Establishing humoral immunity to rabies in a person with multiple sclerosis through booster vaccination: A case report

It is known that certain disease-modifying therapies for multiple sclerosis impair humoral immunity; however, data on the effect of therapies on humoral immunity with human diploid cell rabies vaccine is limited. Here we present a case of a 31-year-old male with multiple sclerosis on ofatumumab who had a bat of unknown rabies status fly into his hand. Despite completing the standard rabies vaccination series per the World Health Organization recommendations, he did not establish humoral immunity until he received two additional booster vaccinations. This case highlights novel aspects of humoral immunity to rabies in a person taking ofatumumab.