Immunogenicity and safety of WHO-approved TRC-ID regimen with a chromatographically purified Vero cell rabies vaccine with or without rabies immunoglobulin in children

ABSTRACT

Introduction: Children are at risk of rabies exposure in many Asian countries. The safety and immunogenicity profile of the WHO-approved two-site intradermal Thai Red Cross regimen (modified TRC-ID regimen; 2–2-2–0-2) with a new chromatographically purified Vero-cell rabies vaccine (CPRV) is lacking.

Area covered: We studied the safety and immunogenicity of the TRC-ID regimen with a new CPRV in non-immunized Thai children with possible or proven rabies exposure. Thirty-nine seronegative patients (age range 2–14 years) with rabies exposure (WHO categories II or III) received two 0.1-mL intradermal doses of CPRV at both deltoid regions on days 0, 3, 7, and 28. Twenty-five patients (64.1%) received rabies immunoglobulin due to having rabies exposure, according to WHO category III. All serum samples were tested for rabies neutralizing antibody (Nab) by the rapid fluorescent focus inhibition test (RFFIT) before vaccination, and on days 14 and 90 after vaccination. All patients had an adequate immune response (Nab titers ≥ 0.5 IU/mL) on days 14 and 90. No patients died of rabies infection. No serious adverse reactions were observed.

Expert commentary: CPRV is economic, safe, and immunogenic if given as the modified TRC-ID regimen in children.

KEYWORDS:

• Rabies
• rabies vaccination
• chromatographically purified Vero cell rabies vaccine
• children

Author contributions

Piyada Angsuwatcharakon, Sumana Khomvilai and Terapong Tantawichien were involved in conception and design, analysis and interpretation of the data, drafting the article, critical revision of the article for important intellectual content and final approval.

Piyada Angsuwatcharakon, Natchaya Ratananpinit, Apinya Khamchat and Teeranit Sanitnai were involved in patient recruitment and data collection.

Piyada Angsuwatcharakon, Sumana Khomvilai, Terapong Tantawichien, Kornvika Limsuwan, were involved in interpretation of the data, critical revision of the article for important intellectual content and final approval of the article.

Declaration of interest

T Tantawichien has received lectureship from Sanofi Pasteur, Pfizer, Merck and Bioent. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

The manuscript was funded by Liaoning Cheng Da Biotechnology Company of China.