Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-25T20:02:47.640Z Has data issue: false hasContentIssue false
  • English
  • Français

Smallpox, Risks of Terrorist Attacks, and the Nash Equilibrium: An Introduction to Game Theory and an Examination of the Smallpox Vaccination Program

Published online by Cambridge University Press:  28 June 2012

Richard Hamilton  and
Roger McCain
Richard Hamilton*
Affiliation:
Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
Roger McCain
Affiliation:
Elbow College of Business, Drexel University, Philadelphia, Pennsylvania, USA
*
Chair, Department of Emergency MedicineDrexel University College of Medicine245 N. 15th Street, Mailstop 1011Philadelphia, Pennsylvania 19102USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The smallpox vaccination emergency preparedness program has been unsuccessful in enrolling sufficient numbers of healthcare workers.

Objective:

The objective of this study was to use game theory to analyze a pre-event vaccination versus post-event vaccination program using the example of a terrorist considering an attack with smallpox or a hoax.

Methods:

A three-person game (normal and extensive form), and an in-person game are played for pre-event and post-event vaccinations of healthcare workers facing the possibility of a smallpox attack or hoax.

Results:

Full pre-event vaccinations of all targeted healthcare workers are not necessary to deter a terrorist attack. In addition, coordinating vaccinations among healthcare workers, individual healthcare worker risk aversion, and the degree to which terrorists make the last move based on specific information on the status of pre-event vaccination all greatly impact strategy selection for both sides. A Nash Equilibrium of pre- and post-event vaccination strategies among a large number of healthcare professionals will tend to eliminate the advantage (of the terrorists) of a smallpox attack over a hoax, but may not eliminate some probability of a smallpox attack.

Conclusions:

Emergency preparedness would benefit from game theory analysis of the costs and payoffs of specific terrorism/counter-terrorism strategies.

Keywords

game theoryhoaxsmallpoxpreventionresponse teamterrorismvacciniaweapons of mass destruction
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 3 , June 2009 , pp. 231 - 238
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Aumann, RJ: Presidential address. Games and Economic Behavior 2003;45:2–14.Google Scholar
2.Sandler, T, Arce, DG: Terrorism and game theory. Simulation and Gaming 2003;34:319–337.Google Scholar
3.Poundstone, W: Prisoner's Dilemma. New York: Doubleday, 1992.Google Scholar
4.Nash, JF: Non-cooperative games. Annals of Mathematics 1951;54:286–295.Google Scholar
5.Ehud, Kalai: Presidential Address, Second World Congress of the Game Theory Society “What would von Neumann and Morgenstern Say?” Marseille, France, July 2004.The story is A. Conan Doyle, “The Final Problem.”Google Scholar
6.Committee on Smallpox Vaccination Program Implementation, Baciu, A, Pernack, Anason A, Stratton, K, Strom, B (eds): The Smallpox Vaccination Program: Public Health in an Age of Terrorism. Washington DC: Institute of Medicine of the National Academies, 2005.Google Scholar
7.Aragon, TJ, Fernyak, SE: The risk and benefits of pre-event smallpox vaccination: Where you stand depends on where you sit. Ann Emerg Med 2003;42(5):681–684.Google Scholar
8.Yih, WK, Lieu, TA, Rêgo, VH, O'Brien, MA, Shay, DK, Yokoe, DS, Platt, R: Attitudes of healthcare workers in U.S. hospitals regarding smallpox vaccination. BMC Public Health 2003;11(3):20.Google Scholar
9.Leask, A, Delpech, V, McAnulty, J: Anthrax and other suspect powders: initial responses to an outbreak of hoaxes and scares. N S W Public Health Bull 2003;14(11–12):218–221.Google Scholar
10.Kuhles, DJ, Ackman, DM: The Federal Smallpox Vaccination Program: Where do we go from here? Public Health: Small Pox Program Web Exclusive. Health Affairs 22 October 2003. Pub Med Citation Health Aff (Millwood). 2003 Jul-Dec;Suppl Web Exclusives:W3-503-10. available at http://content.healthaffairs.org/cgi/reprint/hlthaff.w3.503v1. Accessed on December 8, 2007Google Scholar
11.Ortega-Sanches, IR, Sniadack, MM, Mootrey, GT: Economics of cardiac adverse events alter smallpox vaccination; Lessons from the 2004 US Vaccination Program. Clin Infect Dis 2008;46:s168–s178.Google Scholar
12.Hupert, N, Wattson, D, Cuomo, J, Benson, S: Anticipating demand for emergency health services dues to medication-related adverse events after rapid mass prophylaxis campaigns. Acad Emerg Med 2007;24:268–274.Google Scholar
13.Harsanyi, JC: Games with incomplete information played by “Bayesian”players, I-III. Part I. The basic model. Management Science 1967;14:159–182.Google Scholar
14.Arthur, AW: Inductive reasoning and bounded rationality (The El Farol Problem). Amer Econ Review (Papers and Proceedings) 1994;84:406.Google Scholar
15.Axelrod, R: The Evolution of Strategies in the Iterated Prisoner's Dilemma. In: Davis, LD (ed): Genetic Algorithms and Simulated Annealing. New York: Morgan Kaufmann, 1987, pp 32–41.Google Scholar
16.Moulin, H: Game Theory for the Social Sciences. New York: NYU Press, 1982.Google Scholar
17.Vega-Redondo, F: Evolution, Games and Economic Behavior. Oxford, England: Oxford University Press, 1996.Google Scholar