Social Response and Measles Dynamics

Abstract

Measles remains one of the leading causes of death among young children globally, even though a safe and cost-effective vaccine is available. Vaccine hesitancy and social response to vaccination continue to undermine efforts to eradicate measles. In this study, we consider data about measles vaccination and measles prevalence in Germany for the years 2008–2012 in 345 districts. In the first part of the paper, we show that the probability of a local outbreak does not significantly depend on the vaccination coverage, but—if an outbreak does take place—the scale of the outbreak depends significantly on the vaccination coverage. Additionally, we show that the willingness to be vaccinated is significantly increased by local outbreaks, with a delay of about one year. In the second part of the paper, we consider a deterministic delay model to investigate the consequences of the statistical findings on the dynamics of the infection. Here, we find that the delay might induce oscillations if the vaccination coverage is rather low and the social response to an outbreak is sufficiently strong. The relevance of our findings is discussed at the end of the paper.

Keywords

• measles vaccination
• measles outbreaks
• social response
• zero-inflated negative binomial regression
• delay differential equation