two abbreviated pre-exposure rabies vaccination schedules

5 Study 1 One week schedule ( 3 injections on day 0,3,7) Study 2 One clinic visit (Single dose)

6 One week schedule 0, 7,28 Gr.A ID ( 2 sites ) on day 0, 7,28 0, 3, 7 Gr.B ID ( 2 sites ) on day 0, 3, 7 0, 3, 7 Gr.C IM on day 0, 3, 7 PVRV potency 7.5 IU/0.5 mL

7 Booster : ID (2 sites) on day 0,3 1 year later One week schedule Blood collection : before booster (1 year), 7 and 14 days

8 GroupDay 360Day 367 Day 374 A. IDx2 Age 18-35 GMT 0.9629.1449.39 day 0,7,28 M/F 5/11 Range 0.32-2.95 6.7-227.813.1-308.4 (n=16 ) >0.5 IU/ml 81%100% B. IDx 2 Age 18-32 GMT 1.1222.99105.08 day 0,3,7 M/F 4/12Range 0.30-4.765.9-295.426.1-496.7 (n=16 ) >0.5 IU/ml 94%100% C. IM Age 18-40 GMT 0.9735.16125.0 day 0,3,7 M/F 8/12Range 0.27-4.7612.0-191.529.7-800.0 (n=20 ) >0.5 IU/ml 80%100% Booster : ID(2 sites) on day 0,3 1 year later

9 Previous vaccination regimenTimes (yrs) day0day7day14day28 PVRVID8 mths 0.0816.025.019.3 PVRVID 1 neg 1.118.26.7 PVRVID 20.185.016.711.8 PVRVID 31.1436.434.920.8 unknownIM4neg2.430.632.0 No previous vaccination TRC-ID 2-2-2-0-1-1 neg0.065.565.84 One injection for 1- 4 years ( at QSMI )

10 Conclusions: 3 injections on day 0,3,7 is as immunogenic as 3 injections on day 0,7,28 Provide at least 1 year of immune memory

11 Single dose for rabies pre-immunization ( one clinic visit )

12 Pre-immunization ID 0.1 ml (2 sites) on day 0 Single dose for rabies pre-immunization Booster ( 1 year later ) ID 0.1 ml ( 2 sites ) on day 0, 3 PVRV lot no 0525 potency 7.5 IU/0.5mL

13 Primary vaccination Day 360 ( Before booster ) Day 367 ( 7 days) Day 374 ( 14 days ) I. ID 0.1 ml (2sites) on day 0 booster ID 0.1ml (2 sites ) booster ID 0.1ml (2 sites ) day0,3 day0,3 >0.5 IU/ml 0.41 (0.06–3.7) 5/13 38% 9.15 (3.36-22.6) 10/10 100% 51.96 (13.6-141.4) 9/9 100% Single dose rabies pre-immunization

14 Primary vaccination Day 360 (Before booster) Day 367 ( 7 days) Day 374 ( 14 days) I. ID 0.1 ml (2sites) on day 0 0.41 (0.06–3.7) 5/13 38% 9.15 (3.36-22.6) 10/10 100% 51.96 (13.6-141.4) 9/9 100% II.TRC-ID 2-2-2-0-1-1 (PVRV) No previous rabies vaccination No previous rabies vaccination<0.030.06 (0.03 –0.15) 0%5.56 (1.15 - 53.8) 100% III.TRC-ID 2-2-2-0-1-1 (PCEC) No previous rabies vaccination No previous rabies vaccination<0.030.06 (<0.03– 0.3) 0%8.54 (1.56 – 27.3) 100% Single dose injection Single dose injection Single dose rabies pre-immunization

15 Conclusion: One clinic visit ( ID 0.1 ml (2 sites) one time) provide at least 1 year of immune memory

16 Pre-immunization vaccination ID 0.1 ml (1 site) on day 0 Booster ( 1 or 3 years later ) ID 0.1 ml ( 1 site ) on day 0, 3 PCEC Lot no 725 potency 7.25 IU/mL Single dose for rabies pre-immunization in Petchaboon province

17 Booster Booster : ID 0.1ml (1 site) on day 0,3 1 year later Subject no.Day 360Day 367Day 374 010320.073.696.59 010420.12.296.04 010490.0618.7421.51 010700.182.6222.15 01098neg5.009.72

18 Subject no. Day 360Day 367Day 374 030220.272.0920.57 030270.713.085.73 030500.134.184.42 030510.151.043.56 030590.461.685.98 030660.092.137.76 030820.071.0019.28 030930.21.0414.23 Booster Booster : ID 0.1ml (1 site) on day 0,3 3 years later

19 3 injections on day 0,3 and 7 One clinic visit ID 0.1 ml ( 2 sites) one time Provide immune memory at least 1 year or more Conclusions:

20 reliable booster vaccination long lasting ???? NEED FURTHER STUDIES Application for rabies pre-immunization

21 Thank you for your attention

22 Bite Prevention PET = 100% Preventions Exposed Pre-exposure vaccination Animal control


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