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Demographic and socioeconomic spatial data also are limited degree of vaccine hesitancy in communities of color. How do
in that they do not always describe patients’ behavior, for these concerns get incorporated into models? Can we actually
example behavior in seeking appropriate services. Enter agent- model all of the reasons for hesitancy? It seems that Epistemix’s
based modelling or ABM. ABM is a method of analysis used FRED model might be the way.
to simulate macro- and micro-level health system behavior.
This methodology has been used in a variety of areas of study Dr. Geraghty said that one of the great benefits Epistemix
adds to the conversation is the ability to look at a concept
including transportation, infrastructure investment, and
public health. like herd immunity geographically and understand that
different communities have different levels of interaction and
Epistemix is a new company based on the research of Dr. movement; we might find that we can achieve herd immunity
Donald Burke and John Grefenstette. With their colleagues at with lower vaccination rates in some areas. This is yet to be
the University of Pittsburgh, they developed the Framework determined, but the possibility is there, and could lessen
for Reconstructing Epidemiological Dynamics as an agent- concerns like vaccine hesitancy and whether there are enough
based modeling system to predict the progression of disease distribution sites with appropriate chilling facilities.
outbreaks. While the system is not new, the partnership It will be interesting to see how health departments work
between ESRI and Epistemix is a little over a year old, and
seeks to leverage the power of geography and behavioral through the coming challenges, but collaborations like ESRI
and Epistemix and the inclusion of the FRED modeling
modeling to understand and manage the spread of disease.
system may play a significant role in how the public health
community combats this current global health crisis.
A timely connection
Article Sources
Originally, the researchers were looking at applying the system
to the spread of measles, but Drs. Geraghty, Burke, and the team Alboaneen, D.; Pranggono, B.; Alshammari, D.; Alqahtani, N.; Alyaffer,
quickly realized that FRED was ideal for mapping the spread R. Predicting the Epidemiological Outbreak of the Coronavirus Disease
of COVID-19, and understanding issues of herd immunity, 2019 (COVID-19) in Saudi Arabia. Int. J. Environ. Res. Public Health
vaccine distribution, and the implications of human behavior 2020, 17, 4568. https://www.mdpi.com/752142
in disease management. Understanding where data gaps exist Khashoggi, B.F.; Murad, A. Issues of Healthcare Planning and GIS:
can lead to better, more complete decision-making. A Review. ISPRS Int. J. Geo-Inf. 2020, 9, 352. https://www.mdpi.

“We are in such a state of uncertainty,” said Dr. Geraghty. com/726924
“Anything that has scientific methodologies and can give us Jennifer Badham, Edmund Chattoe-Brown, Nigel Gilbert, Zaid
actionable insights, even if imperfect, I think is incredibly Chalabi, Frank Kee, Ruth F. Hunter, Developing agent-based models
valuable because we need some level of certainty and clarity of complex health behaviour, Health & Place, Volume 54, 2018,
to make decisions.” Pages 170-177, https://doi.org/10.1016/j.healthplace.2018.08.022.
Cassidy, R., Singh, N.S., Schiratti, PR. et al. Mathematical modelling
What we know, and where we go for health systems research: a systematic review of system dynamics
from here and agent-based models. BMC Health Serv Res 19, 845 (2019).

The CDC has already determined how many doses of the vaccine https://doi.org/10.1186/s12913-019-4627-7
likely are needed in each state, based on a variety of factors. As we Reprinted from Dimensions Magazine, Online edition,
move into the next phase of the COVID-19 event, it won’t be December 9, 2020
enough to just map vaccine distribution locations and potential
populations of need. We also need to understand the surrounding
environment(s), potential risks, and how populations negotiate
these factors. Questions raised include:
• Those facilities that have cold storage capabilities – are they
near populations that can actually get to them? If they are,
do people’s behaviors match?
• Are populations at risk likely to take advantage of services?
Dr. Geraghty pointed out that, in addition to some of these
general issues around disease spread and appropriately locating
vaccine distribution sites, there are also particular public health
challenges when dealing with vaccination, including some

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