Optimal Vaccination Strategies to Reduce Endemic Levels of Meningitis in Africa

Meningococcal meningitis is a deadly acute bacterial infection caused by the Neisseria meningitidis bacterium that affects the membrane covering the brain and spinal cord. The World Health Organization launched the “Defeating bacterial meningitis by 2030” initiative in 2018, which relies on recent discoveries of cheap and effective vaccines. Here, we consider one important factor—human behavior—which is often neglected by immunization campaigns. We constructed a game-theoretic model of meningitis in the meningitis belt, where individuals make selfish rational decisions whether to vaccinate based on the assumed costs and the vaccination decisions of the entire population. We identified conditions when individuals should vaccinate, and we found the optimal (equilibrium) population vaccination rate. We conclude that voluntary compliance significantly reduces the endemic levels of meningitis if the cost of vaccination relative to the cost of the disease is sufficiently low, but it does not eliminate the disease. We also performed uncertainty and sensitivity analysis on our model.