Safety and immunogenicity of intradermal rabies vaccination for post exposure prophylaxis

Background: The affordability to anti-rabies vaccine (ARV) for intramuscular administration in post exposure prophylaxis (PEP) is a major constraint. Therefore, in countries, where there are financial constraints, WHO recommends intradermal rabies vaccination (IDRV) that reduces the quantity and cost of vaccination. The aim of the study was to evaluate the safety and immunogenicity of IDRV implemented under National pilot project. Methods: A longitudinal study was conducted at anti rabies clinic (Government referral hospital), India where IDRV is implemented. The study included 515 animal bite cases who received PEP as recommended by WHO. ARV was administered intradermally using updated Thai red-cross regimen. Results: The incidence of adverse drug events was 9.7% and all resolved without any complication. The geometric mean concentration of rabies virus neutralizing antibodies among the vaccinees was 11.89IU/mL on day 14, which was above the WHO recommended titers of ≥ 0.5IU/mL. Conclusions: IDRV was found to be safe and immunogenic in PEP.