Indian Journal of Community Medicine

LETTER TO EDITOR
Year
: 2012  |  Volume : 37  |  Issue : 2  |  Page : 136-

Different routes of administration of cell culture rabies vaccines


Sanjeev M Chaudhary 
 Department of Preventive and Social Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India

Correspondence Address:
Sanjeev M Chaudhary
Department of Preventive and Social Medicine, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra
India




How to cite this article:
Chaudhary SM. Different routes of administration of cell culture rabies vaccines.Indian J Community Med 2012;37:136-136


How to cite this URL:
Chaudhary SM. Different routes of administration of cell culture rabies vaccines. Indian J Community Med [serial online] 2012 [cited 2021 Apr 16 ];37:136-136
Available from: https://www.ijcm.org.in/text.asp?2012/37/2/136/96109


Full Text

Sir,

Kudos to the team of Asma Rahim for highlighting the economic advantages of using intradermal regimen in antirabies treatment in resource-starved countries like ours. [1] It is true that it also reduces the indirect cost involved in terms of man hour cost, travel time, and expenses for one extra visit in intramuscular regimen. I would like to highlight the problem faced by medical institutions while delivering antirabies prophylaxis services.

The Drug Controller General of India approved the use of intradermal route of administration of cell culture vaccines from February 2006. [2] But its use is still in infancy. ID regimen is being used in public health (primary and secondary care centers) while IM regimen is being used in medical institutions (tertiary care centers) for antirabies management in Maharashtra. At times the patient has to change the healthcare facility for continuation of ongoing treatment due to various reasons like stock not available at the center, shift of residence or other social causes. In such cases it is impractical to change the route of administration between an ongoing regimen. Hence a new schedule/regimen with different route of administration has to be started. This results in wastage of resources which are already scarce in government settings.

In a vast nation like India, health is a state issue. Thus, each state has its own policies. [3] The intradermal route for antirabies vaccination is followed in few states like Karnataka, Uttar Pradesh, and Orissa. For the proper prevention of the fatal disease, rabies, it is necessary that national guidelines should be put down to be followed alike by all states. Thus it is recommended that a similar line of treatment (the ID regimen) should be followed in all states, at all levels of healthcare delivery system, including private practitioners, all over India. This cost-effective intervention, which is expected to reduce the burden of human rabies in India, if coupled with suitable supportive canine population and rabies control activities, would make plausible the prospects of "Rabies Free India by 2020." [4]

References

1Rahim A, Kuppuswamy K, Thomas B, Raphael L. Intradermal cell culture rabies vaccine: A cost effective option in antirabies treatment. Indian J Community Med 2010;35:443-4.
2National guidelines for rabies prophylaxis and intradermal administration of cell culture rabies vaccine. NICD; 2007.
3Siddiqui MN. Intradermal rabies vaccination in Uttar Pradesh. Special Report. Available from: http://rabies.org.in/rabies-journal/rabies-09-1/SplReport2.htm [Last accessed on 2011 Sept 6].
4Sudarshan MK, Mahendra BJ, Ashwath Narayana DH. Introducing intra-dermal rabies vaccination in India: Rationale and action plan. Special article.Available from: http://rabies.org.in/rabies-journal/rabies-07/intradermal.htm [Last accessed on 2011 Sept 6].