Abstract
Breakthrough infections and reinfection are key factors leading to recurrent epidemic waves. However, sustained control strategies can lead to unnecessary resource wastage when tacking these issues. There is an urgent need to establish dynamic intervention systems capable of rapid response and efficient resource utilization. To address the question of how breakthrough infections and reinfections affect the dynamics of the pandemic, this study develops an infectious disease model that incorporates both breakthrough infections and reinfections, and while introduces bang-bang optimal control as an efficient public health intervention strategy to provide a new perspective and solutions. In theoretical analysis, we derive basic reproduction number via next-generation matrix method, prove the global stability of the disease-free equilibrium, and establish sufficient conditions for the existence of multiple endemic equilibria and the occurrence of backward bifurcation. Numerical simulations further confirm the critical role of breakthrough infections and reinfection in disease persistence and recurrent outbreaks. In control strategy research, we prove the existence of bang-bang optimal solutions based on optimal control theory and demonstrate their distinct advantages in rapidly outbreaks while minimizing operational costs. Simulation results show that a combined strategy implemented under the bang-bang control—reducing transmission rates, expanding vaccine coverage, and enhancing vaccine protection—most effectively contains disease spread. This results provide both theoretical foundation and practical guidance for developing efficient control strategies against recurrent infectious disease outbreaks.
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References
Centers for Disease Control and Prevention. COVID-19 Vaccination. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html (2022).
Li, Y., Qin, S., Dong, L. et al. Long-term effects of Omicron BA. 2 breakthrough infection on immunity-metabolism balance: A 6-month prospective study. Nat. Commun. 15(1), 2444 (2024).
Osterholm, M. T. et al. Efficacy and effectiveness of influenza vaccines: A systematic review and meta-analysis. Lancet Infect. Dis. 12(1), 36–44 (2012).
Gupta, R. K. & Topol, E. J. COVID-19 vaccine breakthrough infections. Science 374(6575), 1561–1562 (2021).
Centers for Disease Control and Prevention. Seasonal Influenza (Flu). https://www.cdc.gov/flu/professionals/antivirals/antiviral-use-influenza.htm (2021).
Centers for Disease Control and Prevention. Chickenpox (Varicella). https://web.archive.org/web/20170225050958/https://www.cdc.gov/chickenpox/hcp/clinical-overview.html (2017).
Bergwerk, M. et al. COVID-19 breakthrough infections in vaccinated health care workers. N. Engl. J. Med. 385(16), 1474–1484 (2021).
Alcendor, D. J. et al. Breakthrough COVID-19 infections in the US: implications for prolonging the pandemic. Vaccines 10(5), 755 (2022).
Abu-Raddad, L. J. et al. Relative infectiousness of SARS-CoV-2 vaccine breakthrough infections, reinfections, and primary infections. Nat. Commun. 13(1), 532 (2022).
Chemaitelly, H. et al. Addressing bias in the definition of SARS-CoV-2 reinfection: Implications for underestimation. Front. Med. 11, 1363045 (2024).
Pulliam, J. R. C. et al. Increased risk of SARS-CoV-2 reinfection associated with emergence of Omicron in South Africa. Science 376(6593), 4947 (2022).
Fonville, J. M. et al. Antibody landscapes after influenza virus infection or vaccination. Science 346(6212), 996–1000 (2014).
Van der Kuyl, A. C. & Cornelissen, M. Identifying HIV-1 dual infections. Retrovirology 4, 1–12 (2007).
Ghosh, M., Olaniyi, S. & Obabiyi, O. S. Mathematical analysis of reinfection and relapse in malaria dynamics. Appl. Math. Comput. 373, 125044 (2020).
Anggriani, N. et al. The effect of reinfection with the same serotype on dengue transmission dynamics. Appl. Math. Comput. 349, 62–80 (2019).
Wang, J. et al. COVID-19 reinfection: A rapid systematic review of case reports and case series. J. Invest. Med. 69(6), 1253–1255 (2021).
Glynn, J. R. et al. High rates of recurrence in HIV-infected and HIV-uninfected patients with tuberculosis. J. Infect. Dis. 201(5), 704–711 (2010).
Costenaro, P. et al. SARS-CoV-2 infection in people living with HIV: A systematic review. Rev. Med. Virol. 31(1), 1–12 (2021).
Mary, K. People with HIV at higher risk of COVID reinfection: CDC. https://abcnews.go.com/Health/people-hiv-higher-risk-covid-reinfection-cdc/story?id=104035803 (2023).
Centers for Disease Control and Prevention. What is COVID-19 Reinfection? https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfection.html (2019).
Perkins, T. A. et al. An agent-based model of dengue virus transmission shows how uncertainty about breakthrough infections influences vaccination impact projections. Plos Comput. Biol. 15(3), e1006710 (2019).
Azimaqin, N. et al. Vaccine failure, seasonality and demographic changes associate with mumps outbreaks in Jiangsu Province, China: Age-structured mathematical modelling study. J. Theor. Biol. 544, 111125 (2022).
Xu, C. et al. A mathematical model to study the potential hepatitis B virus infections and effects of vaccination strategies in China. Vaccines 11(10), 1530 (2023).
Elbasha, E. H., Podder, C. N. & Gumel, A. B. Analyzing the dynamics of an SIRS vaccination model with waning natural and vaccine-induced immunity. Nonlinear Anal. Real World Appl. 12(5), 2692–2705 (2011).
Yuliana, R., Alfiniyah, C. & Windarto, W. Stability analysis of SIVS epidemic model with vaccine ineffectiveness. In AIP Conference Proceedings. Vol. 2329(1) (2021).
Jing, S. et al. Age-structured modeling of COVID-19 dynamics: The role of treatment and vaccination in controlling the pandemic. J. Math. Biol. 90(1), 1–49 (2025).
Montalbán, A., Corder, R. M. & Gomes, M. G. M. Herd immunity under individual variation and reinfection. J. Math. Biol. 85(1), 2 (2022).
Rehman, A., Singh, R. & Singh, J. Mathematical analysis of multi-compartmental malaria transmission model with reinfection. Chaos Solitons Fract. 163, 112527 (2022).
Anggriani, N. et al. The effect of reinfection with the same serotype on dengue transmission dynamics. Appl. Math. Comput. 349, 62–80 (2019).
Gomes, M. G. M., White, L. J. & Medley, G. F. Infection, reinfection, and vaccination under suboptimal immune protection: Epidemiological perspectives. J. Theor. Biol. 228(4), 539–549 (2004).
Agusto, F. B. Mathematical model of Ebola transmission dynamics with relapse and reinfection. Math. Biosci. 283, 48–59 (2017).
Rodrigues, P., Margheri, A., Rebelo, C. & Gomes, M. G. Heterogeneity in susceptibility to infection can explain high reinfection rates. J. Theor. Biol. 259(2), 280–290 (2009).
Megala, T., Nandha Gopal, T., Siva Pradeep, M. et al. Dynamics of re-infection in a hepatitis B virus epidemic model with constant vaccination and preventive measures. J. Appl. Math. Comput. 1–27 (2025).
Van den Driessche, P. Reproduction numbers of infectious disease models. Infect. Dis. Model. 2(3), 288–303 (2017).
Fleming, W. H. & Rishel, R. W. Deterministic and Stochastic Optimal Control (Springer, 1975).
Pontryagin, L. S. Mathematical Theory of Optimal Processes. (CRC Press, 1987).
Acknowledgements
We would like to thank the reviewers for their valuable comments and suggestions which helped us to improve the presentation of this paper significantly.
Funding
This work was supported by the National Natural Science Foundation of China (No. 12471462, No. 12101373, No. 12171291), Fundamental Research Program of Shanxi Province (No. 202403021211154).
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Y. C.: Data curation, Formal analysis, Validation,Writing – original draft, Writing – review & editing. W. J.: Data curation, Formal analysis, Visualization, Writing – original draft, Writing – review & editing. J. Z.: Conceptualization, Investigation, Methodology, Supervision, Writing – review & editing P. Q.: Conceptualization, Data curation, Software, Supervision, Writing – review & editing
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Appendix
Appendix
The proof of Lemma 1
Proof
Summing the four equations of system (1) up yields \(\frac{dN}{dt}=0\). Thus the total population N(t) is a constant. For convenience, let \(N(t)=K\). Next, we prove that the solution of system (1) is non-negative.
Solving to the third equation of system (1) yields
Plugging it into the fourth equation of system (1), we can get
Besides, sloving the first equation of system (1), we obtion
Let \(t_1>0\) be the first time that \(\text {min}\left\{ S(t_1),V(t_1)\right\} =0\). Assuming that \(S(t_1)=0\), then S(t) and \(V(t)>0\), for\(\forall t\in [0,t_1)\). Furthermore we can get
this contradicts the assumption \(S(t_1)=0\). Similarly, let us assume that \(V(t_1)=0\), then according to the second equation of system (1), we can get
which contradicts the assumption of \(V(t_1)=0\). This mean that all solution of system (1) are non-negative and \(\Gamma\) is the positively invariant set of system (1). This completes the proof. \(\square\)
The proof of Theorem 1
Proof
The Jacobian matrix of system (2) at the disease-free equilibrium \(P_0\) is
The characteristic polynomial corresponding to matrix \(K(P_0)\) is
where
The roots of the characteristic polynomial (8) are \(\lambda _1=-\gamma\), \(\lambda _2=-\alpha -\theta , \lambda _3=\frac{\beta (\sigma \alpha +\theta )-\eta (\alpha +\theta )}{\alpha +\theta }\). Obviously, when \(R_0<1\), \(\lambda _3<0\). Therefore, the disease-free equilibrium \(P_0\) of system (2) is locally asymptotically stable, if \(R_0<1\).
When \(R_0=1\), \(\lambda _3=0\). At this time, the central manifold theorem is used to prove the stability of the disease-free equilibrium \(P_0\) . The following affine transformation is defined
Furthermore,
the linear part here is the Jordan canonical form of the matrix K, and
Let \(R_*=\frac{[(\alpha \sigma +\theta ) (\gamma +\eta )+\gamma \eta \sigma ](\alpha \sigma +\theta )}{\eta (\alpha +\theta ) [(\alpha \sigma +\theta )\epsilon +\gamma \sigma ]}\). Then, if \(R_0\ne R_*\),there exists a one-dimensional central manifold
Therefore, system (2) is simplified to
It is to see that disease-free equilibrium \(P_0\) is a saddle node. When \(R_0=R_*\), according to the center manifold theorem, the center manifold of system (2) at the far point can be expressed as
Since \(\sigma , \epsilon \in [0,1]\), the disease-free equilibrium \(P_0\) is a stable node, when \(R_0=1\) and \(R_0=R_*\). \(\square\)
The proof of Theorem 2
Proof
The Jacobian matrix of system (2) at the equilibrium \(P_2\) is
The characteristic equation of \(K(P_2)\) is
where
Obviously, \(d_2>0\), \(f(i_2)=0\). According to \(R_0<1\) and \(R_*<R_0\), we have that \(g(i_2)<0\), \(d_0<0\). Let the three roots of Eq. (14) be \(\Lambda _1\), \(\Lambda _2\) and \(\Lambda _3\), respectively. According to Vieta’s theorem, it has
Therefore, according to expression (15), the roots of Eq. (14) include the following three cases: three positive roots, one positive root and a pair of conjugate complex roots, one positive root and two negative roots. According to expression (16), Eq. (14) has a pair of conjugate complex roots or negative roots with negative real parts. In summary, there are two cases of the roots of Eq. (14): one positive root and a pair of conjugate complex roots, one positive root and two negative roots. Therefore, the endemic equilibrium \(P_2\) is unstable. \(\square\)
The proof of Theorem 3
Proof
The Jacobian matrix of system (2) at the endemic equilibrium \(P_3\) is
The characteristic equation of \(K(P_3)\) is
where
Obviously, \(e_2>0\), \(e_1>0\), \(F(i_3)=0\). According to \(R_{**}<R_{0}\), \(R_*<R_0\) and \(R_*<1\), we obtain that \(G(i_3)>0\), and then \(e_0>0\). Therefore,
According to the Hurwitz criterion, all the roots of Eq. (17) have negative real parts. Therefore, the endemic equilibrium \(P_3\) is locally asymptotically stable. \(\square\)
The proof of Lemma 2
Proof
Let
Then, system (7) can be rewritten as \(\vec {x}'(t)=\vec {f_*}(t,\vec {x})+\vec {g_*}(t,\vec {x},\vec {u})\vec {u}\). We prove that the following four conditions are satisfied:
- (i)
\(\vec {f_*}(t,\vec {x})+\vec {g_*}(t,\vec {x},\vec {u})u\) is first-order continuously differentiable, and there exists a constant C such that
$$\begin{aligned} |\vec {f_*}(t,0,0)|\le C, |\vec {f_*}(\vec {x})+\vec {g_*}(\vec {x},\vec {u})\vec {u}|\le C(1+|\vec {u}|), |\vec {g_*}(\vec {x},\vec {u})|\le C. \end{aligned}$$ - (ii)
The solution set of system (7) corresponding to the control parameters in the control set U is non-empty.
- (iii)
The dominating set U is a closed convex compact set.
- (iv)
The integrand in the objective function J is convex in U.
Firstly, it is easy to see that \(\vec {f_*}(t,\vec {x})+\vec {g_*}(t,\vec {x},\vec {u})u\) is first-order continuously differentiable, and \(|\vec {f_*}(t,0,0)|=0\). Since s, v, i are non-negative and bounded, there exists a constant C such that \(|\vec {f_*}(t,0,0)|\le C, |\vec {f_*}(\vec {x})+\vec {g_*}(\vec {x},\vec {u})\vec {u}|\le C(1+|\vec {u}|), |\vec {g_*}(\vec {x},\vec {u})|\le C.\) This shows that condition (i) is true, It can be seen that the system (7) has a unique solution, which means that condition (ii) is established.
The control set U is a closed convex compact set and the integrand of the objective function is a constant function. So conditions (iii) and (iv) are valid. In summary, the time optimal control problem has an optimal solution. \(\square\)
The proof of Theorem 4
Proof
In order to find the minimum disease eradication time and the time-dependent control variable \(\vec {u}^*(t)\), it is equivalent to the problem of minimizing the Hamiltonian system. Let the Hamiltonian system be
where \(\Lambda _1, \Lambda _2, \Lambda _3\) are the adjoint variables associated with the state variables s, v, i. Using the Pontryagin maximum principle36, we can see that the relationship between adjoint control and optimal control is as follows
and the transversality condition is \(\Lambda _1(T)=\Lambda _2(T)=\Lambda _3(T)=0\).
Therefore, the adjoint system is
The corresponding switching functions and their time derivatives are
where
Next, we prove that the switching function \(\Phi\) disappears only at isolated points. Assuming that \(\Phi (\vec {x},\Lambda _1,\Lambda _2,\Lambda _3,t)\) disappears in an open set L, then in the neighborhood L, \(\Phi =\frac{d\Phi }{dt}=0\), so there is \(\Lambda _1=\Lambda _2=\Lambda _3=0\). Then, the Hamiltonian system calculated along the optimal solution can be \(H(\vec {x},\Lambda _1,\Lambda _2,\Lambda _3,t)=1\ne 0\), which creates a contradiction. This implies that \(\vec {u}^*(t)\) is a Bang-Bang control, that is a piecewise function. \(\square\)
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Chen, Y., Jing, W., Zhang, J. et al. Bang-bang control optimization in infectious disease model with incorporating breakthrough and reinfection. Sci Rep (2026). https://doi.org/10.1038/s41598-026-44921-7
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DOI: https://doi.org/10.1038/s41598-026-44921-7


