Forecasting and optimal control model to assess the potential role of vaccine hesitancy and supportive care in East...

In this study, we developed a novel compartmental model of measles transmission that takes into account vaccine hesitancy and supportive care, applied to East Java Province, Indonesia. The discussion includes calculating the basic reproduction number (R₀) as an indicator of disease transmission. We show that the disease-free equilibrium point is locally and globally asymptotically stable when R₀ is less than one. Using Descartes' Rule, the endemic equilibrium point exists when R₀ is greater than one. Sensitivity analysis results suggest that increasing vaccination coverage and strengthening recovery rate remain the most effective strategies for reducing R₀ in hesitant populations. Using parameter values based on fitting data from East Java Province, Indonesia, various intervention scenarios were simulated to evaluate the impact of vaccination hesitancy on the effective reproduction number and outbreak size, as well as several health system response scenarios to assess their impact on the number of infections. Furthermore, we evaluated the optimal control problem to suppress measles spread at minimal cost through averted population analysis and Incremental Cost-Effectiveness Ratio (ICER) calculations. We concluded that a combination of an integrated awareness campaign with two doses of vaccine and supportive care was the most efficient strategy.