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Figure 3 | BMC Public Health

Figure 3

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 3

Effects of vaccination coverage and the contact rate in neighborhoods on the control of measles epidemics. We used the parameters’ values in Table 1 and combinations of vaccination coverage and contact rates in the neighborhood, and ran 256 iterations for each combination to simulate the uncontrolled outbreak probability and the outbreak size in 365 days under three scenarios: (A) without contact investigations, (B) with contact investigations and less intervention delay for contacts of the index case, and (C) with contact investigations and more intervention delay for contacts of the index case. For each of the scenarios A, B, and C, red cells show the combinations with uncontrolled outbreaks (the simulated uncontrolled outbreak probabilities >0; light red cells indicate combinations with lower uncontrolled outbreak probabilities; dark red cells indicate combinations with higher uncontrolled outbreak probabilities); and blue cells represent the simulated outbreak sizes of the combinations without uncontrolled outbreaks (the simulated uncontrolled outbreak probabilities =0), and scale the outbreak sizes from low (dark blue) to high (light blue). The frontiers between adjacent combinations with and without uncontrolled outbreaks are shown by the black lines. These simulations suggest: contact investigation plays an important role in preventing measles uncontrolled outbreaks and reducing the total outbreak size; with contact investigations, reducing the contact rates in the neighborhood may lower the vaccination coverage required to prevent uncontrolled measles outbreaks; with contact investigations and the highest vaccination coverage, measles outbreaks may be prevented even with very high contact rates in the neighborhood; less intervention delays for contacts of the index case may help contact investigations reduce the probability of uncontrolled measles outbreaks and the total outbreak size.

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