Comparative Immunogenicity and Safety Trial of 2 Different Schedules of Single-visit Intradermal Rabies Postexposure Vaccination

Clin Infect Dis. 2019 Aug 16;69(5):797-804. doi: 10.1093/cid/ciy983.


Background: Effective and safe single-visit rabies vaccination for pre- and postexposure prophylaxis (PrEP and PEP) could substantially simplify rabies prevention and therefore increase compliance.

Methods: In a comparative trial, 303 healthy adults received a primary vaccination that consisted of 2 intradermal (ID) doses of 0.1 mL of the purified chicken embryo cell vaccine (PCEV) during a single visit. One year later, participants were randomly assigned to receive either 4 or 2 ID PEP booster doses of 0.1 mL PCEV during a single visit. The primary endpoint for immunogenicity was the percentage of participants with an adequate antibody level (>0.5 IU/mL) 7 days after the booster doses. The safety endpoint was the proportion of participants who developed adverse events (AEs) following primary and/or booster vaccination.

Results: All participants, except 1 (99.3%) in each study group, had a rabies antibody titer >0.5 IU/mL on day 7 following the booster schedules. Participants exposed to the 4-dose PEP schedule had a geometric mean titer of 20 IU/mL vs 14 IU/mL for the 2-dose PEP schedule (P = .0228). Local reactions at the injection site following PrEP and PEP were mild and transient and only seen in 14.9% and 49.6%-53% of the participants, respectively. No serious AEs were reported.

Conclusions: In healthy adults, a 2-dose (2 × 0.1 mL) single-visit ID PEP schedule was as immunologically adequate and safe as a 4-dose (4 × 0.1 mL) single-visit PEP schedule 7 to 28 months following a 2-dose (2 × 0.1 mL) single-visit ID PREP.

Clinical trials registration: EudraCT 2014-00183612.

Keywords: Rabies; intradermal; postexposure prophylaxis; pre-exposure prophylaxis; single-visit.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Neutralizing / immunology
  • Antibodies, Viral / immunology
  • Female
  • Humans
  • Immunization Schedule*
  • Immunization, Secondary
  • Injections, Intradermal
  • Injections, Intramuscular
  • Male
  • Post-Exposure Prophylaxis*
  • Rabies / prevention & control*
  • Rabies Vaccines / administration & dosage
  • Rabies Vaccines / immunology*
  • Vaccination / statistics & numerical data
  • Young Adult


  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Rabies Vaccines

Associated data

  • EudraCT/2014-00183612