Self-enforcing regional vaccination agreements

Petra Klepac, Itamar Megiddo, Bryan T. Grenfell, Ramanan Laxminarayan

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)
50 Downloads (Pure)


In a highly interconnected world, immunizing infections are a transboundary problem, and their control and elimination require international cooperation and coordination. In the absence of a global or regional body that can impose a universal vaccination strategy, each individual country sets its own strategy. Mobility of populations across borders can promote free-riding, because a country can benefit from the vaccination efforts of its neighbours, which can result in vaccination coverage lower than the global optimum. Here we explore whether voluntary coalitions that reward countries that join by cooperatively increasing vaccination coverage can solve this problem. We use dynamic epidemiological models embedded in a game-theoretic framework in order to identify conditions in which coalitions are self-enforcing and therefore stable, and thus successful at promoting a cooperative vaccination strategy. We find that countries can achieve significantly greater vaccination coverage at a lower cost by forming coalitions than when acting independently, provided a coalition has the tools to deter free-riding. Furthermore, when economically or epidemiologically asymmetric countries form coalitions, realized coverage is regionally more consistent than in the absence of coalitions.
Original languageEnglish
Article number20150907
Number of pages11
JournalJournal of the Royal Society Interface
Issue number114
Publication statusPublished - 1 Jan 2016


  • transboundary movement
  • regional cooperation
  • epidemic dynamics
  • SIR model
  • metapopluation


Dive into the research topics of 'Self-enforcing regional vaccination agreements'. Together they form a unique fingerprint.

Cite this