An interdisciplinary team of authors from Canada, Austria, the USA and Germany outlines how immuno-epidemiology and individual decision-making on non-pharmaceutical interventions (NPIs) can be understood jointly in future — and which data are still missing.
To the Point:
• Decisions and epidemics influence one another: NPI adherence arises from feedback loops between local infection levels, peer behaviour and external information (e.g. media/social media).
• Perceived vs actual immunity is a central blind spot: misperceptions of one’s own or collective immunity can measurably shift risk assessment, behaviour and thus transmission.
• Progress requires an iterative approach: stepwise models must be tightly linked with longitudinal behavioural, immunological and epidemiological data — including social factors such as trust, disinformation and group processes.
Why does one person consistently follow non-pharmaceutical measures — and another not? The authors argue that this question cannot be answered purely psychologically or purely epidemiologically. Individual decision-making, immunity and infection dynamics form a system of feedbacks: local infection levels and peer behaviour matter, as does external information — including media and social media. What is decisive is which information source dominates decisions: the immediate environment or external signals. This, in turn, determines whether adherence and local infection numbers remain closely coupled or drift apart.
A key blind spot lies in the gap between actual and perceived immunity. Immunity changes — through vaccination, recovery, immune waning and pathogen evolution. At the same time, it is unclear how accurately people assess their own immunity. Those who mistakenly believe they are immune may be more likely to forgo protective measures; those who underestimate their immunity may remain more cautious. Such miscalibrations can also appear at population level, for example when people infer “community immunity” from case counts or vaccination data.
The perspective article calls for a new research programme: models that bring together immunity, epidemiology and behaviour — built step by step and closely integrated with longitudinal data collection. Proposed approaches include, among others, combining serology with surveys on perceived immunity, as well as repeated surveys on risk perception, peer influences and external information sources — including misinformation and disinformation. Social mechanisms such as group processes and out-group aversion are also identified as important building blocks.
Anyone seeking to understand why measures work in epidemic outbreaks — or do not — will find here a map of important open questions.
© Michael Hesse
Prof. Dr. Arne Traulsen
Managing Director
Scientific Member (Director)
Department of Theoretical Biology
Max Planck Institute for Evolutionary Biology
Chadi M. Saad-Roy, Ninan Abraham, Christian Hilbe, Ayesha S. Mahmud, Arne Traulsen, Interactions between immuno-epidemiology and individual decision-making for nonpharmaceutical interventions, Trends in Microbiology, 2026, https://doi.org/10.1016/j.tim.2026.01.006.
Visualization of decision-making processes at the intersection of perceived immunity, risk assessmen ...
Copyright: MPI EvolBio, created with ChatGPT
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Visualization of decision-making processes at the intersection of perceived immunity, risk assessmen ...
Copyright: MPI EvolBio, created with ChatGPT
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