The Status of Rabies Post Exposure Prophylaxis Using Nerve Tissue Anti-Rabies Vaccine in Ethiopia

The use of anti-rabies vaccine as post-exposure prophylaxis started during the year 1885 and play significant role in preventing rabies cases in humans. Since then, anti-rabies vaccines have undergone several developments in terms of safety and efficacy. Ethiopia has been producing nerve tissue anti-rabies vaccine since 1960s for post exposure prophylaxis. Such type of vaccine was discouraged by WHO due to its low immunogenicity and sever nerve complication. During the last years, anti-rabies vaccine needs increasing from time to time due to the lack of effective rabies prevention and control measures. Although nerve tissue vaccine production capacity increased significantly, still demand has not met. According to WHO report, from 0.14 to 7 out of 1000 people received this nerve tissue vaccine has the probability to develop vaccine associated complications. This study reveals that during the last seven years of NTV production and distribution (213,856 doses), few vaccines associated complications reported to EPHI or recorded at health facilities with only minor local reaction (8.72%). In other cases, health professionals informally report severe nerve complications in some patients following vaccination. This indicates documentation problem at health facilities during full course of vaccination, making difficult to show exact vaccine related complication. The other problems identified during supportive supervision were vaccine shortage, health professionals’ knowledge gap in rabies case screening, vaccination dose/site of inoculation and inappropriate vaccine handling and transportation. To overcome such problems, it is recommended to give emphasis to current vaccine production technology transfer and avail cell culture anti-rabies vaccine for accessible, safe and effective post exposure prophylaxis. In addition, comprehensive training should be provided for health professionals in the area of vaccine handling and storage, rabies case screening and vaccination. Keywords Health facilities; Nerve tissue vaccine; Rabies; Vaccine distribution; Vaccine associated complications