Synthesizing epidemiological and economic optima for control of immunizing infections

Petra Klepac, Ramanan Laxminarayan, Bryan T. Grenfell

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Epidemic theory predicts that the vaccination threshold required to interrupt local transmission of an immunizing infection like measles depends only on the basic reproductive number ℛ 0 and hence transmission rates. When the search for optimal strategies is expanded to incorporate economic constraints, the optimum for disease control in a single population is determined by relative costs of infection and control, rather than transmission rates. Adding a spatial dimension, which precludes local elimination unless it can be achieved globally, can reduce or increase optimal vaccination levels depending on the balance of costs and benefits. For weakly coupled populations, local optimal strategies agree with the global cost-effective strategy; however, asymmetries in costs can lead to divergent control optima in more strongly coupled systems - in particular, strong regional differences in costs of vaccination can preclude local elimination even when elimination is locally optimal. Under certain conditions, it is locally optimal to share vaccination resources with other populations.

Original languageEnglish (US)
Pages (from-to)14366-14370
Number of pages5
JournalProceedings of the National Academy of Sciences of the United States of America
Volume108
Issue number34
DOIs
StatePublished - Aug 23 2011

All Science Journal Classification (ASJC) codes

  • General

Keywords

  • Eradication threshold
  • Resource allocation
  • Transboundary model

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