In temperate regions, respiratory virus epidemics recur on a yearly basis, primarily during the winter season. This is believed to be induced by seasonal forcing, where the rate at which the virus can be transmitted varies cyclically across the course of each year. Seasonal epidemics can place substantial burden upon the healthcare system, with large numbers of infections and hospitalisations occurring across a short time period. However, the interactions between seasonal forcing and the factors necessary for epidemic resurgence — such as waning immunity, antigenic variation or demography — remain poorly understood. In this manuscript, we examine how the dynamics of antibody waning and antigenic variation can shape the seasonal recurrence of epidemics. We develop a novel susceptible-infectious-susceptible ( SIS ) immuno-epidemiological model of respiratory virus spread, where the susceptible population is stratified by their antibody level against the currently circulating strain of the virus, with this decaying as both antibody waning and antigenic drift occur. In the absence of seasonal forcing, we demonstrate the existence of two Hopf bifurcations over the effective antibody decay rate, with associated periodic model solutions. When seasonal forcing is introduced, we identify complex interactions between the strength of forcing and the effective antibody decay rate, yielding myriad dynamics including multi-year periodicity, quasiperiodicity and chaos. The timing and magnitude of seasonal epidemics is highly sensitive to this interaction, with the distribution of infection timing (by time of year) varying substantially across the parameter space. Finally, we show that seasonal forcing can produce resonant damping resulting in a cumulative infection incidence that is less than would otherwise be observed.
Tobin et al. (2026) studied this question.