Optimal vaccination strategies and rational behaviour in seasonal epidemics

Social vs. individual age-dependent costs of imperfect vaccination

In diseases with long-term immunity, vaccination is known to increase the average age at infection as a result of the decrease in the pathogen circulation. This implies that a vaccination campaign can have negative effects when a disease is more costly (financial or health-related costs) for higher ages. This work considers an age-structured population transmission model with imperfect vaccination. We aim to compare the social and individual costs of vaccination, assuming that disease costs are age-dependent, while the disease's dynamic is age-independent. A model for pathogen deterministic dynamics in a population consisting of juveniles and adults, assumed to be rational agents, is introduced. The parameter region for which vaccination has a positive social impact is fully characterized and the Nash equilibrium of the vaccination game is obtained. Finally, collective strategies designed to promote voluntary vaccination, without compromising social welfare, are discussed.

Impact of vaccine measures on the transmission dynamics of COVID-19

In many nations, efforts to prevent and control COVID-19 have been significantly impeded by the SARS-CoV-2 virus ongoing mutation. The Omicron strain, a more recent and prevalent strain, has had more significant detrimental effects in countries worldwide. To investigate the impact of the Omicron BA.2 strain on vaccine efficacy, we proposed a model with vaccination and immunological decline in this research. Then, we fitted our model based on the number of daily new instances reported by the government in Jilin and Shanghai, China. We estimated the effective reproduction number Re = 4.71 for the Jilin and Re = 3.32 for Shanghai. Additionally, we do sensitivity analysis to identify the critical factors affecting the effective reproduction number Re. It was found that vaccination rate, effectiveness rate, and declining rate had a significant effect on Re. Further, we investigate the relevant parameter thresholds that make Re lower than unity. Finally, rich numerical experiments were then carried out. We observed that even when vaccine efficiency was not high, increasing vaccination rates had a significant effect on early disease transmission, that limiting social distance was the most economical and rational measure to control the spread of disease, and that for a short period, reducing immune decline was not significant in curbing disease transmission.

A mathematical interpretation for outbreaks of bacterial meningitis under the effect of time-dependent transmission parameters

We consider a SIR-type compartmental model divided into two age classes to explain the seasonal exacerbations of bacterial meningitis, especially among children outside of the meningitis belt. We describe the seasonal forcing through time-dependent transmission parameters that may represent the outbreak of the meningitis cases after the annual pilgrimage period (Hajj) or uncontrolled inflows of irregular immigrants. We present and analyse a mathematical model with time-dependent transmission. We consider not only periodic functions in the analysis but also general non-periodic transmission processes. We show that the long-time average values of transmission functions can be used as a stability marker of the equilibrium. Furthermore, we interpret the basic reproduction number in case of time-dependent transmission functions. Numerical simulations support and help visualize the theoretical results.

A game-theoretic model of rabies in domestic dogs with multiple voluntary preventive measures

Game theory is now routinely applied to quantitatively model the decision making of individuals presented with various voluntary actions that can prevent a given disease. Most models consider only a single preventive strategy and the case where multiple preventative actions are available is severely understudied. In our paper, we consider a very simple SI compartmental model of rabies in the domestic dog population. We study two choices of the dog owners: to vaccinate their dogs or to restrict the movements of unvaccinated dogs. We analyze the relatively rich patterns of Nash equilibria (NE). We show that there is always at least one NE at which the owners utilize only one form of prevention. However, there can be up to three different NEs at the same time: two NEs at which the owners use exclusively only the vaccination or movement restriction, and the third NE when the owners use both forms of prevention simultaneously. However, we also show that, unlike the first two types of NEs, the third kind of NE is not convergent stable.

The Multi-Compartment SI(RD) Model with Regime Switching: An Application to COVID-19 Pandemic

We study—with existence and unicity results—a variant of the SIR model for an infectious disease incorporating both the possibility of a death outcome—in a short period of time—and a regime switch that can account for the mitigation measures used to control the spreading of the infections, such as a total lockdown. This model is parametrised by three parameters: the basic reproduction number, the mortality rate of the infected, and the duration of the disease. We discuss a particular example of application to Portuguese COVID-19 data in two short periods just after the start of the epidemic in 4 March 2020, with the first two cases dated that day. We propose a simple and effective method for the estimation of the main parameters of the disease, namely, the basic reproduction number and the mortality rate of the infected. We correct these estimated values to take into account the asymptomatic non-diagnosed members of the population. We compare the outcome of the model in the cases of the existence, or not, of a regime switch, and under three different scenarios, with a remarkable agreement between model and data deaths in the case of our basis scenario. In a final short remark, we deal with the existence of symmetries for the proposed model.

Antivax movement and epidemic spreading in the era of social networks: Nonmonotonic effects, bistability, and network segregation

In this work, we address a multicoupled dynamics on complex networks with tunable structural segregation. Specifically, we work on a networked epidemic spreading under a vaccination campaign with agents in favor and against the vaccine. Our results show that such coupled dynamics exhibits a myriad of phenomena such as nonequilibrium transitions accompanied by bistability. Besides we observe the emergence of an intermediate optimal segregation level where the community structure enhances negative opinions over vaccination but counterintuitively hinders-rather than favoring-the global disease spreading. Thus our results hint vaccination campaigns should avoid policies that end up segregating excessively antivaccine groups so that they effectively work as echo chambers in which individuals look to confirmation without jeopardizing the safety of the whole population.

Optimal time-profiles of public health intervention to shape voluntary vaccination for childhood diseases

In order to seek the optimal time-profiles of public health systems (PHS) Intervention to favor vaccine propensity, we apply optimal control (OC) to a SIR model with voluntary vaccination and PHS intervention. We focus on short-term horizons, and on both continuous control strategies resulting from the forward-backward sweep deterministic algorithm, and piecewise-constant strategies (which are closer to the PHS way of working) investigated by the simulated annealing (SA) stochastic algorithm. For childhood diseases, where disease costs are much larger than vaccination costs, the OC solution sets at its maximum for most of the policy horizon, meaning that the PHS cannot further improve perceptions about the net benefit of immunization. Thus, the subsequent dynamics of vaccine uptake stems entirely from the declining perceived risk of infection (due to declining prevalence) which is communicated by direct contacts among parents, and unavoidably yields a future decline in vaccine uptake. We find that for relatively low communication costs, the piecewise control is close to the continuous control. For large communication costs the SA algorithm converges towards a non-monotone OC that can have oscillations.

Voluntary vaccination dilemma with evolving psychological perceptions

Voluntary vaccination is a universal control protocol for infectious diseases. Yet there exists a social dilemma between individual benefits and public health: non-vaccinators free ride via the herd immunity from adequate vaccinators who bear vaccination cost. This is due to the interplay between disease prevalence and individual vaccinating behavior. To complicate matters further, individual vaccinating behavior depends on the perceived vaccination cost rather than the actual one. The perception of vaccination cost is an individual trait, which varies from person to person, and evolves in response to the disease prevalence and vaccination coverage. To explore how evolving perception shapes individual vaccinating behavior and thus the vaccination dynamics, we provide a model combining epidemic dynamics with evolutionary game theory which captures the voluntary vaccination dilemma. In particular, individuals adjust their perception based on the inertia effect in psychology and then update their vaccinating behavior through imitating the behavior of a more successful peer. We find that i) vaccination is acceptable when the expected vaccination cost considering perception and actual vaccination cost is less than the maximum of the expected non-vaccination cost; ii) the evolution of perception is a "double-edged sword" for vaccination dynamics: it can improve vaccination coverage when most individuals perceive exaggerated vaccination cost, and it inhibits vaccination coverage in the other cases.

Prevention of treatable infectious diseases: A game-theoretic approach

We model outcomes of voluntary prevention using an imperfect vaccine, which confers protection only to a fraction of vaccinees for a limited duration. Our mathematical model combines a single-player game for the individual-level decision to get vaccinated, and a compartmental model for the epidemic dynamics. Mathematical analysis yields a characterization for the effective vaccination coverage, as a function of the relative cost of prevention versus treatment; note that cost may involve monetary as well as non-monetary aspects. Three behaviors are possible. First, the relative cost may be too high, so individuals do not get vaccinated. Second, the relative cost may be moderate, such that some individuals get vaccinated and voluntary vaccination alleviates the epidemic. In this case, the vaccination coverage grows steadily with decreasing relative cost of vaccination versus treatment. Unlike previous studies, we find a third case where relative cost is sufficiently low so epidemics may be averted through the use of prevention, even for an imperfect vaccine. However, we also found that disease elimination is only temporary-as no equilibrium exists for the individual strategy in this third case-and, with increasing perceived cost of vaccination versus treatment, the situation may be reversed toward the epidemic edge, where the effective reproductive number is 1. Thus, maintaining relative cost sufficiently low will be the main challenge to maintain disease elimination. Furthermore, our model offers insight on vaccine parameters, which are otherwise difficult to estimate. We apply our findings to the epidemiology of measles.