| dc.description.abstract | Health-related perceptions and behaviors can change as cultures evolve. In the last decade, despite the proven efficacy of vaccines, the developed world has seen a resurgence of vaccine-preventable diseases (VPDs). Vaccine hesitancy, an individual disposition influenced by historical, political, and socio-cultural forces, is believed to be a primary factor responsible for decreasing vaccine coverage, thereby increasing the occurrence of VPD outbreaks. Behavior-change models have been increasingly employed to understand disease dynamics and intervention effectiveness. However, since health behaviors are culturally influenced, it is valuable to examine them within a cultural evolutionary context. Here, applying cultural evolutionary theory and mathematical modeling, I explore the cultural evolutionary dynamics of vaccine hesitancy and vaccination behavior. With one model, I shed light on facets of cultural evolution (parental transmission, community influences, homophily, etc.) that promote the spread of vaccine hesitancy, ultimately affecting levels of vaccination coverage and VPD outbreak risk in a population. I also explore the effects of external factors, particularly vaccine mandates and vaccine inaccessibility, that could decouple parental beliefs from their vaccination behaviors. Finally, using agent-based modeling, I explore the effects of varying decision-making biases in the population, which may explain fluctuations in the acceptance of both established and novel vaccines. I present my models as generalizable frameworks for exploring belief-behavior interactions when humans’ beliefs influence, but do not strictly dictate, their behaviors. I show that parental vaccine confidence and level of preference to choose a partner who shares one’s vaccine-related beliefs can both be driving forces of vaccine coverage. I also show that vaccine mandates can lead to a phenomenon in which high vaccine hesitancy co-occurs with high vaccination coverage, and that high vaccine confidence can be maintained even in areas where access to vaccines is limited. Finally, I demonstrate that the distribution of decision-making patterns within a population can affect vaccine-confidence and vaccination coverage outcomes, as well as the coupling between those dynamics. My work provides useful insights for designing effective public health strategies that account for the cultural context of a population. | |
