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AAP backs revised rabies vaccine dose

The American Academy of Pediatrics has endorsed the CDC’s Advisory Committee on Immunization Practices recommendation to reduce, from five to four, the number of doses of human diploid cell vaccine or purified chick embryo cell vaccine required for post-exposure prophylaxis to prevent rabies in humans.

In a policy statement published online, the AAP’s Committee on Infectious Diseases recommended that the first dose should be given on day 0 of the post-exposure prophylaxis (PEP) series, then administered on days 3, 7 and 14 after the first vaccination.

Due to a shortage of rabies vaccine in 2007, the ACIP recommended a four-dose series, and from that experience, the ACIP’s working group on rabies recommended shortening the regimen. In its statement, the AAP’s committee backs the work group’s recommendation to continue the five-dose regimen in those who are immunocompromised.

The statement authors wrote that use of the reduced-dose schedule could result in a $16 million savings, based on preliminary economic studies.

Worldwide, approximately 55,000 people die of rabies every year, and nearly half are children.

Disclosure: The study researchers report no relevant financial disclosures.

For more information:

• Committee on Infectious Diseases. Pediatrics. 2011;doi:10.1542/peds.2011-009.
• CDC. MMWR 2010;59(No. RR-#2):1-10.

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