New human rabies vaccines in the pipeline

• Published in: Vaccine 2019-10, Vol.37 (Suppl 1), p.A140-A145
• Main Authors: Fooks, Anthony R., Banyard, Ashley C., Ertl, Hildegund C.J.
• Format: Article
• Language: English
• Subjects: Bats; Clinical Trials as Topic; Combined vaccines; Correlates of protection; Disease transmission; Dogs; Drug Development - trends; Drug Discovery - trends; Drug Evaluation, Preclinical; Exposure; Fatalities; Globulins; Health care access; Humans; Immunization; Immunogenicity; Immunoglobulins; Lyssavirus; Post-exposure prophylaxis (PEP); Post-Exposure Prophylaxis - methods; Pre-exposure prophylaxis (or PrEP); Pre-Exposure Prophylaxis - methods; Rabies; Rabies - prevention & control; Rabies immune globulin (RIG); Rabies Vaccines - immunology; Rabies Vaccines - isolation & purification; Surveillance; Vaccines; Viruses
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2018.08.039

Rabies remains endemic in more than 150 countries. In 99% of human cases, rabies virus is transmitted by dogs. The disease, which is nearly always fatal, is preventable by vaccines given either before and/or after exposure to a rabid animal. Numerous factors including the high cost of vaccines, the relative complexity of post-exposure vaccination protocols requiring multiple doses of vaccine, which in cases of severe exposure have to be combined with a rabies immune globulin, lack of access to health care, and insufficient surveillance contribute to the estimated 59,000 human deaths caused by rabies each year. New, less expensive and more immunogenic rabies vaccines are needed together with improved surveillance and dog rabies control to reduce the death toll of human rabies. Here, we discuss new rabies vaccines that are in clinical and pre-clinical testing and evaluate their potential to replace current vaccines.