Targeted immunization strategies

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Targeted immunization strategies are approaches designed to increase

the immunization level of populations and decrease the chances
of epidemic outbreaks.[1] Though often in regards to use in healthcare practices and
the administration of vaccines to prevent biological epidemic outbreaks, [2] these
strategies refer in general to immunization schemes in complex networks, biological,
social or artificial in nature.[1] Identification of at-risk groups and individuals with
higher odds of spreading the disease often plays an important role in these
strategies.[1][3]

Contents

 1Background
 2Network-based strategies
 3Increasing immunization coverage
 4See also
 5References

Background[edit]
The success of vaccines in preventing major outbreaks relies on the mechanism
of herd immunity, also known as community immunity, where the immunization of
individuals provides protection for not only the individuals, but also the community at
large.[4] In cases of biological contagions such as influenza, measles, and chicken
pox, immunizing a critical community size can provide protection against the disease
for members who cannot be vaccinated themselves (infants, pregnant women,
and immunocompromised individuals). Often however these vaccine programmes
require the immunization of a large majority of the population to provide herd
immunity.[5] A few successful vaccine programmes have led to the eradication of
infectious diseases like small pox[6] and rinderpest, and the near eradication of polio,
[7]
 which plagued the world before the second half of the 20th century. [8][9]

Network-based strategies[edit]
More recently researchers have looked at exploiting network connectivity properties
to better understand and design immunization strategies to prevent major epidemic
outbreaks.[10] Many real networks like the Internet, World Wide Web, and even sexual
contact networks[11] have been shown to be scale-free networks and as such exhibit
a power-law distribution for the degree distribution. In large networks this results in
the vast majority of nodes (individuals in social networks) having few connections or
low degree k, while a few "hubs" have many more connections than the average
<k>.[12] This wide variability (heterogeneity) in degree offers immunization strategies
based on targeting members of the network according to their connectivity rather
than random immunization of the network. In epidemic modeling on scale-free
networks, targeted immunization schemes can considerably lower the vulnerability of
a network to epidemic outbreaks over random immunization schemes. Typically
these strategies result in the need for far fewer nodes to be immunized in order to
provide the same level of protection to the entire network as in random
immunization.[1][13] In circumstances where vaccines are scarce, efficient immunization
strategies become necessary to preventing infectious outbreaks. [14]
Examples
A common approach for targeted immunization studies in scale-free networks
focuses on targeting the highest degree nodes for immunization. These nodes are
the most highly connected in the network, making them more likely to spread the
contagion if infected. Immunizing this segment of the network can drastically reduce
the impact of the disease on the network and requires the immunization of far fewer
nodes compared to randomly selecting nodes.[1] However, this strategy relies on
knowing the global structure of the network, which may not always be practical. [citation
needed]

A recent centrality measure, Percolation Centrality, introduced by Piraveenan et al.

[15]
 is particularly useful in identifying nodes for vaccination based on the network
topology. Unlike node degree which depends on topology alone, however,
percolation centrality takes into account the topological importance of a node as well
as its distance from infected nodes in deciding its overall importance. Piraveenan et
al.[15] has shown that percolation centrality-based vaccination is particularly effective
when the proportion of people already infected is on the same order of magnitude as
the number of people who could be vaccinated before the disease spreads much
further. If infection spread is at its infancy, then ring-vaccination surrounding the
source of infection is most effective, whereas if the proportion of people already
infected is much higher than the number of people that could be vaccinated quickly,
then vaccination will only help those who are vaccinated and herd immunity cannot
be achieved.[5] Percolation centrality-based vaccination is most effective in the critical
scenario where the infection has already spread too far to be completely surrounded
by ring-vaccination, yet not spread wide enough so that it cannot be contained by
strategic vaccination. Nevertheless, Percolation Centrality also needs full network
topology to be computed, and thus is more useful in higher levels of abstraction (for
example, networks of townships rather than social networks of individuals), where
the corresponding network topology can more readily be obtained. [citation needed]

Increasing immunization coverage[edit]

Millions of children worldwide do not receive all of the routine vaccinations as per
their national schedule. As immunization is a powerful public health strategy for
improving child survival, it is important to determine what strategies work best to
increase coverage. A Cochrane review assessed the effectiveness of intervention
strategies to boost and sustain high childhood immunization coverage in low- and
middle-income countries.[16] Fourteen trials were included but most of the evidence
was of low quality. Providing parents and other community members with information
on immunization, health education at facilities in combination with redesigned
immunization reminder cards, regular immunization outreach with and without
household incentives, home visits, and integration of immunization with other
services may improve childhood immunization coverage in low-and middle-income
countries.[citation needed]

See also[edit]
 Influenza vaccine
 Immunization
 Vaccine-preventable diseases
 Smallpox eradication
 Poliomyelitis eradication
 Infectious diseases
 ILOVEYOU (computer worm epidemic in 2000)
 Epidemiology
 Epidemic model
 Network Science
 Critical community size
 Scale-free network
 Complex network
 Percolation theory
 Pandemic

References[edit]
1. ^ Jump up to:a b c d e Pastor-Satorras R, Vespignani A (March
2002). "Immunization of complex networks".  Physical Review
E.  65  (3 Pt 2A):
036104. arXiv:cond-mat/0107066.  Bibcode:2002PhRvE..65c6104
P.  doi:10.1103/PhysRevE.65.036104. PMID 11909162.  S2CID 1
5581869.
2. ^ "Vaccines and immunization". www.cdc.gov/vaccines/. Center
for Disease Control and Prevention. Retrieved  17
November 2014.
3. ^ Piddle S (October 14, 2014).  "VNA nurses bring shots to
school". Clinton Herald. Retrieved 15 November 2014.
4. ^ John TJ, Samuel R (2000-07-01). "Herd immunity and herd
effect: new insights and definitions". European Journal of
Epidemiology. 16 (7): 601–
6. doi:10.1023/A:1007626510002. PMID 11078115.  S2CID 2350
4580.
5. ^ Jump up to:a b "Community Immunity ("Herd" Immunity)".
National Institute of Allergy and Infectious Diseases. Retrieved 7
April  2014.
6. ^ Bazin H (2000).  The Eradication of Small Pox. London:
Academic Press.  ISBN  978-0-12-083475-4.
7. ^ "Updates on CDC's Polio Eradication
Efforts".  www.cdc.gov/polio. Center for Disease Control and
Prevention. Retrieved 17 November 2014.
8. ^ Lewis T (October 28, 2014). "Polio Vaccine: How the US' Most
Feared Disease Was Eradicated". LiveScience. Purch.
Retrieved 15 November 2014.
9. ^ McNeil Jr DG (May 5, 2014).  "Polio's Return After Near
Eradication Prompts a Global Health Warning".  The New York
Times. Retrieved  18 November  2014.
 10. ^ Campbell E, Salathé M (May 28, 2013). "Complex social
contagion makes networks more vulnerable to disease
outbreaks". Scientific Reports. 3:
1905.  arXiv:1211.0518.  Bibcode:2013NatSR...3E1905C. doi:10.1
038/srep01905. PMC  3664906.  PMID  23712758.
11. ^ Liljeros F, Edling CR, Amaral LA, Stanley HE, Aberg Y (June
2001). "The web of human sexual contacts".  Nature.  411  (6840):
907–8. arXiv:cond-mat/0106507.  Bibcode:2001Natur.411..907L. 
doi:10.1038/35082140. PMID 11418846.  S2CID 14559344.
12. ^ Barabasi AL, Albert R (October 1999). "Emergence of scaling in
random networks".  Science.  286  (5439): 509–12. arXiv:cond-
mat/9910332.  Bibcode:1999Sci...286..509B. doi:10.1126/
science.286.5439.509.  PMID  10521342. S2CID  524106.
13. ^ Tanaka G, Urabe C, Aihara K (July 2014).  "Random and
targeted interventions for epidemic control in metapopulation
models". Scientific Reports. 4  (5522):
5522.  Bibcode:2014NatSR...4E5522T.  doi:10.1038/srep05522. P
MC  4099978.  PMID  25026972.
14. ^ Glasser J, Taneri D, Feng Z, Chuang JH, Tüll P, Thompson W,
Mason McCauley M, Alexander J (September 2010). "Evaluation
of targeted influenza vaccination strategies via population
modeling".  PLOS ONE. 5  (9):
e12777. Bibcode:2010PLoSO...512777G. doi:10.1371/journal.pon
e.0012777. PMC  2941445.  PMID  20862297.
15. ^ Jump up to:a b Piraveenan M, Prokopenko M, Hossain L (2013-
01-22).  "Percolation centrality: quantifying graph-theoretic impact
of nodes during percolation in networks". PLOS ONE.  8 (1):
e53095. Bibcode:2013PLoSO...853095P. doi:10.1371/journal.pon
e.0053095. PMC  3551907.  PMID  23349699.
16. ^ Oyo-Ita A, Wiysonge CS, Oringanje C, Nwachukwu CE,
Oduwole O, Meremikwu MM (July 2016). "Interventions for
improving coverage of childhood immunisation in low- and middle-
income countries". The Cochrane Database of Systematic
Reviews. 7:
CD008145. doi:10.1002/14651858.CD008145.pub3.  PMC 49816
42.  PMID  27394698.

Categories: 
 Vaccination
 Social networks
 Epidemiology
 Epidemics
 Preventive medicine
 Pandemics
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