The Potential Beneficial Effects of Vaccination on Antigenically Evolving Pathogens

Although vaccines against antigenically evolving pathogens such as seasonal influenza ; and are designed to protect against circulating strains by affecting the emergence and transmission of antigenically divergent strains, they might in theory also be able to change the rate of antigenic evolution. Vaccination might slow antigenic evolution by increasing immunity, reducing the overall prevalence or population size of the pathogen. This reduction could decrease the supply and growth rates of mutants and might thereby slow adaptation. But vaccination might accelerate antigenic evolution by increasing the transmission advantage of more antigenically diverged strains relative to less diverged strains (i.e., by positive selection). Such evolutionary effects could affect vaccination's direct benefits to individuals and indirect benefits to the host population (i.e., the private and social benefits). To investigate these potential impacts, we simulated vaccination against a continuously circulating influenza-like pathogen in a simple population. On average, more vaccination decreased the incidence of infection. Notably, this decrease was driven partly by a vaccine-induced decline in the rate of antigenic evolution. To understand how the evolutionary effects of vaccines might affect their social and private benefits, we fitted linear panel models to simulated data. By slowing evolution, vaccination increased the social benefit and decreased the private benefit. Thus, vaccination's potential social and private benefits may differ from current theory, which omits evolutionary effects. These results suggest that conventional vaccines against influenza and other antigenically evolving pathogens, if protective against transmission and given to the appropriate populations, could further reduce disease burden by slowing antigenic evolution.