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Principal Investigator: Ricardo Castillo Neyra
Organization: UNIVERSITY OF PENNSYLVANIA
Fiscal Year: 2024
Award: $633,891
Funding agency: National Institute of Allergy and Infectious Diseases
Spatially Responsive Mass Vaccination Campaigns for Urban Rabies
SUMMARY
Epidemics of vaccine-preventable zoonotic diseases are ongoing in major urban centers across Latin
America and worldwide. Mass vaccination campaigns can prevent and control epidemics of infectious
diseases among humans and animals. The realities of mass vaccination efforts, however, often fall short
of their promise. In place of high and even vaccination coverage, many campaigns leave spatial 'pockets'
of under-vaccinated individuals. Pathogens, taking advantage of these under-vaccinated areas, can
persist, diversify, and re-emerge. Modern computational approaches can mitigate geographic inequities
through the careful placement of vaccination sites, increasing demand for vaccination. However,
increased demand creates long queues for service, an additional barrier to receiving vaccination.
The main hypothesis of our study is that participation in mass vaccination campaigns can be
significantly increased through spatially responsive vaccination strategies. These strategies have the
potential to maximize coverage, reduce spatial heterogeneity, minimize waiting time at vaccination sites,
and increase equity in access to immunization in hard-to-reach populations. We test our methods in the
context of an ongoing canine rabies epidemic in the city of Arequipa, Peru.
In the first aim we compare the coverage and spatial equity of a new vaccination strategy,
incorporating spatial optimization and queueing theory, to current practice through a stepped-wedge
cluster randomized trial. In the second aim we develop and test data-driven methods to reach
underserved populations through mop-up “precision vaccination” campaigns. In the third aim we assess
the acceptability, scalability, and transferability of spatially responsive vaccination strategies for local,
regional, and national stakeholders.
Our work will lead to new principles and practices that bridge operational research and zoonotic
disease epidemiology to better guide vaccination programs. It will allow for the design of effective
elimination strategies that will take into account access to healthcare and spatial behavior of vaccinators.
Terms: <Acceleration><Acute><Adoption><Affect><Algorithms><Animals><Area><COVID-19 vaccination><Canine Species><Canis familiaris><Cities><Cluster randomization trial><Cluster randomized trial><Communicable Diseases><Complex><Data><Disease><Disorder><Dogs><Dogs Mammals><Ensure><Environment><Epidemic><Epidemiology><Equity><Evaluation><Exclusion><Geography><Goals><Health><Health Services><Health system><Heterogeneity><Hour><Human><Immunization><Immunization Programs><Improve Access><Inequity><Infectious Disease Pathway><Infectious Diseases><Infectious Disorder><Infrastructure><Interview><K01 Award><K01 Mechanism><K01 Program><Laboratories><Latin America><Location><Maintenance><Mass Vaccinations><Mentored Research Scientist Development Award><Mentored Training Award><Methods><Modeling><Modern Man><Modernization><Peru><Play><Population><Queuing Theory><Rabies><Rabies Human Diploid Cell Vaccine><Rabies Vaccines><Research><Research Resources><Research Scientist Development Award><Resources><Role><Running><SARS-CoV-2 vaccination><Scheme><Services><Severe acute respiratory syndrome coronavirus 2 vaccination><Site><Spatial Behavior><Supplementation><Sustainable Development><Testing><Time><Underserved Population><Update><Vaccinated><Vaccination><Vaccination Programs><Vaccinee><Vaccines><Wait Time><Work><Zoonoses><Zoonotic><Zoonotic Infection><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><canine><coronavirus disease 2019 vaccination><deliver vaccines><design><designing><domestic dog><effectiveness/implementation hybrid><epidemic containment><epidemic control><epidemic mitigation><epidemic response><epidemiologic><epidemiological><evaluation/testing><field based data><field learning><field study><field test><geographic disadvantage><geographic disparity><geographic inequality><geographic inequity><geographic location disparity><health care access><health care availability><health care service access><health care service availability><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><immunization strategy><implementation science><improved><intervention refinement><lyssa><pathogen><prevent><preventing><programs><rabies vaccination><rabies virus vaccination><social role><theories><under served group><under served individual><under served people><under served population><underserved group><underserved individual><underserved people><vaccinate against COVID-19><vaccinate against SARS-CoV-2><vaccinate against coronavirus disease 2019><vaccinate against severe acute respiratory syndrome coronavirus 2><vaccinated individual><vaccinated participant><vaccinated patient><vaccinated person><vaccinated subject><vaccination against COVID-19><vaccination against SARS-CoV-2><vaccination against Severe acute respiratory syndrome coronavirus 2><vaccination against coronavirus disease 2019><vaccination strategy><vaccine delivery>