Abstract | Immuno-Epidemiological models combine individual (in-host) and population (epidemiology) level approaches to create an overall perspective of pathogen spread. We have developed a within-host model for the dynamics of measles, whose resultant dynamics can be used to drive an epidemiological model. Under the assumption of life-long immunity the population-level dynamics of the typical SEIR model of measles spread and our immuno-epidemiological model are identical. However, if immunity wanes over time, as evidence suggests, the effects of waning immunity can only be mechanistically captured by an immuno-epidemiological model. We find that, prior to vaccination, waning of immunity is epidemiologically irrelevant since repeated exposure to measles leads to multiple boosting events. However, with high levels of vaccination immunity can wane to such an extent that large-scale epidemics can ensue. We discuss the implications of this observation and the insights that immuno-epidemiology can bring to infection control. |