Vaccination games and imitation dynamics with memory.

In this paper, we model dynamics of pediatric vaccination as an imitation game, in which the rate of switching of vaccination strategies is proportional to perceived payoff gain that consists of the difference between perceived risk of infection and perceived risk of vaccine side effects. To account for the fact that vaccine side effects may affect people's perceptions of vaccine safety for some period of time, we use a delay distribution to represent how memory of past side effects influences current perception of risk. We find disease-free, pure vaccinator, and endemic equilibria and obtain conditions for their stability in terms of system parameters and characteristics of a delay distribution. Numerical bifurcation analysis illustrates how stability of the endemic steady state varies with the imitation rate and the mean time delay, and this shows that it is not just the mean duration of memory of past side effects, but also the actual distribution that determines whether disease will be maintained in the population at some steady level, or if sustained periodic oscillations around this steady state will be observed. Numerical simulations illustrate a comparison of the dynamics for different mean delays and different distributions, and they show that even when periodic solutions are observed, there are differences in their amplitude and period for different distributions. We also investigate the effect of constant public health information campaigns on vaccination dynamics. The analysis suggests that the introduction of such campaigns acts as a stabilizing factor for endemic equilibrium, allowing it to remain stable for larger values of mean time delays.