Health perceptions and health-related behaviors can change at the population level as cultures evolve. In the last decade, despite the proven efficacy of vaccines, the developed world has seen a resurgence of vaccine-preventable diseases (VPDs) such as measles, pertussis, and polio. Vaccine hesitancy, which is influenced by historical, political, and socio-cultural forces, is believed to be a primary factor responsible for decreasing vaccine coverage, thereby increasing the risk and occurrence of VPD outbreaks. Behavior change models have been increasingly employed to understand disease dynamics and intervention effectiveness. However, since health behaviors are culturally influenced, it is valuable to examine them within a cultural evolution context. Here, using a mathematical modeling framework, we explore the effects of cultural evolution on vaccine hesitancy and vaccination behavior. With this model, we shed light on facets of cultural evolution (vertical transmission, community influences, homophily, etc.) that promote the spread of vaccine hesitancy, ultimately affecting levels of vaccination coverage and VPD outbreak risk in a population. In addition, we present our model as a generalizable framework for exploring cultural evolution when humans’ beliefs influence, but do not strictly dictate, their behaviors. This model offers a means of exploring how parents’ potentially conflicting beliefs and cultural traits could affect their children’s health and fitness. We show that vaccine confidence and vaccine-conferred benefits can both be driving forces of vaccine coverage. We also demonstrate that an assortative preference among vaccine-hesitant individuals can lead to increased vaccine hesitancy and lower vaccine coverage.

随着文化的发展，健康观念和与健康相关的行为可能会在人口层面发生变化。在过去十年中，尽管疫苗的功效已得到证实，但发达国家仍出现麻疹、百日咳和脊髓灰质炎等疫苗可预防疾病 (VPD) 死灰复燃的情况。受历史、政治和社会文化力量影响的疫苗犹豫被认为是导致疫苗覆盖率下降的主要因素，从而增加了 VPD 爆发的风险和发生率。行为改变模型越来越多地被用来了解疾病动态和干预效果。然而，由于健康行为受到文化影响，因此在文化进化背景下研究它们是有价值的。在这里，使用数学建模框架，我们探讨文化进化对疫苗犹豫和疫苗接种行为的影响。通过这个模型，我们揭示了文化进化的各个方面（垂直传播、社区影响、同质性等），这些方面促进了疫苗犹豫的蔓延，最终影响了人群中的疫苗接种覆盖率和 VPD 爆发风险。此外，我们将我们的模型作为探索文化进化的通用框架，当人类的信仰影响但不严格规定他们的行为时。该模型提供了一种探索父母潜在冲突的信仰和文化特征如何影响孩子的健康和健身的方法。我们表明，疫苗信心和疫苗带来的好处都可以成为疫苗覆盖率的驱动力。