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{
    "pk": 13368,
    "title": "Rabies Vaccination Compliance and Reasons for Incompletion",
    "subtitle": null,
    "abstract": "Introduction:\n Rabies is a fatal disease with a 91% mortality rate in the United States. Current treatment of rabies consists of post-exposure prophylaxis treatment involving a complicated vaccination regimen. Studies conducted in other countries have found that patients do not complete their rabies vaccination treatment due to forgetting about their treatment, lack of time for visits, and the financial burden of treatment. However, little is known about why patients do not complete the rabies series in the US. The objective of this study was to determine the reasons why patients in the US do not complete rabies treatment.\nMethods:\n We performed a retrospective study to evaluate rabies post-exposure prophylaxis completion in the emergency department of an academic suburban hospital between June 2014–  July 2017. Further review was performed for patients who received inadequate vaccination to determine the cause of treatment incompletion. We conducted additional follow-up by phone survey for those patients who did not complete their rabies treatment but had no explanation for discontinuation available in the medical chart review.\nResults: \nResults indicated 198 patients received rabies post-exposure treatment during the inclusion period. Of these, 145 patients completed the rabies vaccination regimen. Reasons for treatment incompletion were found for 29 patients, and 24 patients were lost to follow-up. Of the 29 patients for which discontinuation was assessed, 23 patients (79.3%) stopped treatment due to appropriate reasons – either the animal involved tested negative for the rabies virus or the patient had prior rabies treatment and only required two booster shots. Reasons for not completing the series when medically indicated included the patient deciding to not return for treatment, lack of awareness of the full vaccination regimen, and the patient declining initiation of rabies vaccination.\nConclusion:\n Most patients in the US discontinue their rabies vaccination treatment for appropriate reasons; however, there is a proportion of patients who discontinue rabies vaccination when further treatment is medically indicated. This subset of patients is particularly at risk of rabies-related mortality, and additional measures need to be taken to ensure increased treatment compliance.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Rabies Vaccination"
        }
    ],
    "section": "Endemic Infections",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5x80w4z8",
    "frozenauthors": [
        {
            "first_name": "Tony",
            "middle_name": "",
            "last_name": "Shi",
            "name_suffix": "",
            "institution": "The Pennsylvania State University College of Medicine, Hershey, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Eleanor",
            "middle_name": "F.",
            "last_name": "Dunham",
            "name_suffix": "",
            "institution": "Penn State Milton S. Hershey Medical Center, Department of Emergency Medicine, Hershey, Pennsylvania",
            "department": "None"
        },
        {
            "first_name": "Jennifer",
            "middle_name": "E.",
            "last_name": "Nyland",
            "name_suffix": "",
            "institution": "The Pennsylvania State University College of Medicine, Department of Neural and Behavioral Sciences, Hershey, Pennsylvania",
            "department": "None"
        }
    ],
    "date_submitted": "2019-11-15T00:26:09Z",
    "date_accepted": "2019-11-15T00:26:09Z",
    "date_published": "2020-07-02T19:42:24Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13368/galley/7017/download/"
        }
    ]
}