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Figure 2 | BMC Public Health

Figure 2

From: The role of vaccination coverage, individual behaviors, and the public health response in the control of measles epidemics: an agent-based simulation for California

Figure 2

Effects of intervention delays and the contact finding probability on the control of measles epidemics. We simulated the main outcomes for each combination of the intervention delay for contacts of the index case and the contact finding probability under 9 combinations (A, B, C, D, E, F, G, H and I) of vaccination coverage (V= 0.85, 0.9 and 0.95) and the level of immunity clustering (Ω=0, 0.5 and 1). Cells in red indicate the combinations with which the simulations had uncontrolled outbreaks with the uncontrolled outbreak probabilities ranging from low to high. Cells in light blue show the combinations without uncontrolled outbreaks but with higher outbreak sizes than the combinations without uncontrolled outbreaks represented by dark blue cells. The frontiers between adjacent combinations with and without uncontrolled outbreaks are shown by the black lines. The results in (A), (B) and (C) suggest that increasing vaccination coverage levels and the contact finding probability while reducing intervention delays may reduce the uncontrolled outbreak probability. However, measles outbreaks may not be prevented with the highest level of immunity clustering. The results in (D), (E) and (F) suggest that scenarios with a lower level of immunity clustering, increasing vaccination coverage and contact finding probability, and reducing intervention delays have smaller uncontrolled outbreak probabilities than the highest level of immunity clustering (shown in Figures 2(A), (B) and (C)), and 95% of vaccination may be enough to prevent measles outbreak which is consistent with the result shown in Figure 1 (the cell with V=95% and Ω=0.5); when V=90%, measles outbreaks may be prevented by the combinations of low intervention delays and a high contact finding probability. The results in (G), (H) and (I) suggest that with the lowest level of immunity clustering, increasing vaccination coverage may dramatically reduce measles outbreaks.

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