Prevention as a Game-Theoretical Simulation in Bayesian Equilibria and Control through Real- World Data from Vaccination Monitoring

Abstract

Abstract Background: Game theory is an economic model used to understand social conflict situations, identify problems, and propose solutions. In the field of medicine, which involves a tension between resource orientation and medical necessity, certain issues can benefit from game-theoretical models, particularly when social conflict situations influence the actions of public health services. Therefore, it is a possible consideration to view questions related to the COVID-19 pandemic from a game-theoretical perspective. Method: A literature review of game theory applied to medical issues was conducted to develop a model of dynamic equilibriums concerning the question of compulsory vaccination. This model was then evaluated using freely available data from the European Centre for Disease Prevention and Control (ECDC) and the Robert Koch Institute (RKI). Results: It was found that when preventive measures allow citizens some form of choice, they tend to make a decision with a constant probability (dynamic equilibrium). This results in a decreasing proportion of individuals continuously opting for the preventive measure, including vaccinations. Regarding vaccinations, it was observed that regardless of the existence of compulsory vaccination, there can be an asymptotic decline in the proportion of those choosing to get vaccinated within the total population, though this decline was practically unobservable in the case of SARS-CoV-2 basic immunization. Conclusion: With all factors determining the decision for or against a preventive measure held constant, the probability remains constant with each repetition. This suggests that both the initial probability and the number of repetitions are crucial for the success of a preventive measure (e.g., basic immunization). In the case of COVID-19 vaccinations, unlike many other recommended vaccinations, it was possible to convey to the public that basic immunization consists of two doses, which increased the proportion of individuals getting the second dose. Compulsory vaccination for a single-dose vaccination that does not require boosting for a lifetime can fulfill its purpose according to this reasoning. However, compulsory vaccination for a vaccination that requires ongoing repetition cannot fulfill its purpose as the proportion of those choosing to get vaccinated decreases with each repetition. Public health decision-makers should consider this when contemplating preventive measures.