Can Influenza Epidemics Be Prevented by Voluntary Vaccination 英文参考文献.docVIP

CanInfluenzaEpidemicsBePrevented byVoluntaryVaccination? Raffaele Vardavas, Romulus Breban, Sally Blower* SemelInstituteforNeuroscienceandHumanBehavior,UniversityofCaliforniaLosAngeles,LosAngeles,California,UnitedStatesofAmerica Previous modeling studies have identified the vaccination coverage level necessary for preventing influenza epidemics,buthavenotshownwhetherthiscriticalcoveragecanbereached.Hereweusecomputationalmodelingto determine,forthefirsttime,whetherthecriticalcoverageforinfluenzacanbeachievedbyvoluntaryvaccination.We construct a novel individual-level model of human cognition and behavior; individuals are characterized by two biological attributes (memory and adaptability) that they use when making vaccination decisions. We couple this model with a population-level model of influenza that includes vaccination dynamics. The coupled models allow individual-level decisions to influence influenza epidemiology and, conversely, influenza epidemiology to influence individual-level decisions. By including the effects of adaptive decision-making within an epidemic model, we can reproducetwoessentialcharacteristicsofinfluenzaepidemiology:annualvariationinepidemicseverityandsporadic occurrence of severe epidemics. We suggest that individual-level adaptive decision-making may be an important (previously overlooked) causal factor in driving influenza epidemiology. We find that severe epidemics cannot be preventedunlessvaccinationprogramsofferincentives.Frequencyofsevereepidemicscouldbereducedifprograms provide, as an incentive to be vaccinated, several years of free vaccines to individuals who pay for one year of vaccination.Magnitudeofepidemicameliorationwillbedeterminedbythenumberofyearsoffreevaccination,an individuals’adaptabilityindecision-making,andtheirmemory.Thistypeofincentiveprogramcouldcontrolepidemics ifindividualsareveryadaptableandhavelong-termmemories.However,incentive-basedprogramsthatprovidefree vaccination for families could increase the freque