Optimal Management of Public Perceptions During A Flu Outbreak: A Game-Theoretic Perspective

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Optimal Management of Public Perceptions During A Flu Outbreak: A Game-Theoretic Perspective Aniruddha Deka1 · Buddhi Pantha2 · Samit Bhattacharyya1 Received: 24 September 2019 / Accepted: 2 October 2020 © Society for Mathematical Biology 2020

Abstract Public perceptions and sentiments play a crucial role in the success of vaccine uptake in the community. While vaccines have proven to be the best preventive method to combat the flu, the attitude and knowledge about vaccines are a major hindrance to higher uptake in most of the countries. The yearly coverage, especially in the vulnerable groups in the population, often remains below the herd immunity level despite the Flu Awareness Campaign organized by WHO every year worldwide. This brings immense challenges to the nation’s public health protection agency for strategic decision-making in controlling the flu outbreak every year. To understand the impact of public perceptions and vaccination decisions while designing optimal immunization policy, we model the individual decision-making as a two-strategy pairwise contest game, where pay-off is considered as a function of public health effort for the campaign. We use Pontryagin’s maximum principle to identify the best possible strategy for public health to implement vaccination and reduce infection at a minimum cost. Our optimal analysis shows that the cost of public health initiatives is qualitatively and quantitatively different under different public perceptions and attitudes towards vaccinations. When individual risk perception evolves with vaccine uptake or disease induced death, our model demonstrates a feed-forward mechanism in the dynamics of vaccination and exhibits an increase in vaccine uptake. Using numerical simulation, we also observe that the optimal cost can be minimized by putting the effort in the beginning and later part of the outbreak rather than during the peak. It confers that public health efforts towards disseminating disease severity or actual vaccination risk might accelerate the vaccination coverage and mitigate the infection faster. Keywords Vaccination · Herd immunity · SIR model · Free-riding behaviour · Evolutionary game theory · Pontryagin’s maximum principle

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1 Introduction Public health department of every country faces several challenges—economical, infrastructure, epidemiological, political and social—to prevent and control influenza every year. Among these, individual or patient-level perceptions about vaccinations are paramount. Despite the flu awareness program each year by the World Health Organization (WHO), influenza vaccination coverage among high-risk groups has nonetheless been declining in a number of countries, especially, in the WHO European Region in recent years (Jones 2012). Local beliefs, lack of trust in the health care system, misperception about the probability of infection, indigenous health practices to avoid or treat influenza an