1. Introduction
With a good understanding of the course of the epidemic, we will be in a better position to prevent or monitor communicable diseases, such as Coronavirus Disease 2019 (COVID-19), and to help with the decision making for an effective control strategy. The mathematical epidemic models can forecast the epidemic trajectories and estimate the dynamics of disease transmission and recovery. This information can guide public health practitioners’ responses, offer policymakers a reference for the best allocation of medical resources, and reduce the risk caused by the spread of the epidemic.
Both deterministic and stochastic models have been proposed to model infectious diseases. Modern epidemic models are mostly constructed under the framework of the Susceptible-infected-recovered (SIR) model [
1], and most of these models are presented in a deterministic system [
2,
3,
4]. We refer you to [
5] for a detailed presentation about the concepts and the related tools for deterministic models. Recently, many articles have introduced stochastic processes to epidemic models. For example, [
6,
7] brought in random disturbances to the transmission rate of the traditional Susceptible-infected-susceptible (SIS) model. Ref. [
8] added random disturbances to the deterministic Susceptible-infected-recovered-susceptible (SIRS) model and explored the impact of intervention strategies. Ref. [
9] imported Levy noise in the SIS model.
Quarantine and vaccination are the primary strategies against infectious diseases. Recent studies in the literature have considered models of quarantine [
10,
11,
12,
13,
14] and have incorporated the social network into models. However, due to the high cost of quarantine, vaccination is among the most effective and long-term approaches. Hence, there is considerable literature discussing infectious disease models with vaccines. For example, [
15,
16,
17] introduced vaccination into SIS models. Ref. [
18] discussed the vaccination under the SIR model from the perspective of optimal control. Ref. [
19] presented a multi-strain infectious disease model allowing the virus to mutate into a new strain when there is vaccination in the SIR model.
The first reported cases of COVID-19 emerged in 2019 and has infected people around the world. The rapid spread of COVID-19 in the past two years has presented challenges to the international public health and economy. As of 17 April 2022, over 500 million confirmed cases and over six million deaths had been reported globally [
20]. Many countries have developed COVID-19 vaccines to prevent the spread of the epidemic. There are several widely known and administered vaccines available on a large scale, including AstraZeneca (AZ), Moderna, Pfizer-BioNTech (BNT), Janssen (Johnson & Johnson), and Sputnik V. Over time, considerable discussions on vaccine-related topics have emerged. For example, [
21] presented a systematic review. They provided an overview of clinical data from COVID-19 vaccine development and discussed the strategies to develop vaccines from different infectious diseases, with the aim to aid in developing therapeutic approaches for treatment and prevention of COVID-19. Ref. [
22] proposed a new model to discuss the vaccine-resistant issue of COVID-19. Ref. [
23] modified the SEIR compartmental model to forecast the possible development of the second COVID-19 wave in European countries. Ref. [
24] proposed a multi-regional, hierarchical-tier model for understanding the complexity and heterogeneity of COVID-19 spread and control.
Due to an urgent need for COVID-19 vaccines, the vaccine administration of COVID-19 is in the mode of emergency use authorization requiring less data than typically needed in the early stage. The vaccine development time is therefore extraordinary short; however, to achieve sufficient protection, administering two doses are, in general, recommended within a specific time. Depending on which vaccine was administered, the recommended time-period between doses or the rate of administration may vary.
Therefore, it would be important to obtain an appropriate interval between two vaccinations, which can be then verified through clinical experiment. Recently, [
25] proposed an extended SEAIRD compartmental model to describe the epidemic dynamics with both single-dose and double-dose vaccine administrations. They utilized the deterministic framework of nonlinear constrained optimal control problems to solve optimal vaccine administration problems. In addition, they only focused on the scenario with only one strain, which does not resemble reality. In this study, we hope to conduct a broader discussion on vaccination frequency through the construction of mathematical models. Additionally, due to a fast-spreading and higher mutation rate of the virus, there is already evidence to have more than one mutated strain of the new coronavirus. To take these into consideration, we will therefore construct a stochastic, multi-strain SIR model for a two-dose vaccine.
We structure the rest of this paper as follows.
Section 2 presents the reasoning of our model and discusses its basic properties, such as equilibrium points and basic reproduction numbers of the deterministic model.
Section 3 then focuses on its properties associated with the main stochastic model. Some numerical examples are shown to illustrate the results of our model in
Section 4. We conclude this work in
Section 5.
2. The Model
Table 1 lists the variables and parameters of our model.
We consider a multi-strain SIR model as shown in (1). We assume that there are
types of strain and only one single vaccine available. The model includes susceptible population (
), the number of individuals who received only one dose of the vaccine (
), the number of individuals who received two doses of the vaccine (
), the number of people infected by the kth strain (
), and the number of individuals who were recovered (
). We assume that each susceptible person is infected with at most a single strain at a time. We present their relationship between the compartments in
Figure 1, and introduce the following proposed model
We assume that the vaccine has a complete anti-epidemic effect on each strain, but its effect will disappear at a certain rate, returning the vaccinated person to the situation before the vaccination. Although this is different from reality, it may approximate the ineffectiveness of the vaccine against different strains.
Suppose that the number of total populations is
. It implies
Then, we have
,
, where
To simplify the following discussion, we assume
. Next, we will discuss the stability of model (1) on an invariant set
:
where
,
,
,
.
2.1. The Equilibrium Point and the Basic Reproduction Number
We have some equilibrium points of our model on
, and its first point is the disease-free equilibrium point
, where
If the number of infected people is positive only for strain
and the rest is 0, the endemic equilibrium point is
, and
. Note that
means
and
.
Using the next generation method, we can obtain the basic reproduction number.
The next generation matrix is
Substituting
with
, we have the basic reproduction number
for strain
in the deterministic model, that is,
. This yields the basic reproduction number of model (1) with
2.2. Sensitivity Analysis of the Basic Reproduction Number to Parameters
Sensitivity analysis can be used to explore the effect on outcomes due to the changes in each parameter within a specified range in a mathematical model. In the studies of [
26,
27], the LHS/PRCC (Latin hypercube sampling/partial rank correlation coefficients) technique was used to analyze the sensitivity of parameters in
. In this subsection, we use the same technique to find the parameters that have more influence on
.
First, we set the probability functions of the parameters. We assign the birth rate to have a uniform distribution between 0 and 5, and denote it as ~U(0, 5). Except for , we set the rest of the parameters to have uniform distributions between 0 and 1. We assume to have a lower vaccine failure rate after two doses of the vaccine, and hence, < . We set ~U (0, ).
There are 3K + 7 parameters in model (1), and we set the number of simulations to 1000 times. In other words, we generate a 1000 × (3K + 7) LHS table as the input matrix and use
as the output variable. Next, we calculate the PRCCs and test whether the coefficients are 0′s. We use the lhs package in R to generate the LHS table and use the sensitivity package to test the PRCCs. Note that the bootstrap method with repeated sampling 2000 times is used. The results with K = 3 are shown in
Table 2 and
Figure 2.
Except for and , other parameters are significant, but these two parameters are directly related to and . Both and are negatively correlated with , that is, the higher the vaccination rate, the smaller the . This is in line with the hypothesis that vaccines inhibit disease transmission. Conversely, and represent vaccine failure rates, which are positively correlated with . The most sensitive parameters are b and . The ratio represents the upper limit of the population. From Equation (5), this ratio has a definite linear relationship with the value of .
2.3. The Stochastic Model
Following the spirit of the model in [
6], we assume that the disease transmission rates fluctuate around some average values. Let
be a complete probability space, and
, where
are independent standard Brownian motions,
is the expected value of
, and
are the amplitudes of
,
. Thus, the proposed stochastic model becomes
Note that model (12) is generalized from SIR or can be seen as a special case of the SVIRS model [
28]. However, unlike the previous articles, we considered the impact of two vaccine doses on the epidemic under multi-strain infectious diseases.
4. Numerical Examples
We illustrate the main results with some numerical examples. To simplify the discussion, we consider the scenario with only 3 strains, that is, we set . The first three examples are mainly to verify our theoretical results. Example 4 is to discuss the situations with different vaccination rates. In Examples 1 to 4, the initial values of the variables are given as , , , , and , . We provide Example 5 to further mimic the reality and present explanations in more detail.
Example 1. We set the study durationand the gap of simulation. Assume the parameters are given by,,,,,, and.
Then, we have and. It impliesand,. The model meets condition (a) of Theorem 2, but not condition (b) of Theorem 2.
We simulated the numbers of infected individuals for each of three strains, and we show the results in
Figure 3. As the result of Theorem 2, the number of infected individuals approached 0 with time.
Example 2. We set and. Assume the parameters are given by,,,,,, and.
Then, we have and,. The model meets condition (b) of Theorem 2. As and,, it does not meet condition (a) of Theorem 2.
We simulated the numbers of infected individuals for each of three strains. The results are shown in
Figure 4, indicating that the number of infected individuals approached 0 with time.
Example 3. We set and. Assume the parameters are given by,,, ,, , and
Then, the basic reproduction numbers are,, and. We have. As, it implies,.
We simulated the numbers of infected individuals of the three strains and we present the results in
Figure 5.
Note that , , , and . Obviously, only the first strain will persist, and the other two strains will go extinct.
Moreover, we assume cost model (31) with the costs , , and . The optimal , and we have the optimal basic reproduction number . Note that if no one is vaccinated at all, .
If we assume cost model (36) with , , and , then the optimal and we have . If no one is vaccinated at all, .
Example 4. We use the same setting for all parameters as that in Example 3 except forand. We setand bothandtake 3 levels, 0.1, 0.5, and 0.9. The ’s and’srelated to differentcombinations are shown inTable 3. All’s and’s decrease asandincrease. This echoes the sensitivity analysis in Section 2. It also means that the higher the vaccination rate, the higher the immune effect that can be achieved. We simulated the total number of infected individuals by three strains (
) and we present the results in
Figure 6. The number of total infected individuals fluctuated within a fixed range after a certain time point. The level of its oscillation position is related to the vaccination rate.
Example 5. In order to mimic the actual COVID-19 infection situation, we consult the parameter information in Table 1 in [22] for simulation. First, we set b = 10 and μ_N = 0.01 to meet the value ofin the table, and we use the data in the table to set ,, and,. We assume that people who received one dose of the vaccine had twice the rate of loss of immunity compared with those who received two doses. Then, we set and. As the vaccination rate is between 0.001 and 0.015, we set. As the transmission rate is betweenandin the table, we assignand.
Then, the basic reproduction numbers are,, and.
We simulated the numbers of infected individuals of the three strains with
, and the initial conditions are given as
,
, and
,
. The results are presented in
Figure 7.
As the and are both greater than 1, the number of infected patients gradually increases at the beginning and then decline after reaching a peak. The second strain slowly goes extinct, while the first strain continues oscillating between 25 and 50. is less than 1, and it tends to go extinct from the beginning. This phenomenon can reflect that changes in the epidemic often return to a relatively flat fluctuation after a wave of peaks.