Using Game Theory to Examine Incentives in Influenza Vaccination Behavior (original) (raw)
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The social good often depends on the altruistic behavior of specific individuals. For example, epidemiological studies of influenza indicate that elderly individuals, who face the highest mortality risk, are best protected by vaccination of young individuals, who contribute most to disease transmission. To examine the conditions under which young people would get vaccinated to protect elderly people, we conducted a game-theory experiment that mirrored real-world influenza transmission, with "young" players contributing more than "elderly" players to herd immunity. Participants could spend points to get vaccinated and reduce the risk of influenza. When players were paid according to individual point totals, more elderly than young players got vaccinated, a finding consistent with the Nash equilibrium predicting self-interested behavior. When players were paid according to group point totals, however, more young than elderly players got vaccinated-a finding consistent with the utilitarian equilibrium predicting group-optimal behavior-which resulted in higher point totals than when players were paid for their individual totals. Thus, payout structure affected whether individuals got vaccinated for self-interest or group benefit.
The influence of altruism on influenza vaccination decisions
Journal of the Royal Society, Interface / the Royal Society, 2012
Game theory is based on the assumption that individuals act according to self-interest and make decisions that maximize their personal payoffs. To test this fundamental assumption, we conducted a survey study in the context of influenza vaccination decisions. Contrary to the assumption of self-interest, we found that altruism plays an important role in vaccination decisions. Nevertheless, altruistic motivation has not yet been considered in epidemiological models, in predictions of vaccination decisions or in the design of vaccination policies. To determine the impact of altruism on the adherence to optimal vaccination policies and on resulting disease burden, we incorporated altruism into a game-theoretic epidemiological model of influenza vaccination. We found that altruism significantly shifted vaccination decisions away from individual self-interest and towards the community optimum, greatly reducing the total cost, morbidity and mortality for the community. Therefore, promoting altruism could be a potential strategy to improve public health outcomes.
Herd immunity and a vaccination game: An experimental study
PLOS ONE, 2020
Would the affected communities voluntarily obtain herd immunity if a cure for COVID-19 was available? This paper experimentally investigates people's vaccination choices in the context of a nonlinear public good game. A "vaccination game" is defined in which costly commitments (vaccination) are required of a fraction of the population to reach the critical level needed for herd immunity, without which defectors are punished by the natural contagion of epidemics. Our experimental implementation of a vaccination game in a controlled laboratory setting reveals that endogenous epidemic punishment is a credible threat, resulting in voluntary vaccination to obtain herd immunity, for which the orthodox principle of positive externalities fails to account. The concave nature of the infection probability plays a key role in facilitating the elimination of an epidemic.
Optimal H1N1 vaccination strategies based on self-interest versus group interest
BMC Public Health, 2011
Background: Influenza vaccination is vital for reducing H1N1 infection-mediated morbidity and mortality. To reduce transmission and achieve herd immunity during the initial 2009-2010 pandemic season, the US Centers for Disease Control and Prevention (CDC) recommended that initial priority for H1N1 vaccines be given to individuals under age 25, as these individuals are more likely to spread influenza than older adults. However, due to significant delay in vaccine delivery for the H1N1 influenza pandemic, a large fraction of population was exposed to the H1N1 virus and thereby obtained immunity prior to the wide availability of vaccines. This exposure affects the spread of the disease and needs to be considered when prioritizing vaccine distribution. Methods: To determine optimal H1N1 vaccine distributions based on individual self-interest versus population interest, we constructed a game theoretical age-structured model of influenza transmission and considered the impact of delayed vaccination.
Incentives' Effect in Influenza Vaccination Policy
Management Science, 2013
I n the majority of developed countries, the level of influenza vaccination coverage in all age groups is suboptimal. Hence, the authorities offer different kinds of incentives for people to become vaccinated such as subsidizing immunization or placing immunization centers in malls to make the process more accessible. We built a theoretical epidemiological game model to find the optimal incentive for vaccination and the corresponding expected level of vaccination coverage. The model was supported by survey data from questionnaires about people's perceptions about influenza and the vaccination against it. Results suggest that the optimal magnitude of the incentives should be greater when less contagious seasonal strains of influenza are involved and greater for the nonelderly population rather than the elderly, and should rise as high as $57 per vaccinated individual so that all children between the ages of six months and four years will be vaccinated.
Interplay between cost and effectiveness in influenza vaccine uptake: a vaccination game approach
Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences
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 proc...
“Wait and see” vaccinating behaviour during a pandemic: A game theoretic analysis
Vaccine, 2011
During the 2009 H1N1 pandemic, many individuals did not seek vaccination immediately but rather decided to "wait and see" until further information was available on vaccination costs. This behaviour implies two sources of strategic interaction: as more individuals become vaccinated, both the perceived vaccination cost and the probability that susceptible individuals become infected decline. Here we analyze the outcome of these two strategic interactions by combining game theory with a disease transmission model during an outbreak of a novel influenza strain. The model exhibits a "wait and see" Nash equilibrium strategy, with vaccine delayers relying on herd immunity and vaccine safety information generated by early vaccinators. This strategic behaviour causes the timing of the epidemic peak to be strongly conserved across a broad range of plausible transmission rates, in contrast to models without such adaptive behaviour. The model exhibits not only feedback mechanisms but also a feed-forward mechanism: a high initial perceived vaccination cost perpetuates high perceived vaccine costs (and lower vaccine coverage) throughout the remainder of the outbreak. This suggests that any effect of risk communication at the start of a pandemic outbreak will be amplified compared to the same amount of risk communication effort distributed throughout the outbreak.
Modeling Behavioral Response to Vaccination Using Public Goods Game
IEEE Transactions on Computational Social Systems, 2019
Epidemics of infectious disease can be traced back to the early days of mankind. Only in the last two centuries vaccination has become a viable strategy to prevent such epidemics. In addition to the clinical efficacy of this strategy, the behavior and public attitudes affect the success of vaccines. This paper describes modeling the efficacy of vaccination considering the cost and benefit of vaccination to individual players. The model is based on the public goods game and is presented as a spatial game on a lattice. Using this model, individuals can contribute to the public health by paying the cost of vaccination or choose to be protected by the public who is vaccinated rather than pay the cost and share the risk of vaccination. Thus, in this model individuals can choose to stay susceptible, can become infected, or choose to vaccinate once in each episode. This paper presents the behavioral changes of the population and the cost to the society as a function of the cost of vaccines, cost of being infected, and the "fear factor" created by the public media.
Behavioral incentives in a vaccination-dilemma setting with optional treatment
Physical Review E
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.