Preventative childhood vaccination to rabies.

INTRODUCTION: Rabies is prevented by post-exposure vaccination with several doses of vaccine given over 4 - 14 weeks. In case of severe exposure, the first dose of vaccine is combined with passive transfer of a rabies virus-specific immunoglobulin preparation. Preventative vaccination for rabies, also referred as pre-exposure vaccination, is reserved for humans at high risk. Although available vaccines are efficacious in preventing disease, rabies still claims the lives of an estimated 55,000 humans residing in Africa and Asia each year. Half of the death occurs in children under the age of 15.

AREAS COVERED: This paper discusses whether preventative vaccination of all children in Africa and Asia, which was deemed non-cost-effective compared to post-exposure vaccination using currently licensed vaccines in Thailand, could be cost-effective using more immunogenic novel vaccines.

EXPERT OPINION: At least in theory, novel one-dose rabies vaccines may be cost-effective for preventative childhood immunization, which in turn should reduce the incidence of this disease. Further clinical testing of such vaccines with the goal to develop a low-cost vaccine that can be incorporated into childhood immunization programs for areas with a high incidence of rabies-related death should be strongly encouraged.