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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.37 no.4 São Paulo July/Aug. 1995

http://dx.doi.org/10.1590/S0036-46651995000400012 

VACCINE STUDIES

 

Studies on human anti-rabies immunization in Brazil. II - Preliminary evaluation of the 2-1-1 schedule for human pre-exposure anti-rabies immunization, employing suckling mouse brain vaccine

 

Estudos sobre imunização anti-rábica humana no Brasil. II - Avaliação preliminar do esquema 2-1-1 para imunização anti-rábica humana pré-exposição, empregando vacina de tecido nervoso de camundongos recém-nascidos

 

 

Carlos Roberto ZanettiI; Luiza Marny LeeI; Luciana Botelho ChavesI; José Luiz RodriguesII; Gilton C. EleutérioII; Octavio Augusto de C. PereiraI

IInstituto Pasteur - São Paulo, SP, Brazil
IILaboratório Biovet S.A.

Correspondence to

 

 


SUMMARY

This study reports preliminary results of virus neutralizing antibody (VNA) titers obtained on different days in the course of human anti-rabies immunization with the 2-1-1 schedule (one dose is given in the right arm and one dose in the left arm at day 0, and one dose is apllied on days 7 and 21), recommended by WHO for post-exposure treatment with cell culture vaccines. A variant schedule (double dose on day zero and another on day 14) was also tested, both employing suckling mouse brain vaccine. A complete seroconversion rate was obtained after only 3 vaccine doses, and almost all patients (11 of 12) presented titers higher than 1.0 IU/ml. Both neutralizing response and seroconversion rates were lower in the group receiving only 3 doses, regardless of the sample collecting day. Although our results are lower than those found with cell culture vaccines, the geometry mean of VNA is fully satisfactory, overcoming the lower limit recommended by WHO of 0.5 IU/ml. The 2-1-1 schedule could be an alternative one for pre exposure immunization, shorter than the classical 3+1 regimen (one dose on days 0, 2, 4 and 30) with only three visits to the doctor, instead of four.

Keywords: Rabies; Human pre-exposure vaccination; 2-1-1 schedule; Mouse brain vaccine.


RESUMO

Este estudo apresenta resultados preliminares de títulos de anticorpos neutralizantes (AcN) obtidos em diferentes dias durante imunização anti-rábica humana empregando o esquema 2-1-1 (uma dose administrada em cada deltóide no dia 0, e uma dose nos dias 7 e 21), recomendado pela OMS para tratamento pós-exposição com vacinas de cultivo celular. Um esquema variante (dose dupla no dia zero e outra no dia 14) também foi testado; em ambos esquemas utilizamos a vacina produzida em cérebro de camundongos recém-nascidos. Obteve-se taxa de soroconversão total após 3 doses de vacina, e quase todos os pacientes (11 de 12) apresentaram títulos maiores que 1,0 UI/ml. Tanto os títulos de anticorpos neutralizantes como a taxa de soroconversão foram menores no grupo que recebeu apenas 3 doses, independentemente do dia da coleta de soro. Embora nossos resultados tenham sido inferiores àqueles encontrados com vacinas de cultivo celular, a média geométrica de AcN foi inteiramente satisfatória, sobrepondo o limite mínimo de 0,5 UI/ml recomendado pela OMS. O esquema 2-1-1 pode ser alternativa para tratamento pré-exposição: mais curto que o esquema clássico 3 + 1 (uma dose nos dias 0, 2, 4 e 30) e com apenas três idas ao médico, ao invés de quatro.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

ACKNOWLEDGEMENTS

The authors gratefully acknowledge Mrs. Dolores Ayako Yoda for technical assistence.

 

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Correspondence to:
Carlos Roberto Zanetti (PhD)
Instituto Pasteur
Av. Paulista, 393
01311-000 São Paulo, SP, Brazil
FAX: 55.11.289-0831

Recebido para publicação em 06/02/1995
Aceito para publicação em 06/04/1995

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