Summary
HDCS rabies vaccine has been used for nearly 10 years, since when 2.4 million doses have been commercialised. The general production and control rules for this vaccine are recalled, in particular, results of NIH activity tests and stability tests are reported for the 127 batches produced over the past 3 years.
About 10% of total production is used for pre-exposure vaccination, which should be recommended for high-risk subjects, as it significantly reduces the length and cost of any treatment following a rabid contact. The different pre-exposure vaccination schedules recommended in different countries are compared. Immunisation trials using reduced volumes of vaccine injected intradermally are reported and discussed.
Most HDCS vaccine production is presently used for post-exposure treatment. The treatment schedules used in different countries are at present very similar and recognised as being highly effective if treatment is started rapidly. The addition of a dose of antirabies hyperimmune gammaglobulin, associated with the first vaccine injection, constitutes the main difference between the different recommendations.
Résumé
Le vaccin rabique HDCS est utilisé depuis près de 10 ans; 2,4 millions de doses ont été mises sur le marché. Les règles générales de production et de contrôle de ce vaccin sont rappelées; en particulier les résultats du test d’activité NIH et du test de stabilité sont rapportés pour les 127 lots produits depuis 3 ans.
Environ 10% de la production totale sont utilisés pour la vaccination avant exposition qui doit être recommandée pour les sujets à risque, car elle réduit très significati-vement la longueur et le coût d’un éventuel traitement en cas de contact rabique. Les différents schémas de vaccination avant exposition recommandés dans différents pays sont comparés. Les essais d’immunisation utilisant des volumes réduits de vaccin injecté par la voie intradermique sont rapportés et commentés.
La majorité de la production de vaccin HDCS est actuellement utilisée pour le traitement après exposition. Les schémas de traitements utilisés dans différents pays sont actuellement très similaires et reconnus comme très efficaces si le traitement est entrepris rapidement.
L’addition d’une dose de gammaglobuline hyperimmune antirabique, associée à la première injection de vaccin, représente la différence principale entre les diverses recommandations.
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Roumiantzeff, M., Montagnon, B., Vincent-Falquet, J.C., Bussy, L., Charbonnier, C. (1985). Rapport sur l’Utilisation du Vaccin Rabique Préparé sur Culture de Cellules Diploides Humaines pour l’Immunisation avant et après Exposition. In: Kuwert, E., Mérieux, C., Koprowski, H., Bögel, K. (eds) Rabies in the Tropics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-70060-6_12
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