From pulse to continuous: community-led delivery sustains rabies vaccination coverage and reduces costs in rural Tanzania

Background: Mass dog vaccination (MDV) prevents human rabies but remains underused in sub-Saharan Africa. The conventional annual centralised pulse campaigns require high coverage to maintain herd immunity, yet costs rise sharply as coverage increases while immunity declines rapidly between campaigns due to dog population turnover. We tested whether a community-led decentralised hybrid strategy using thermotolerant vaccines could reduce costs and sustain coverage above the 40% herd immunity threshold.

A single-shot measles vaccine expressing the rabies virus glycoprotein confers dual protection against rabies virus and measles virus.

Rabies (RABV) is a neglected tropical disease responsible for ~59,000 global human deaths annually, 99% of these being due to dog bites. Efforts to control RABV in the dog population have been unsuccessful due to insufficient dog vaccinations and animal population control. The current RABV vaccine is 100% effective at preventing RABV deaths when administered correctly, but the average cost of human RABV pre & post-exposure vaccines is currently ~$108, which precludes its widespread use in low-income RABV endemic countries.

Elimination of Arctic fox variant rabies from southern Ontario, Canada

The province of Ontario, Canada, experienced a major epizootic of rabies due to the Arctic fox virus variant (AFVV) beginning in northern Ontario in 1954. The disease quickly spread south in red fox (Vulpes vulpes) populations and by 1958 was firmly established across southern Ontario. Between 1958 and the start of wildlife rabies control efforts in 1989, Ontario reported 49,125 AFVV rabies cases, averaging 1535 per year.

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