Network structural metrics as early warning signals of widespread vaccine refusal in social-epidemiological networks

Sudden shifts in vaccine uptake, vaccine opinion, and infection incidence can occur in coupled behaviour-disease systems going through a bifurcation as the perceived risk of the vaccine increases. Literature shows that such regime shifts are sometimes foreshadowed by early warning signals (EWS). We propose and compare the performance of various measures of network structure as potential EWS indicators of epidemics and changes in population vaccine opinion. We construct a multiplex model coupling transmission of a vaccine-preventable childhood infectious disease and social dynamics concerning vaccine opinion. We find that the modularity of pro- and anti-vaccine network communities perform well as EWS, as do several measures of the number and size of opinion-based communities, and the size of pro-vaccine echo chambers. The number of opinion changes also gives early warnings, although the clustering coefficient and metrics concerning anti-vaccine echo chambers provide little warning. Stronger social norms are found to compromise the ability of all EWS metrics to provide advance warning. These exploratory results suggest that EWS indicators based on the network structure of online social media communities might assist public health preparedness by providing early warning of potential regime shifts.