Immunogenicity of pre-exposure rabies vaccination comparing number of doses and routes of administration: A systematic review and meta-analyses
Bibliographic record
Abstract
INTRODUCTION: Human rabies is rare, though almost universally fatal. Rabies pre-exposure prophylaxis (PrEP) simplifies the post-exposure prophylaxis regimen and may offer some protection from unrecognized rabies exposures. Several different PrEP schedules are recommended by different jurisdictions. The objective of this review was to systematically analyze the impact of schedule and route of administration on immune responses to rabies vaccine in the short-term, long-term, and post-booster, specifically comparing one-, two-, and three-dose schedules, and intramuscular (IM) and 2-site intradermal (ID) routes of administration. METHODS: An existing systematic review was leveraged, and an updated search was conducted in three databases from inception to January 15, 2024. Meta-analyses of seroconversion (≥0.5 IU/mL) and geometric mean titres (GMTs) from direct comparison studies, studies which allowed comparisons of schedules within the same participants/groups of participants, and pooled data across study arms were conducted. RESULTS: Fifty-four studies met the eligibility criteria. Short-term, most participants who received two or three doses achieved titres ≥0.5 IU/mL regardless of route of administration; seroconversion and GMTs were significantly lower with one-dose schedules. Titres fell over time for all schedules with lower maintenance of seroconversion for two-dose IM schedules than three-dose IM schedules. Following the administration of booster doses, all schedules boosted to GMTs higher than after the primary series resulting in almost 100 % seroconversion, with the lowest seroconversion (98.7 %) for those who received a one 2-site ID dose for their primary vaccination. When comparing IM to 2-site ID administration of rabies vaccine, generally, no significant differences in seroconversion and limited differences in GMTs were observed. CONCLUSION: Two- and three-dose schedules had similar seroconversion regardless of route of administration in the short-term and after the booster, but two doses given IM resulted in lower maintenance of seroconversion in the long-term than three doses IM. Seroconversion was significantly reduced with a one-dose schedule in the short- and long-term. Immune responses to all schedules decreased over time, but almost all participants seroconverted following a booster dose. Responses between 2-site ID and IM administration were generally similar with only a few differences observed.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.038 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.037 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".