Improving dog vaccinations: a development and feasibility study to pave the way for effective, synchronized dog vaccination campaigns in Africa - Rabies causes an estimated 59,000 human deaths each year in Africa and Asia. Although rabies transmission can be interrupted by vaccinating at least 70% of susceptible dogs, achieving and sustaining this coverage remains a major operational challenge in rabies-endemic countries. In Tanzania and much of Africa, mass dog vaccinations (MDV) are normally delivered through centralized teams moving from village to village. This costly and logistically demanding approach often misses hard-to-reach communities and leaves pockets of unvaccinated dogs that sustain transmission. This K43 project will evaluate whether synchronized MDV delivered within a narrow time window, with or without coordinated media support, can achieve higher and more evenly distributed coverage than standard rolling campaigns. We will conduct a three-arm cluster randomized implementation trial across six districts comparing: (i) standard team-led delivery, (ii) synchronized vaccination without media support, and (iii) synchronized vaccination combined with coordinated media campaigns. Primary outcomes will include coverage, campaign completeness, cost per dog vaccinated, human rabies exposures, operational feasibility, and stakeholder engagement in MDV planning and implementation. The project will provide advanced training in implementation science, trial design, transmission modeling, and economic evaluation through mentorship from U.S. and Tanzanian investigators, strengthening the candidate’s capacity to lead large-scale implementation trials. This research must be conducted in rabies-endemic settings where MDV operate under real logistical constraints. Tanzania provides sustained transmission, established surveillance systems, and field platforms suitable for evaluating MDV delivery strategies under operational conditions. The findings are also relevant to the United States because imported rabid dogs continue to trigger costly public health investigations, and post-exposure prophylaxis. U.S. citizens who travel or work in rabies-endemic countries remain at risk of exposure, including tourists, military personnel, diplomats, Peace Corps volunteers, and field researchers. By reducing rabies transmission at its source, this work will help protect U.S. citizens, strengthen U.S. biosecurity preparedness, and provide evidence on scalable MDV delivery and health communication strategies relevant to rabies elimination and other large-scale vaccination programs.
