Spatial early warning signals of social and epidemiological tipping points in a coupled behaviour-disease network.

The resurgence of infectious diseases due to vaccine refusal has highlighted the role of interactions between disease dynamics and the spread of vaccine opinion on social networks. Shifts between disease elimination and outbreak regimes often occur through tipping points. It is known that tipping points can be predicted by early warning signals (EWS) based on characteristic dynamics near the critical transition, but the study of EWS in coupled behaviour-disease networks has received little attention. Here, we test several EWS indicators measuring spatial coherence and autocorrelation for their ability to predict a critical transition corresponding to disease outbreaks and vaccine refusal in a multiplex network model. The model couples paediatric infectious disease spread through a contact network to binary opinion dynamics of vaccine opinion on a social network. Through change point detection, we find that mutual information and join count indicators provided the best EWS. We also show the paediatric infectious disease natural history generates a discrepancy between population-level vaccine opinions and vaccine immunity status, such that transitions in the social network may occur before epidemiological transitions. These results suggest that monitoring social media for EWS of paediatric infectious disease outbreaks using these spatial indicators could be successful.