Pre-exposure rabies vaccination: strategies and cost-minimization study

Citation
C. Strady et al., Pre-exposure rabies vaccination: strategies and cost-minimization study, VACCINE, 19(11-12), 2001, pp. 1416-1424
Citations number
24
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Veterinary Medicine/Animal Health",Immunology
Journal title
VACCINE
ISSN journal
0264-410X → ACNP
Volume
19
Issue
11-12
Year of publication
2001
Pages
1416 - 1424
Database
ISI
SICI code
0264-410X(20010108)19:11-12<1416:PRVSAC>2.0.ZU;2-5
Abstract
An alternative strategy for pre-exposure rabies vaccination to the institut ional recommendations of the World Health Organization and the Centers for Disease Control and Prevention is proposed based on recent long-term follow -up of post-vaccinal seroconversion rates. The alternative strategy uses th e same primary series (i.e. vaccination in the deltoid area on D0, D7, and D28), but is completed by a scheduled booster vaccination at D365. The freq uency of recommended subsequent booster injections depends on the serologic al test results obtained by a RFFIT on D379 and 3 years later. The objectiv e of this study was to compare the efficiency of the two pre-exposure strat egies. A cost-minimization analysis was carried out to compare the two rabi es pre-exposure vaccination and serological test strategies based on the da ta from two published studies on the long-term evolution of the immunity ac hieved using the different recommendations. For a theoretically equivalent immunogenicity, the cost of the alternative strategy ranged from 1.7 to 5.2 times lower than that of the institutional recommendations. A sensitivity analysis confirmed the robustness of the results. The alternative strategy should be validated externally under field conditions. This approach would compare its real efficiency to the institutional recommendations. (C) 2001 Elsevier Science Ltd. All rights reserved.