Spatially responsive mass vaccination strategies for urban rabies

城市狂犬病的空间响应大规模疫苗接种策略

• 批准号: 10606567
• 负责人: Ricardo Castillo Neyra
• 金额: $ 63.36万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-08 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606567
• 关键词: Acceleration; Acute; Adoption; Affect; Algorithms; Animals; Area; COVID-19 vaccination; Canis familiaris; Cities; Cluster randomized trial; Communicable Diseases; Complex; Data; Disease; Ensure; Environment; Epidemic; Epidemiology; Equity; Evaluation; Exclusion; Geography; Goals; Health; Health Services; Health Status; Health system; Heterogeneity; Hour; Human; Immunization; Immunization Programs; Improve Access; Inequity; Infrastructure; Interview; Laboratories; Latin America; Location; Maintenance; Mass Vaccinations; Mentored Research Scientist Development Award; Methods; Modeling; Modernization; Peru; Play; Population; Queuing Theory; Rabies; Research; Resources; Role; Running; Scheme; Services; Site; Spatial Behavior; Supplementation; Sustainable Development; Testing; Time; Underserved Population; Update; Vaccinated; Vaccination; Vaccinee; Vaccines; Wait Time; Work; Zoonoses; design; effectiveness/implementation hybrid; epidemic response; evaluation/testing; falls; field study; geographic disparity; health care availability; implementation science; improved; intervention refinement; pathogen; prevent; programs; theories; vaccination strategy; vaccine delivery

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.

针对城市狂犬病的空间响应大规模疫苗接种运动 总结 疫苗可预防的人畜共患病的流行正在拉丁美洲的主要城市中心持续 美国和全世界。大规模疫苗接种运动可以预防和控制传染病的流行 人类和动物的疾病。然而，大规模疫苗接种工作的现实往往不足 他们的承诺。许多运动留下了空间“口袋”， 疫苗接种不足的人。病原体利用这些疫苗接种不足的地区， 坚持，多样化，重新出现。现代计算方法可以减轻地理不平等 通过精心布置疫苗接种点，增加疫苗接种需求。然而，在这方面， 需求的增加造成了排长队的服务，这是接受疫苗接种的另一个障碍。 我们研究的主要假设是，参与大规模疫苗接种运动可以 通过空间响应疫苗接种策略显著增加。这些战略具有 有可能最大限度地扩大覆盖面，减少空间异质性，最大限度地减少疫苗接种点的等待时间， 并增加难以接触到的人群获得免疫接种的机会。我们测试我们的方法在 在秘鲁阿雷基帕市持续的犬狂犬病流行的背景下。 在第一个目标中，我们比较了一种新的疫苗接种策略的覆盖率和空间公平性， 结合空间优化和生态平衡理论，通过一个阶梯式的楔形体， 整群随机试验在第二个目标中，我们开发和测试数据驱动的方法， 通过扫荡“精确疫苗接种”运动，为得不到充分服务的人群提供疫苗。在第三个目标中，我们评估 空间响应疫苗接种策略的可接受性、可扩展性和可转移性， 区域和国家利益攸关方。 我们的工作将导致新的原则和做法，桥梁业务研究和人畜共患病 疾病流行病学，以更好地指导疫苗接种计划。它将允许设计有效的 消除战略将考虑到获得医疗保健和接种者的空间行为。