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Vaccination is widely recognized as the most effective way of immunizationagainst many infectious diseases. However, unfounded claims about supposed sideeffects of some vaccines have contributed to spread concern and fear amongpeople, thus inducing vaccination refusal. For instance, MMR vaccine coveragehas undergone an important decrease in a large part of Europe and US as aconsequence of erroneously alleged side effects, leading to recent measlesoutbreaks. In this work, we propose a general agent-based model to study thespread of vaccination behavior in social networks, not as an isolated binaryopinion spreading on it, but as part of a process of cultural dissemination inthe spirit of Axelrod's model. We particularly focused on the impact of a smallanti-vaccination movement over an initial population of pro-vaccination socialagents. Additionally, we have considered two classes of edges in the underlyingsocial network: personal edges able to spread both opinions and diseases; andthe non-personal ones representing interactions mediated by informationtechnologies, which only allow opinion exchanges. We study the clustering ofunvaccinated agents as a dynamical outcome of the model, together with itsdirect relation with the increase of the probability of occurrence and thefinal size of measles outbreaks. Finally, we illustrate the mitigating effectof a public health campaign, represented by an external field, against theharmful action of anti-vaccination movements. We show that the topologicalcharacteristics of the clusters of unvaccinated agents determine the scopes ofthis mitigating effect.

Vaccination and public trust: a model for the dissemination of vaccination behavior with external intervention