Disease Modelling Lab, Department of Mathematics, School of Natural Sciences, Shiv Nadar University, India.
J Theor Biol. 2019 Jun 7;470:108-118. doi: 10.1016/j.jtbi.2019.03.014. Epub 2019 Mar 20.
Communicable diseases are leading cause of child mortality in developing and under-developed countries. Public health ministries in states and country allocate a considerable amount of budget every year for vaccination campaigns to control infections. Even third-party agencies such as Gates Foundation, UNDP, GAVI, World Bank, WHO also allocate huge funds to under-developed and developing countries for vaccination programs and disease eliminations. However, economic constraints and current disease prevalence are not enough driving factors for optimal decisions in budget allocations for vaccinations and controlling the disease. In a population under voluntary vaccination campaign, high vaccine coverage cannot be taken for granted, as individuals' free-riding behaviour plays a significant role in achieving the herd immunity level coverage. Individual-level vaccine exemptions and ignoring this important component by the policymakers are key determinants for failure of disease elimination program these days in many under-developed and developing countries. We integrate evolutionary game theory and compartmental model of disease transmission to analyze how individual vaccination choice influence the budget allocations and vice-versa. Our model illustrates that individuals' perceived risk plays an important role in optimal budget allocations to minimize infections. Analyses of our model indicate that the optimal distribution of third-party funds may be very different than usual, especially in multiple populations with contrasting demographic and economic profiles. These findings are certainly useful to public health policymakers and may help to quantify certain parameters in budget allocations to control vaccine-preventable diseases.
传染病是发展中国家和不发达国家儿童死亡的主要原因。各国的公共卫生部每年都会拨出相当数量的预算用于疫苗接种运动,以控制感染。甚至盖茨基金会、联合国开发计划署、全球疫苗免疫联盟、世界银行、世界卫生组织等第三方机构也为疫苗接种计划和疾病消除向不发达国家和发展中国家分配大量资金。然而,经济限制和当前疾病的流行程度并不是预算分配用于接种疫苗和控制疾病的最佳决策的充分驱动因素。在自愿疫苗接种运动的人群中,不能理所当然地认为疫苗接种率很高,因为个人的搭便车行为在达到群体免疫水平方面起着重要作用。个人层面的疫苗豁免和政策制定者忽略这一重要因素,是导致如今许多不发达国家和发展中国家疾病消除计划失败的关键决定因素。我们将进化博弈论和疾病传播的隔室模型相结合,分析个人接种疫苗的选择如何影响预算分配,反之亦然。我们的模型表明,个人的感知风险在最小化感染的最佳预算分配中起着重要作用。对我们模型的分析表明,第三方资金的最佳分配可能与通常情况大不相同,尤其是在人口结构和经济状况截然不同的多个群体中。这些发现对公共卫生政策制定者肯定是有用的,并可能有助于量化控制疫苗可预防疾病的预算分配中的某些参数。