Vaccinating behaviour, information, and the dynamics of SIR vaccine preventable diseases

The increasing level of disease control by vaccination jointly with the growing standard of living and health of modern societies could favour the spread of exemption as a "rational" behaviour towards vaccination. Rational exemption implies that families will tend to relate the decision to vaccinate their children to the available information on the state of the disease. Using an SIR model with information dependent vaccination we show that rational exemption might make elimination of the disease an unfeasible task even if coverages as high as 100% are actually reached during epochs of high social alarm. Moreover, we show that rational exemption may also become responsible for the onset of sustained oscillations when the decision to vaccinate also depends on the past history of the disease. (C) 2007 Elsevier Inc. All rights reserved.