Antibody response to rabies pre-exposure vaccination among village health volunteers in a northern region of Thailand.

Background: Rabies is a lethal, however the disease is preventable through vaccination either before or immediately after an exposure. This study aimed to provide a pre-exposure prophylaxis rabies immunization to village health volunteers (VHV) who provide rabies vaccination for pets and free-roaming dogs in their villages and evaluate the antibody level and adverse effects after vaccination. We also assessed the knowledge related to rabies of these VHVs before field trip for pet vaccination.

Methods: This study was conducted at Mae Kha sub district, San Pa Tong district, Chiangmai, Thailand between January and March 2020. Consenting participants were interviewed using a questionnaire, received an intradermal two-dose, seven-day pre-exposure rabies vaccination, and sera were tested for anti-rabies antibody levels with the cost effective easy competitive enzyme-linked immunosorbent assay (CEE-cELISA) before and after vaccination.

Results: A total of 27 VHVs were recruited from 14 villages in Mae Kha sub district. All of them were male and had a median age of 61.5 years (interquartile range: 55-64). After vaccination, seroconversion rate was 92 % (23/25) with a median of 12.4 EU/mL (interquartile range: 8.9-20.1). Two participants who had rabies vaccination one year previously still had adequate levels before receiving a booster dose. All participants did not show any serious adverse reactions after vaccination.

Conclusion: A regimen of two-dose, seven-day vaccination series in high-risk health volunteers using an intradermal administration provides a high seroconversion rate, efficacy and safe for pre-exposure vaccination schedule. In addition, rabies-related knowledge should be provided to village health volunteers before their fieldwork.