Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga-koen, Kasuga-shi, Fukuoka 816-8580, Japan.
Faculty of Engineering Sciences, Kyushu University, Kasuga-koen, Kasuga-shi, Fukuoka 816-8580, Japan; Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga-koen, Kasuga-shi, Fukuoka 816-8580, Japan.
J Theor Biol. 2019 May 21;469:107-126. doi: 10.1016/j.jtbi.2019.02.013. Epub 2019 Feb 23.
We combined the elements of evolutionary game theory and mathematical epidemiology to comprehensively evaluate the performance of vaccination-subsidizing policies in the face of a seasonal epidemic. We conducted multi-agent simulations to, among others, find out how the topology of the underlying social networks affects the results. We also devised a mean-field approximation to confirm the simulation results and to better understand the influences of an imperfect vaccine. The main measure of a subsidy' performance was the total social payoff as a sum of vaccination costs, infection costs, and tax burdens due to the subsidy. We find two types of situations in which vaccination-subsidizing policies act counterproductively. The first type arises when the subsidy attempts to increase vaccination among past non-vaccinators, which inadvertently creates a negative incentive for voluntary vaccinators to abstain from vaccination in hope of getting subsidized. The second type is a consequence of overspending at which point the marginal cost of further increasing vaccination coverage is higher than the corresponding marginal cost of infections avoided by this increased coverage. The topology of the underlying social networks considerably worsens the subsidy's performance if connections become random and heterogeneous, as is often the case in human social networks. An imperfect vaccine also worsens the subsidy's performance, thus narrowing or completely closing the window for vaccination-subsidizing policies to beat the no-subsidy policy. These results imply that subsidies should be aimed at voluntary vaccinators while avoiding overspending. Once this is achieved, it makes little difference whether the subsidy fully or partly offsets the vaccination cost.
我们结合了进化博弈论和数理流行病学的元素,全面评估了疫苗补贴政策在季节性流行疾病面前的表现。我们进行了多主体模拟,以找出底层社会网络的拓扑结构如何影响结果。我们还设计了一个平均场近似值来确认模拟结果,并更好地理解不完美疫苗的影响。补贴表现的主要衡量标准是作为疫苗接种成本、感染成本和补贴引起的税收负担总和的总社会效益。我们发现了两种情况下,疫苗补贴政策会适得其反。第一种情况是,补贴试图增加过去未接种疫苗者的接种率,这无意中为自愿接种者创造了一个负面激励,使其不愿接种疫苗,希望获得补贴。第二种情况是由于过度支出而导致的,此时进一步提高疫苗接种率的边际成本高于通过增加接种率避免的感染的相应边际成本。如果底层社会网络的连接变得随机和异质,就像人类社会网络中经常发生的那样,那么网络拓扑结构会极大地恶化补贴的表现。不完美的疫苗也会恶化补贴的表现,从而缩小或完全关闭疫苗补贴政策优于无补贴政策的窗口。这些结果意味着补贴应该针对自愿接种者,同时避免过度支出。一旦实现了这一点,补贴是否完全或部分抵消疫苗接种成本就没有什么区别了。