Immunogenicity and Safety of Post-Exposure Rabies Vaccination in Children with Primary Immunodeficiency Disorders

Patients with primary immunodeficiency disorders(PIDs) are at risk when expose to rabies since they may have poor antibody responses to rabies vaccination. Our study aimed to evaluate the rabies neutralizing antibody responses (Nab) and safety of rabies vaccine for post-exposure treatment in PID patients after 6 months of vaccination. We evaluated Nab to purified Vero cell rabies vaccine(Verorab®) in PID patients, compared to age and sex-matched controls. All subjects received five doses standard intramuscular regimen of rabies vaccine. Serum rabies Nab titers were measured by the rapid fluorescent focus inhibition test before vaccination and at day14,28,90,180 after vaccination. An acceptable protective level is >0.5 IU/ml. Thirteen PID patients and 13 healthy children were included. After vaccination, the Nab titers were significantly lower in PID patients than controls at all time points(day 14:GMT=0.56 vs 7.39,day28:GMT=0.93 vs 10.17,day90:GMT=0.48 vs 3.99, day180:GMT= 0.14 vs 1.54 IU/ml),p