Abstract for: Characterization of the impacts of heterogeneity in high-risk populations for infectious disease transmission: Modeling polio a
Heterogeneity in immunization can lead to clusters of underimmunized individuals who may participate in transmission for vaccine-preventable diseases like polio and measles. Special populations that decline or miss immunization opportunities consequently may represent groups of concern to policy makers. Prior outbreaks of polio and measles in Anabaptist communities, including the North American Amish, led to identification as high-risk individuals. We developed an individual-based model that characterizes the network and dynamics of mixing among the Amish and applied the model to characterize transmission of introductions of polio or measles. The results of the modeling demonstrate the wide range of potential outcomes that could have occurred retrospectively or may occur prospectively. Our results suggest that improved characterization of historical vaccination among the Amish would improve public health efforts to manage their risks and the risks they may pose to the broader US population and we discuss challenges associated with interpretation and presentation of IB model results for public health decisions.