Work

Operational and intercultural challenges of mass rabies vaccination in the Maxakali Indigenous Territory

Year: 2026

Type: article

Abstract: Rabies is a fatal but preventable zoonosis that disproportionately affects vulnerable populations with limited access to healthcare. Mass vaccination of dogs and cats is the main control strategy, but evidence from Indigenous and remote settings is scarce. The aim of this study was to examine the operational, epidemiological, and sociocultural challenges associated with a mass rabies vaccination campaign implemented in response to a human rabies outbreak in Indigenous communities in Brazil. This qualitative descriptive study with an operational research component was conducted in Maxakali villages, Minas Gerais, after a rabies outbreak (April–May 2022). Data were collected through document analysis, field diaries, and direct observation, and analyzed using thematic content analysis guided by a One Health framework. Epidemiological indicators on vaccinated animals were also assessed. A total of 553 animals were vaccinated, including 427 dogs (77.2%) and 126 cats (22.8%), with heterogeneous distribution across villages. Although high operational coverage was achieved, the absence of reliable population denominators limited precise estimation of vaccination coverage. Major challenges included geographical barriers, difficulties in maintaining the cold chain, limited availability of trained personnel, and scarcity of animal restraint equipment. Sociocultural factors, such as language barriers and initial resistance to vaccination, influenced community adherence, which improved through the involvement of Indigenous leaders and health agents. Poor animal health conditions and free-roaming behavior further complicated the campaign. Mass rabies vaccination in indigenous territories is feasible but requires context-specific strategies addressing logistics, intercultural communication, and animal management. Strengthening integrated surveillance and community-engaged approaches is essential to improve rabies control.

Source: Discover Public Health

DOI: 10.1186/s12982-026-02830-0

Authors: Dilceu Silveira Tolentino Júnior, Mateus Aparecido de Faria, Roberto Carlos de Oliveira, Alessandra de Paula Carli, Priscila Garcia Maia, Eliseu Miranda de Assis