Abstract

A rise in unvaccinated children and subsequent uptick in vaccine-preventable disease has led to a vigorous public debate regarding vaccination status, with some physicians and parents calling for unvaccinated children to be banned from clinics or schools. We simulated a mumps outbreak in a small school system and evaluated how key disease dynamics were impacted by instituting a policy of separating vaccinated and unvaccinated children into different schools. In addition, we evaluated the impact of school separation when used concurrently with physical distancing, self-isolation, school closure, and mandatory isolation.
We used Agent Based Simulation to model mumps outbreaks among students in a small city. Agents move between the school, home and other places on a daily basis. Mumps parameters are modeled based on current literature on infectious diseases. Multiple control strategies were investigated in terms of infection rate, outbreak length, and total costs.
Our motivation for this work was to evaluate the disease impact of a school separation strategy. Given the potential ethical and legal complications, the associated health benefits would have to be significant to persuade policy makers to adopt such a policy. Our results do not suggest that a school separation strategy should be adopted in most of the scenarios since this strategy increases the number of infected students, the chance of outbreaks, and the associated cost in the majority of them. In addition, our work demonstrates that educating students on the benefits of adopting physical distancing and self-isolation is effective in controlling the mumps outbreak size and cost in a population with 90% vaccine coverage, and confirms that mandatory isolation in this population is an effective strategy for managing outbreaks.