Do you need to check antibodies after the whole rabies vaccine?

Antibodies generally refer to specific protective antibodies or neutralizing antibodies produced by the human body after infection with a certain pathogen or vaccination. Specificity is only protective against a specific pathogen, such as hepatitis B vaccination to produce protective antibodies, which generally only work for hepatitis B virus and will not work for influenza virus or other pathogens.

The role of antibodies is not to eliminate pathogens, they recognize and can be combined with the pathogen and its products, can neutralize toxins, blocking the invasion of pathogens. After the antibody binds to the antigen, it prevents the pathogen from attaching and binding to the host cell, and can mobilize the immune cells to clear the pathogen by activating the immune system.

Rabies vaccine is to retain the form of the rabies virus after inactivation, which is not harmful to the human body while retaining the characteristics of the antigen. After vaccination with rabies vaccine, the human body will produce specific antibodies. When there is rabies virus in the body, the antibodies will neutralize the virus in time and finally remove it to protect the human body from rabies virus infection.

Since the mortality rate of rabies is close to 100 percent, people exposed to rabies are often very nervous and afraid of not producing antibodies after vaccination. Some people will ask whether antibody testing is necessary after vaccination, and others will be vaccinated repeatedly. Is antibody testing necessary after rabies vaccination? How long can antibodies last?

Since the Pasteur era, the production technology of rabies vaccine has undergone several generations of updates. We are now using rabies vaccine (Cell Culture and Embryonated Egg-based Rabies Vaccines,CCEEVs) produced by modern cell and tissue embryo culture, with stable quality and high titer. After rabies exposure occurs, vaccination can be carried out according to two procedures, namely, the "2-1-1" procedure (one dose is inoculated on the left and right upper arm deltoids on day 0, and one dose is inoculated on days 7 and 21 respectively) and the 5-needle method (one dose is inoculated on days 0, 3, 7, 14 and 28 respectively), I .e. 4 or 5 doses are inoculated intensively to ensure rapid antibody production by the human body. Clinical trials at home and abroad have shown that both the "2-1-1" procedure or the 5-injection method of rabies vaccine can produce 100 positive antibody in 14 days, that is to say, after the first 3 injections, the recipients can basically produce antibodies. After the whole immunization, the vast majority of recipients can effectively produce protection, there is no need to worry about whether to produce an immune response, that is, there is no need to detect antibodies.

After immunization, it has good immune persistence and immune memory. Most people can still maintain antibody positive one year after vaccination. After strengthening, the antibody level increases rapidly and can be maintained for a long time.

For some patients with immune system defects (such as AIDS patients with obvious clinical symptoms, etc.), the immune function is impaired and cannot produce an effective immune response. Such people can test antibodies after the whole immunization, and the blood collection time is generally recommended as the last one. The needle will take another 14 days, and depending on whether the test is strengthened.

At present, the internationally recommended detection method of rabies serum neutralizing antibody is mouse brain neutralization test or rapid Fluorescent focus Inhibition test (RFFIT), while other detection methods are not recommended, especially the rapid kit method, with a certain proportion of false negative and false positive. It is generally believed that the serum antibody ≥ 0.5IU/ml is positive. According to clinical experience, there is almost no report of the disease after the whole process of standardized treatment, which also confirms that rabies is preventable and incurable.

The fear of rabies in some phobia patients affects their normal work and life. The detection of antibodies can help them relieve their psychological pressure, but they should not form dependence. They should learn more about rabies and vaccines, and deal with rabies objectively and scientifically.

References:

1. Chinese Center for Disease Control and Prevention. Technical guide for rabies prevention and control. 2016.1.

2. Yu Yongxin, etc. Rabies and rabies vaccine [M]. China Medical Science and Technology Press. 2009.1.

3. Ministry of Health. Rabies exposure prevention and disposal work specification [Z]. 2009.12.21.