{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:21:01Z","timestamp":1790263261254,"version":"4.1.0"},"reference-count":31,"publisher":"The Royal Society","issue":"107","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/royalsociety.org\/journals\/ethics-policies\/data-sharing-mining\/"}],"content-domain":{"domain":["royalsocietypublishing.org"],"crossmark-restriction":true},"short-container-title":["J. R. Soc. Interface."],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>Smallpox was eradicated in the 1970s, but new outbreaks could be seeded by bioterrorism or accidental release. Substantial vaccine-induced morbidity and mortality make pre-emptive mass vaccination controversial, and if vaccination is voluntary, then there is a conflict between self- and group interests. This conflict can be framed as a tragedy of the commons, in which herd immunity plays the role of the commons, and free-riding (i.e. not vaccinating pre-emptively) is analogous to exploiting the commons. This game has been analysed previously for a particular post-outbreak vaccination scenario. We consider several post-outbreak vaccination scenarios and compare the expected increase in mortality that results from voluntary versus imposed vaccination. Below a threshold level of post-outbreak vaccination effort, expected mortality is independent of the level of response effort. A lag between an outbreak starting and a response being initiated increases the post-outbreak vaccination effort necessary to reduce mortality. For some post-outbreak vaccination scenarios, even modest response lags make it impractical to reduce mortality by increasing post-outbreak vaccination effort. In such situations, if decreasing the response lag is impossible, the only practical way to reduce mortality is to make the vaccine safer (greater post-outbreak vaccination effort leads only to fewer people vaccinating pre-emptively).<\/jats:p>","DOI":"10.1098\/rsif.2014.1387","type":"journal-article","created":{"date-parts":[[2015,4,30]],"date-time":"2015-04-30T09:00:06Z","timestamp":1430384406000},"page":"20141387","update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":26,"title":["Game theory of pre-emptive vaccination before bioterrorism or accidental release of smallpox"],"prefix":"10.1098","volume":"12","author":[{"given":"Chai","family":"Molina","sequence":"first","affiliation":[{"name":"Department of Mathematics and Statistics, McMaster University, Hamilton, Ontario, Canada L8S 4K1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J. 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