PMID- 30299219
OWN - NLM
STAT- MEDLINE
DCOM- 20200303
LR  - 20200303
IS  - 2164-554X (Electronic)
IS  - 2164-5515 (Print)
IS  - 2164-5515 (Linking)
VI  - 15
IP  - 9
DP  - 2019
TI  - Analysis on the risks of severe adverse events in rabies post-exposure 
      prophylaxis and appropriate decision-making procedure.
PG  - 2121-2125
LID - 10.1080/21645515.2018.1533779 [doi]
AB  - Severe adverse events (AEs) following post-exposure rabies vaccination had been 
      occasionally described in previous studies. Once AEs occurred, immediate medical 
      treatment and appropriate change of vaccine and vaccination schedule were of 
      significance. It was also important and challengeable to determine the 
      relationship among adverse reactions, vaccines residues and laboratory tests for 
      patients, to choose a proper vaccine in resumed vaccination, to avoid the 
      reoccurrence of AEs and to ensure adequate immune response. Here, we present 
      steps about how to cope with AEs by giving an example with a two-year-old girl 
      who was identified as category II exposure to rabies, suffered from anaphylaxis 
      after first dose administration with human diploid rabies vaccine (HDCV) so 
      vaccination was temporarily suspended. Dexamethasone was prescribed to her in 
      anti-allergy therapy. Allergy tests indicated that the patient was not sensitive 
      to allergens and heterologous proteins. Vaccine test report showed that residual 
      kanamycin existed in that batch of vaccines. This reminded us to provide her 
      antibiotic skin sensitivity test which found she was allergic to kanamycin. Thus, 
      we could conclude it was the cause of AEs. Then, 0.5 mL lyophilized Purified Vero 
      Cell Rabies Vaccine (PVRV) without any residues was enrolled in the resumed 
      vaccination. To ensure successful immunization, immunogenicity test was also 
      provided which showed adequate immune response (RVNA >/= 0.5 IU/mL) starting from 
      day14. Besides, no further AEs occurred afterward. This study emphasized the 
      importance of in-depth survey, analysis and implied the necessity to 
      scientifically and properly choose the optimal vaccine for patients and 
      appropriately provide treatments if AEs occurred.
FAU - Huang, Shichun
AU  - Huang S
AUID- ORCID: 0000-0001-6733-0360
AD  - School of Health Sciences, Wuhan University , Wuhan , China.
FAU - Zhu, Zhenggang
AU  - Zhu Z
AD  - Department of Immunization, Wuhan Center for Disease Prevention and Control , 
      Wuhan , China.
FAU - Cai, Li
AU  - Cai L
AD  - Institute of Infectious Disease, Wuhan Center for Disease Prevention and Control 
      , Wuhan , China.
FAU - Zhu, Zerong
AU  - Zhu Z
AD  - Pathogen Biology Laboratory, Wuhan Center for Disease Prevention and Control , 
      Wuhan , China.
FAU - Zhang, Man
AU  - Zhang M
AD  - Department of Immunization, Wuhan Center for Disease Prevention and Control , 
      Wuhan , China.
FAU - Hu, Quan
AU  - Hu Q
AD  - Department of Leprosy, Wuhan Institute of Dermatology and Venereology , Wuhan , 
      China.
FAU - Fang, Yuan
AU  - Fang Y
AD  - Department of Neurology, Union Hospital, Tongji Medical College, Huazhong 
      University of Science and Technology , Wuhan , China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20181026
PL  - United States
TA  - Hum Vaccin Immunother
JT  - Human vaccines & immunotherapeutics
JID - 101572652
RN  - 0 (Anti-Allergic Agents)
RN  - 0 (Antibodies, Neutralizing)
RN  - 0 (Antibodies, Viral)
RN  - 0 (RNA, Viral)
RN  - 0 (Rabies Vaccines)
SB  - IM
CIN - Hum Vaccin Immunother. 2019;15(9):2126. PMID: 30892986
MH  - Anti-Allergic Agents
MH  - Antibodies, Neutralizing/blood
MH  - Antibodies, Viral/blood
MH  - Child, Preschool
MH  - *Decision Making
MH  - Female
MH  - Humans
MH  - *Hypersensitivity
MH  - Immunization/adverse effects
MH  - Immunization Schedule
MH  - Post-Exposure Prophylaxis/*standards/statistics & numerical data
MH  - RNA, Viral/blood
MH  - Rabies/*prevention & control
MH  - Rabies Vaccines/*adverse effects
MH  - Rabies virus/immunology
PMC - PMC6773398
OTO - NOTNLM
OT  - anaphylaxis
OT  - cortisol hormone
OT  - immune response
OT  - rabies vaccines
OT  - resumed vaccination
OT  - safety
OT  - vaccine selection
OT  - vaccines residuals
EDAT- 2018/10/10 06:00
MHDA- 2020/03/04 06:00
PMCR- 2019/10/26
CRDT- 2018/10/10 06:00
PHST- 2018/10/10 06:00 [pubmed]
PHST- 2020/03/04 06:00 [medline]
PHST- 2018/10/10 06:00 [entrez]
PHST- 2019/10/26 00:00 [pmc-release]
AID - 1533779 [pii]
AID - 10.1080/21645515.2018.1533779 [doi]
PST - ppublish
SO  - Hum Vaccin Immunother. 2019;15(9):2121-2125. doi: 10.1080/21645515.2018.1533779. 
      Epub 2018 Oct 26.