To the editors,
Recently, I read a paper published with title “Analysis on the risks of severe adverse events in rabies post-exposure prophylaxis and appropriate decision-making procedure”. As stated in this paper, there was a two-year-old girl receiving post-exposure prophylaxis after being identified as category II exposure; she occurred AEs after the first vaccination with HDCV and the test showed she was allergic to kanamycin which existed in that batch of vaccine. Then, the doctor changed the vaccine to PVRV, which stated “without any residues”, and applied the corticosteroids in the remaining immunization procedure.
I feel the paper is incomplete. Considering these problems may affect the choice of vaccine for our vaccination unit, and furthermore, may influence the timely and exact handling of AEs, I think it is necessary to let the author address these questions.
I have four questions as follows:
In Page 2 lines 34&35 and lines 37&38, Page 4 lines 20–22 and lines 27&28. Test reports have been referred several times in these places, but without references, related links, or official materials attached. Meanwhile, I did not find any resource about the referred test reports from China officially in public channels. Please provide the specific resources and test reports of the referred HDCV and PVRV.
In Page 2 lines 37&38, Page 4 lines 25–27, and Page 5 lines 21–25. I feel “without any residues” is not appropriate; it indicates a strong direction for vaccine choice. The author has stated no antibiotics were added in the processing of scale cultivation. But, as far as I know, antibiotics need to be added in the cell thawing procedure, which has also been referred to in this paper. In my opinion, there are antibiotics residues in PVRV; the author should express that the antibiotics residues are less than a certain value instead of “without any residues”. So I think the expression is inconsistent.
In Page 5 lines 15&16. I think this opinion is not correct. In this paper, the author stated the strength is 1 mL and 0.5 mL for HDCV and PVRV, respectively. Although the potency is same, HDCV and PVRV are two different cell-matrix vaccines made from two manufacturers with different production processes. However, there is no specific residues data stated in the paper. It is hard to convince me that the small dosage would contain fewer residues.
In Page 6 lines 3–6. The paper stated this two-year-old patient received corticosteroids during PVRV vaccination, but no further discussion or evaluation mentioned the relation between AEs occurrence and drug combination. It just focused on the comparison of residues.
Sincerely,