Safety of Intradermal Rabies Vaccination as Pre Exposure Prophylaxis

Abstract

Need for the study: WHO recommends pre exposure prophylaxis in rabies endemic countries for all individuals who are at increased risk of exposure to rabies such as veterinarians, rag-pickers, animal handlers, rabies researchers/laboratory workers, International travellers and children. Objectives: To assess the safety of rabies vaccine administered intradermally as pre-exposure prophylaxis among 3 high risk groups viz., children, rag-pickers and veterinarians. Methods: All the subjects who volunteered from each of the 3 risk groups were taken for the study and were given purified chick embryo cell rabies vaccine having a potency of >2.5 IU per dose, intradermally as pre exposure prophylaxis on days 0, 7 and 21. Subsequently, all were followed up to assess the safety of intradermal rabies vaccination by recording the adverse drug reactions from the day of administration of first dose of vaccination upto 2 weeks after the last dose of vaccination. Results: The present study included 150 children, 225 rag-pickers and 122 veterinary students. The adverse drug reactions to rabies vaccination among these groups were 5.1%, 5.0% and 10.4% respectively which were mild in nature and subsided spontaneously or by taking symptomatic treatment and none of the subjects dropped out because of adverse drug reactions. Conclusion: Pre exposure prophylaxis against rabies by intradermal route is safe and well tolerated by high risk groups, which may be considered as a strategy for eliminating the disease by 2030.