Article Category:
Research Article

Human-Centered Design to Respond to Public Health Crises: Maintaining Canine Rabies Vaccination during the COVID-19 Pandemic in Peru

Ricardo Castillo-Neyra Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania;
Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Elvis W. Díaz Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Lizzie Ortiz-Cam Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Guillermo Porras Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Micaela De La Puente-León Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Gian Franco Condori Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Olimpia Chuquista-Alcarraz National Epidemiology, Prevention, and Disease Control Center, Ministry of Health, Lima, Peru;

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Sergio E. Recuenco Department of Preventive Medicine and Public Health, Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru;

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Laura D. Tamayo Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;

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Alison M. Buttenheim Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania;

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Valerie A. Paz-Soldan Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru;
Department of Tropical Medicine and Infectious Disease, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana

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DOI:
https://doi.org/10.4269/ajtmh.24-0308
Volume/Issue:
Ahead of Print
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In the early coronavirus disease 2019 pandemic, limited understanding of severe acute respiratory syndrome coronavirus 2 transmission and fears of infection hindered mass dog vaccination efforts in dog rabies-affected areas. Interruption of dog rabies vaccination campaigns could lead to a rapid increase in the risk of human rabies. To address these challenges, we applied human-centered design (HCD) principles to develop a vaccination strategy that prioritizes safety while ensuring dog rabies vaccination continuity in Arequipa, Peru, a rabies-affected area. We describe the process of rapid prototyping and testing undertaken by our research team to adapt the vaccination process in response to a health crisis. A multidisciplinary team met twice a week to prototype a fixed-point vaccination campaign that ensured distancing and reduction of fomite transmission while allowing for the continuation of dog vaccination. Field notes and videos informed successive meetings. The final prototype was used in rabies hotspots. In 4 weeks, six prototypes of safe booths and supporting safety protocols were designed, and two copies of each prototype were field tested. During testing, additional innovations were identified and implemented, including virtual vaccine certificates and online data collection forms. The final prototype was implemented across 251 sites, and 17,876 dogs were vaccinated. Using HCD principles, we swiftly developed a mass vaccination strategy that provided safety and enabled the maintenance of rabies vaccination programs. This work highlights the importance of innovative and adaptive approaches to address public health challenges in times of crisis.

Author Notes

Financial support: This project was supported by NIH-National Institute of Allergy and Infectious Diseases grants K01AI139284 (R. Castillo-Neyra), R01AI168291 (R. Castillo-Neyra), and NIH-Fogarty International Center grant D43TW012741 (R. Castillo-Neyra, E.W. Díaz, L. Ortiz-Cam, G.F. Condori, L.D. Tamayo, V. Paz-Soldan). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Disclosure: The views expressed in this publication do not necessarily reflect the views of the National Center for Epidemiology, Prevention, and Disease Control Center (CDC Peru). Our research team has institutional review board (IRB) approval from University of Pennsylvania, Universidad Peruana Cayetano Heredia, and Tulane for conducting a canine rabies vaccination program in Arequipa (IRB 823736, 65369, and 606720, respectively). The work described in this article was not part of our human subjects work but rather a description of the research team’s internal logistics required to adapt strategies to be able to continue the important vaccination processes during the COVID-19 pandemic when Peru was in lockdown for an extended period.

Current contact information: Ricardo Castillo-Neyra, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, and Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mail: cricardo@upenn.edu. Elvis W. Díaz, Lizzie Ortiz-Cam, Guillermo Porras, Micaela De La Puente-León, Gian Franco Condori, and Laura D. Tamayo, Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, E-mails: ede1089@gmail.com, lizzie.ortiz@upch.pe, gmporrasc@gmail.com, virginia.de.la.puente@upch.pe, francoguns16@gmail.com, and lauratamayo41@gmail.com. Olimpia Chuquista-Alcarraz, National Epidemiology, Prevention, and Disease Control Center, Ministry of Health, Lima, Peru, E-mail: olimpia.chuquista@upch.pe. Sergio E. Recuenco, Department of Preventive Medicine and Public Health, Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru, E-mail: sergio.recuenco@gmail.com. Alison M. Buttenheim, Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, E-mail: abutt@nursing.upenn.edu. Valerie A. Paz-Soldan, Zoonotic Disease Research Lab, One Health Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru, and Department of Tropical Medicine and Infectious Disease, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, E-mail: vpazsold@tulane.edu.

Address correspondence to Ricardo Castillo-Neyra, 715 Blockley Hall, 423 Guardian Dr., Philadelphia, PA 19104. E-mail: cricardo@upenn.edu
Copyright:
© American Society of Tropical Medicine and Hygiene 2024
Received:
08 May 2024
|
Accepted:
31 Aug 2024
|
Published Online:
26 Nov 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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