Studies of antirabies immunization of man Fox, John P.; Koprowski, Hilary; Conwell, Donald P. ...
Bulletin of the World Health Organization,
01/1957, Letnik:
17, Številka:
6
Journal Article
Recenzirano
Detailed results are presented of primary immunizations of 387 persons with various courses of HEP Flury vaccine and of 54 persons with Harris- or Semple-type vaccines. Antibody response to HEP Flury ...vaccine was at least as rapid as that to the conventional type, but fell short in uniformity and level of response. The most promising course involved a 4-dose schedule, intradermal alone or combined with intramuscular, at 5-day intervals. A similar subcutaneous course of Semple vaccine yielded results completely equivalent to those of a 14-dose course of Harris vaccine. It is concluded that, although living, the HEP Flury virus does not multiply in man and that its lesser antigenic potency, as compared with Semple or Harris vaccines, is due to its relatively small content of viral antigen.
Further evidence has been obtained that hyperimmune serum may exert a slight suppressive effect on active response, but the opinion is expressed that, with vaccines of full potency, this will not be of practical significance.
Restimulation of immunity by a booster dose of HEP Flury vaccine was studied in 64 experimentally immunized persons and in 136 persons with history of previous Pasteur treatment. In both instances small intradermal inocula were as effective as larger intramuscular inocula in recalling pre-existing immunity.
Study of recipients of Pasteur treatment indicated that antibody commonly persists for at least 5 years after a single course and for 15 or more years after re-treatment. It was also observed that the ability to respond to a booster of HEP Flury vaccine persists for at least 25 years. The response elicited by the booster is prompt and is usually at least equal to that resulting from a full primary course. The suggested conclusion is that previously treated persons need not receive more than a single booster on re-exposure, and that Pasteur treatment provides a solid basis for long-sustained immunity.
Further studies were made on groups of adult humans, previously unexposed to rabies and with no history of rabies vaccination, who were inoculated with different schedules of phenolized inactivated ...vaccine given subcutaneously and high egg passage (HEP) Flury strain vaccine given intradermally, with and without inoculation of antirabies serum. Serum specimens of the inoculated individuals were studied for antibody up to the 60th day after the first inoculation of the vaccines and serum. Studies were also made on the effect of “booster” doses of HEP Flury strain vaccine given 6 months after preparatory inoculations. The results can be summarized as follows:
1. Fourteen daily inoculations of phenolized vaccine produced a superior antibody response to that obtained with 3 inoculations given 5 days apart.
2. Three intradermal inoculations of HEP Flury vaccine given 5 days apart gave a low level of antibody response, but these individuals responded efficiently by producing antibody to a “booster” dose of the same vaccine given 6 months later.
3. Administration of phenolized vaccine or of HEP Flury vaccine alone did not produce detectable antibody in most individuals until between the 10th and the 15th day after the first inoculation of the vaccine.
4. Passive antibody following inoculation of antirabies serum persisted in some individuals for as long as 42 days. Two inoculations of serum administered 5 days apart did not give levels of antibody higher than those obtained with one inoculation.
5. One inoculation of serum completely suppressed antibody response to 3 inoculations of Flury vaccine given intradermally 5 days apart, and also prevented the preparation of the individuals to respond to a later “booster” dose of this vaccine.
6. Three inoculation of phenolized vaccine given 5 days apart acted efficiently in producing antibody by the 60th day. However, the interfering action of one and two inoculations of serum was clearly defined in this schedule.
7. One inoculation of serum had no suppressive effect on the active antibody response to 14 daily doses of phenolized vaccine; two doses of serum given in the same combination definitely interfered with the production of an active antibody response.
This study is the third in a series on virus-neutralizing antibody response to different schedules of antirabies serum and vaccines in previously non-exposed persons. Three types of vaccine were ...studied—phenolized (Semple), duck embryo and high-egg-passage (HEP) chicken embryo. Reduced schedules of vaccine, consisting of 2-7 inoculations given at various intervals, did not give results comparable in efficacy (time of appearance, level and persistence of antibody) with schedules comprising at least 14 daily inoculations of vaccine as determined in previous trials. The effectiveness of a booster dose in previously sensitized individuals was confirmed with a demonstration that a rise in serum antibody appears between 4 and 8 days after the booster inoculation. Effective sensitization appears to be as much a function of spacing of inoculations as of total dosage of vaccine antigen. Interference by immune serum with the antigenicity of subsequently administered vaccine, noted previously by the present authors and by other workers, was again confirmed. This interference could be overcome by the administration of a sufficient amount of vaccine.
