5.4 Duration of immunity

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Cell Culture Embryonated Egg-based Vaccines (CCEEVs) establish immunological memory that is assumed to persist for the individual’s life, even after titers of neutralizing antibodies decrease or are no longer measurable. Clinical data confirm that vaccinated people respond to booster immunization within 7 days, even if the initial course of PrEP or PEP was administered decades previously and regardless of the route of priming or booster immunization (intramuscular or intradermal) and the presence or absence of detectable titers of RABV specific antibodies at the time of the booster. In addition, published data indicate that periodic booster doses of vaccine are not required after primary rabies vaccination, except as an additional precaution for people whose occupation puts them at continual or frequent risk of exposure. Nevertheless, according to the WHO definition of exposure, all vaccinated individuals subsequently exposed to rabies should receive an abbreviated course of PEP.