Analyzing the Costs and Benefits of Utilizing a Mixed-Strategy Approach in Infectious Disease Control under a Voluntary Vaccination Policy.

Infectious diseases pose significant public health risks, necessitating effective control strategies. One such strategy is implementing a voluntary vaccination policy, which grants individuals the autonomy to make their own decisions regarding vaccination. However, exploring different approaches to optimize disease control outcomes is imperative, and involves assessing their associated costs and benefits. This study analyzes the advantages and disadvantages of employing a mixed-strategy approach under a voluntary vaccination policy in infectious disease control. We examine the potential benefits of such an approach by utilizing a vaccination game model that incorporates cost and benefit factors, where lower costs and higher benefits lead to reduced infection rates. Here, we introduce a mixed-strategy framework that combines individual-based risk assessment (IB-RA) and society-based risk assessment (SB-RA) strategies. A novel dynamical equation is proposed that captures the decision-making process of individuals as they choose their strategy based on personal or communal considerations. In addition, we explore the implications of the mixed-strategy approach within the context of social dilemmas. We examine deviations from expected behavior and the concept of social efficiency deficit (SED) by allowing for the evolution of vaccine strategy preferences alongside risk perception. By comprehensively evaluating the financial implications and societal advantages associated with the mixed-strategy approach, decision-makers can allocate resources and implement measures to combat infectious diseases within the framework of a voluntary vaccination policy.

Social distancing as a public-good dilemma for socio-economic cost: An evolutionary game approach.

Partaking in social distancing can contribute to a public good affected by the perceived risk of infection and socioeconomic cost. Although social distancing can save lives by slowing down the disease transmission before introducing any effective medical intervention, the economic fallout of social distancing can be brutal for the poorest, vulnerable, and marginalized members of society. We combined the epidemiological and evolutionary game theoretical (EGT) framework through the consolidations of the SEIR (Susceptible-Exposed-Infected-Removed) disease model to analyze behavior enticements in a social distancing dilemma situation with the complex behavioral decision-making aspect. Extensive theoretical and numerical analyses reveal that socioeconomic cost and infected individuals' compliance behavior are critical factors in reining disease spread in the community. Lower cost for maintaining relative safety distance encourages maximum avoidance of public interactions by a detected infected individual. The benefitted fraction due to compliance is parted from the naturally immunized population. People get insignificant benefits from social distancing when the disease transmission rate is too low or crosses critical higher values. Average Social Payoff (ASP) analysis suggests the correspondence of significant safety distance with lowest cost setting as the best strategy to derive the maximum goods. But mounting inherent cost converts social distancing obedience to a public good dilemma.

Hypothetical assessment of efficiency, willingness-to-accept and willingness-to-pay for dengue vaccine and treatment: a contingent valuation survey in Bangladesh.

In 2019, Bangladesh has grappled with a record-breaking surge in dengue fever, experiencing the highest number of dengue cases since the year 2000. Together, the intensification of dengue fever combined with a lack of dengue vaccines and appropriate medicines is expected to further the public and government's interests in appropriate and potential dengue vaccines to control the epidemic. We considered people's characteristics, dengue experience, and knowledge to assess their willingness-to-accept (WTA) and willingness-to-pay (WTP) for a hypothetical dengue vaccine and ex-post treatment in Bangladesh (June-July 2019). This study implemented a contingent valuation (CV) method with 3,251 respondents in 10 different locations of Bangladesh. All respondents participated in a hypothetical dengue vaccine scenario consisting of 65% (vaccine A), 80% (vaccine B), and 95% (vaccine C) effectiveness levels with three doses of each vaccine and ex-post dengue treatment. Around 71.2% of respondents were willing to pay for at least one of the hypothetical vaccines: A, B, or C. The average WTPs of the three vaccines amounted to US$ 47.0, US$ 66.0, and US$ 89.0, which were defined as the total cost of the doses necessary to obtain immunity. In Bangladesh, there is a significant demand for low-priced dengue vaccines, which was proven by people's higher acceptance of vaccination practices. Though dengue vaccines are not yet available in Bangladesh, this study provides significant support that both the government and private sectors should work together to develop a reliable and affordable dengue vaccine.

Evolutionary game theory modelling to represent the behavioural dynamics of economic shutdowns and shield immunity in the COVID-19 pandemic.

The unprecedented global spread of COVID-19 has prompted dramatic public-health measures like strict stay-at-home orders and economic shutdowns. Some governments have resisted such measures in the hope that naturally acquired shield immunity could slow the spread of the virus. In the absence of empirical data about the effectiveness of these measures, policymakers must turn to epidemiological modelling to evaluate options for responding to the pandemic. This paper combines compartmental epidemiological models with the concept of behavioural dynamics from evolutionary game theory (EGT). This innovation allows us to model how compliance with an economic lockdown might wane over time, as individuals weigh the risk of infection against the certainty of the economic cost of staying at home. Governments can, however, increase spending on social programmes to mitigate the cost of a shutdown. Numerical analysis of our model suggests that emergency-relief funds spent at the individual level are effective in reducing the duration and overall economic cost of a pandemic. We also find that shield immunity takes hold in a population most easily when a lockdown is enacted with relatively low costs to the individual. Our qualitative analysis of a complex model provides evidence that the effects of shield immunity and economic shutdowns are complementary, such that governments should pursue them in tandem.

Cost-efficiency analysis of voluntary vaccination against n-serovar diseases using antibody-dependent enhancement: A game approach.

Records of epidemics acknowledge immunological multi-serotype illnesses as an important aspect of the occurrence and control of contagious diseases. These patterns occur due to antibody-dependent-enhancement (ADE) among serotype diseases, which leads to infection of secondary infectious classes. One example of this is dengue hemorrhagic fever and dengue shock syndrome, which comprises the following four serotypes: DEN-1, DEN-2, DEN-3, and DEN-4. The evolutionary vaccination game approach is able to shed light on this long-standing issue in a bid to evaluate the success of various control programs. Although immunization is regarded as one of the most accepted approaches for minimizing the risk of infection, cost and efficiency are important factors that must also be considered. To analyze the n-serovar aspect alongside ADE consequence in voluntary vaccination, this study establishes a new mathematical epidemiological model that is dovetailed with evolutionary game theory, an approach through which we explored two vaccine programs: primary and secondary. Our findings illuminate that the 'cost-efficiency' effect for vaccination decision exhibits an impact on controlling n-serovar infectious diseases and should be designed in such a manner as to avoid adverse effects. Furthermore, our numerical result justifies the fact that adopting ADE significantly boosted emerging disease incidence, it also suggest that the joint vaccine policy works even better when the complex cyclical epidemic outbreak takes place among multi serotypes interactions. Research also exposes that the primary vaccine is a better controlling tool than the secondary; however, introducing a highly-efficiency secondary vaccine against secondary infection plays a key role to control the disease prevalence.

Interplay between cost and effectiveness in influenza vaccine uptake: a vaccination game approach.

Pre-emptive vaccination is regarded as one of the most protective measures to control influenza outbreak. There are mainly two types of influenza viruses-influenza A and B with several subtypes-that are commonly found to circulate among humans. The traditional trivalent (TIV) flu vaccine targets two strains of influenza A and one strain of influenza B. The quadrivalent (QIV) vaccine targets one extra B virus strain that ensures better protection against influenza; however, the use of QIV vaccine can be costly, hence impose an extra financial burden to society. This scenario might create a dilemma in choosing vaccine types at the individual level. This article endeavours to explain such a dilemma through the framework of a vaccination game, where individuals can opt for one of the three options: choose either of QIV or TIV vaccine or none. Our approach presumes a mean-field framework of a vaccination game in an infinite and well-mixed population, entangling the disease spreading process of influenza with the coevolution of two types of vaccination decision-making processes taking place before an epidemic season. We conduct a series of numerical simulations as an attempt to illustrate different scenarios. The framework has been validated by the so-called multi-agent simulation (MAS) approach.

Behavioral incentives in a vaccination-dilemma setting with optional treatment.

Social dilemmas are situations wherein individuals choose between selfish interest and common good. One example of this is the vaccination dilemma, in which an individual who vaccinates at a cost protects not only himself but also others by helping maintain a common good called herd immunity. There is, however, a strong incentive to forgo vaccination, thus avoiding the associated cost, all the while enjoying the protection of herd immunity. To analyze behavioral incentives in a vaccination-dilemma setting in which an optional treatment is available to infected individuals, we combined epidemiological and game-theoretic methodologies by coupling a disease-spreading model with treatment and an evolutionary decision-making model. Extensive numerical simulations show that vaccine characteristics are more important in controlling the treatment adoption than the cost of treatment itself. The main effect of the latter is that expensive treatment incentivizes vaccination, which somewhat surprisingly comes at a little cost to society. More surprising is that the margin for a true synergy between vaccine and treatment in reducing the final epidemic size is very small. We furthermore find that society-centered decision making helps protect herd immunity relative to individual-centered decision making, but the latter may be better in establishing a novel vaccine. These results point to useful policy recommendations as well as to intriguing future research directions.

ADAR1 is involved in the development of microvascular lung injury.

Deamination of adenosine on pre-mRNA to inosine is a recently discovered process of posttranscription modification of pre-mRNA, termed A-to-I RNA editing, which results in the production of proteins not inherent in the genome. The present study aimed to identify a role for A-to-I RNA editing in the development of microvascular lung injury. To that end, the pulmonary expression and activity of the RNA editase ADAR1 were evaluated in a mouse model of endotoxin (15 mg/kg IP)-induced microvascular lung injury (n=5) as well as in cultured alveolar macrophages stimulated with endotoxin, live bacteria, or interferon. ADAR1 expression and activity were identified in sham lungs that were upregulated in lungs from endotoxin-treated mice (at 2 hours). Expression was localized to polymorphonuclear and monocytic cells. These events preceded the development of pulmonary edema and leukocyte accumulation in lung tissue and followed the local production of interferon-gamma, a known inducer of ADAR1 in other cell systems. ADAR1 was found to be upregulated in alveolar macrophages (MH-S cells) stimulated with endotoxin (1 to 100 microg/mL), live Escherichia coli (5x10(7) colony-forming units), or interferon-gamma (1000 U/mL). Taken together, these data suggest that ADAR1 may play a role in the pathogenesis of microvascular lung injury possibly through induction by interferon.