Clinical Studies of Rabies Vaccines in India: A Review and Pooled Analysis of Immunogenicity and Safety Outcomes

DOI

https://www.doi.org/10.59256/ijrtmr.20260603007

Published In

Volume 6, Issue 3 (2026)

Published Online

May-June 2026

Pages

55-65

Article Type

Review Article

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Rabies remains one of the deadliest vaccine-preventable zoonoses, with near-universal fatality once clinical symptoms develop. India bears a disproportionate share of the global burden, contributing a substantial proportion of annual rabies deaths. Despite the availability of highly effective modern cell-culture rabies vaccines, gaps persist in post-exposure prophylaxis (PEP) delivery, pre-exposure prophylaxis (PrEP) uptake, and integration into national immunization efforts. Numerous clinical studies across India have evaluated purified chick embryo cell vaccines (PCECV), purified Vero cell rabies vaccines (PVRV), indigenous vaccines, intradermal (ID) regimens, and abbreviated schedules. This review synthesizes these investigations, focusing on pooled immunogenicity and safety outcomes and their public health relevance. Across studies, modern cell-culture vaccines consistently achieved high seroprotection rates, often approaching 100% by Day 14. Neutralizing antibody titers exceeded the accepted protective threshold of 0.5 IU/mL, with geometric mean titers typically ranging from 6 to 14.5 IU/mL across comparative trials, regardless of whether administered intramuscularly or intradermally. Safety profiles were uniformly favorable, with no vaccine-related deaths, fatal anaphylaxis, or rabies cases among individuals completing PEP. Overall, Indian evidence demonstrates that these vaccines are highly immunogenic and safe across routes and regimens. Intradermal schedules, including shortened protocols, offer comparable efficacy with added advantages of lower cost and operational feasibility in high-burden settings. Indigenous vaccines perform comparably to internationally marketed alternatives. These findings support expanded adoption of intradermal strategies and inform national and global rabies elimination efforts.