In existing models of pathogen evolution under voluntary vaccination, vaccination behaviour is typically assumed to be static, overlooking the conflicts between individual and collective interests. To address this, we develop a multi-scale model within a game-theoretic framework that couples the dynamic processes of disease transmission, vaccination decision-making, and pathogen evolution. By reformulating vaccine uptake as a time-dependent strategic choice and incorporating a heterogeneous update mechanism, we establish the evolutionary model of vaccination strategies. Numerical results show that heterogeneous updating rules will capture autonomous population decision-making. The co-evolutionary dynamics are highly sensitive to the evolutionary adaptation rates and exhibit an asymmetric relationship between population and evolutionary dynamics. At the early stage of a vaccination scenario, we observed that imitation behaviour dominates due to limited information. Enhancing vaccine uptake is effective in limiting the emergence of detrimental variants, and the long-term evolutionary outcome may favour the emergence of specialist variants. This framework provides quantitative methods and key methodological advancements for multi-scale mathematical modelling in the context of pathogen evolution.
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Liu et al. (2026) studied this question.
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