Comparative evaluation of the effectiveness of measles immunization regimens using agent-based modeling methods

Relevance. Achieving and sustaining measles control requires optimization of vaccination schedules that account for demographic changes, immunity dynamics, and infection transmission patterns. A comparative assessment of the long-term effectiveness of different immunization schedules using modern modeling techniques is a relevant scientific and practical task.

Objective. To conduct a comparative assessment of the long-term epidemiological effect of different measles vaccination schedules using the developed agent-based simulation model.

Materials and Methods. A spatially implicit agent-based stochastic model was developed, integrating modules for demography, migration, maternal and vaccine-induced immunity, and age-specific spatial contacts. In a series of 100-year simulations for a population of 100,000 agents, three scenarios were compared: a standard twodose schedule (SRN: 12 months and 6 years), a schedule with an earlier first dose (SR9: 9 months and 6 years, strict timeliness window), and a schedule with a booster dose (SR3: 12 months, 6 and 18 years). The analysis focused on the long-term average incidence, inter-epidemic intervals, and the age distribution of cases.

Results. The SR9 scenario demonstrated a statistically significant 2.5-fold reduction in the long-term average incidence compared to the baseline SRN scenario. SR9 was associated with longer inter-epidemic intervals (6.12 years vs. 5.75 years for SRN), a twofold reduction in peak incidence, and smoother outbreak dynamics. The age distribution of cases showed a significant reduction in incidence both among children under one year and among adults (18+) in the SR9 scenario compared to SRN and SR3. The introduction of a booster dose (SR3) did not lead to a significant reduction in long-term average incidence compared to the standard schedule.

Conclusions. Optimization of the vaccination calendar involving an earlier administration of the first dose (9 months) combined with strict control over vaccination timeliness can provide a more significant and sustained reduction in measles incidence compared to standard or extended booster schedules. The obtained results highlight the importance of refining the age at vaccination initiation and regulating the timing of vaccine administration as key factors for long-term epidemiological control.

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