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A."],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Typhoid fever has long established itself endemically in rural Ghana despite the availability of cheap and effective vaccines. We used a game-theoretic model to investigate whether the low vaccination coverage in Ghana could be attributed to rational human behaviour. We adopted a version of an epidemiological model of typhoid fever dynamics, which accounted not only for chronic life-long carriers but also for a short-cycle transmission in the immediate environment and a long-cycle transmission via contamination of the water supply. We calibrated the model parameters based on the known incidence data. We found that unless the (perceived) cost of vaccination is negligible, the individually optimal population vaccination rate falls significantly short of the societally optimal population vaccination rate needed to reach herd immunity. We expressed both the herd immunity and the optimal equilibrium vaccination rates in terms of only a few observable parameters such as the incidence rate, demographics, vaccine waning rate and the perceived cost of vaccination relative to the cost of infection. This allowed us not to rely on other uncertain epidemiological model parameters and, in particular, to bypass uncertainties about the role of the carriers in the transmission.<\/jats:p>","DOI":"10.1098\/rspa.2020.0354","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T03:06:17Z","timestamp":1599015977000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":23,"title":["High endemic levels of typhoid fever in rural areas of Ghana may stem from optimal voluntary vaccination behaviour"],"prefix":"10.1098","volume":"476","author":[{"given":"Carmen B.","family":"Acosta-Alonzo","sequence":"first","affiliation":[{"name":"Department of Mathematics and Computer Science, Bennett College, Greensboro, NC 27401, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9892-8568","authenticated-orcid":true,"given":"Igor V.","family":"Erovenko","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, University of North Carolina at Greensboro, Greensboro, NC 27402, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaleah","family":"Lancaster","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Computer Science, Bennett College, Greensboro, NC 27401, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyunju","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Mathematics and Computer Science, University of Guam, Mangilao, Guam 96923, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-2939","authenticated-orcid":true,"given":"Jan","family":"Rycht\u00e1\u0159","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284-2014, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3012-8104","authenticated-orcid":true,"given":"Dewey","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284-2014, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"175","published-online":{"date-parts":[[2020,9,2]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67181-4"},{"key":"e_1_3_7_3_2","unstructured":"WHO. 2018 Weekly Epidemiological Record 30 March 2018 vol. 93 13 (pp. 153\u2013172). https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/272272\/WER9313.pdf?ua=1."},{"key":"e_1_3_7_4_2","first-page":"37","article-title":"Barriers to typhoid fever vaccine access in endemic countries","volume":"8","author":"Khan MI","year":"2017","unstructured":"Khan MI, Franco-Paredes C, Sahastrabuddhe S, Ochiai RL, Mogasale V, Gessner BD. 2017 Barriers to typhoid fever vaccine access in endemic countries. 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