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Rabies Antibody Response After Booster Immunization: A Systematic Review and Meta-analysis

Langedijk, A. C. and De Pijper, C. A. and Spijker, R. and Holman, R. and Grobusch, M. P. and Stijnis, C.

Clin Infect Dis (2018) 67: 1932–1947

DOI: 10.1093/cid/ciy420

Abstract

Although fatal once symptomatic, rabies is preventable by administration of pre- and post-exposure vaccines. International guidelines suggest lifelong protection by a pre-exposure vaccination scheme followed by timely post-exposure vaccines. Rapidity and magnitude of the antibody recall response after booster inoculation are essential, as many people have been previously immunized a long time ago. The objective of this study was therefore to systematically review the evidence on the boostability of rabies immunization to date. We included 36 studies, of which 19 studies were suitable for meta-analysis. Reduced antibody levels were found after intradermal primary schedules as compared to intramuscular schedules. However, responses after booster immunization were adequate for both routes. Although studies showed that antibody levels decline over time, adequate booster responses were still retained over long time intervals indicating that post-exposure treatment is effective without extra measures after long periods of time.

Citation

Langedijk, A. C., De Pijper, C. A., Spijker, R., Holman, R., Grobusch, M. P., & Stijnis, C. (2018). Rabies Antibody Response After Booster Immunization: A Systematic Review and Meta-analysis. Clin Infect Dis, 67(12), 1932–1947. https://doi.org/10.1093/cid/ciy420 Humans, Injections, Intramuscular, Immunologic Factors, Injections, Intradermal, *Post-Exposure Prophylaxis, Antibodies, Viral/*blood, *Immunization, Secondary, Immunization Schedule, Rabies Vaccines/administration & dosage/*immunology, Rabies/*immunology/*prevention & control

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