The Early Kinetics of the Neutralizing Antibody Response after Booster Immunizations with Human Diploid Cell Rabies Vaccine

Daniel B. Fishbein Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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Kenneth W. Bernard Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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Kirk D. Miller Office of Medical Services, United States Peace Corps, Washington, DC

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Theresa van der Vlugt Office of Medical Services, United States Peace Corps, Washington, DC

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Caren E. Gaines Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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J. Thomas Bell College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi

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John W. Sumner Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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Frances L. Reid Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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Robert A. Parker Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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Joseph T. Horman Maryland State Department of Health and Mental Hygiene, Baltimore, Maryland

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Paul F. Pinsky Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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Lawrence B. Schonberger Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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George M. Baer Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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William G. Winkler Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control, U.S. Public Health Service, U.S. Department of Health and Human Services, Atlanta, Georgia

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DOI:
https://doi.org/10.4269/ajtmh.1986.35.663
Volume/Issue:
Volume 35: Issue 3
Page(s):
663–670
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Persons immunized in developing countries were recently shown to have low titers after pre-exposure immunization with human diploid cell rabies vaccine (HDCV). An investigation into the response to HDCV boosters was conducted to determine if immunologic sensitization had occurred and if there was a response difference in persons immunized in and outside of the United States. Intramuscular (im) booster doses of vaccine were administered to 113 persons previously immunized outside the United States and 47 persons immunized in the United States. The post-exposure booster regimen of a single 1.0-ml im booster, as recommended by the World Health Organization for all but the most severe bites, produced a one-dilution (5-fold) rise in antibody titer in 14 (11%) of 123 persons tested 5 days after booster and in 56 (89%) of 63 persons studied 7 days after booster. Persons immunized in the United States and those immunized outside the United States had similar responses. Persons with low pre-booster titers were more likely to exhibit a 5-fold rise in antibody titer 5 days after booster (P = 0.03) than persons with higher pre-booster titers. The post-exposure booster regimen of 2 1.0-ml im doses (one each on days 0 and 3), recommended in the United States, produced a more rapid response than the single booster regimen in only some persons; a 5-fold response occurred in 6 (50%) of 12 persons 5 days after booster. A 7-day delay between booster administration and the development of an acceptable antibody response in many persons brings into question part of the rationale of pre-exposure immunization and underscores the importance of prompt post-exposure therapy for all persons exposed to rabies.

Author Notes

Copyright:
Copyright © 1986 by The American Society of Tropical Medicine and Hygiene 1986
Accepted:
09 Dec 1985
|
Published Online:
May 1986
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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