The evolutionary epidemiology of vaccination.

Vaccination leads to dramatic perturbations of the environment of parasite populations and this can have both demographic and evolutionary consequences. We present a theoretical framework for modelling the short- and long-term epidemiological and evolutionary consequences of vaccination. This framework integrates previous theoretical studies of vaccine-induced parasite evolution, and it allows one to make some useful qualitative predictions regarding the outcome of the competition between different types of vaccine-favoured variants. It can also be used to make quantitative predictions about the speed of such evolutionary processes. This work may help define the relevant parameters that need to be measured in specific parasite populations in order to evaluate the potential evolutionary consequences of vaccination. In particular, we argue that more work should be done evaluating the nature and magnitude of parasite fitness costs associated with adaptation to vaccinated hosts.