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Figure 1.

Nested Host-Parasite-Gene populations.

A) A host may carry susceptible and resistant parasites, a parasite can be either homozygous or heterozygous for the gene associated with resistance; B) Euler diagram of the host population. Alleles associated with drug resistance are initially concentrated within a sub-set (focus) of the host sub-population (target) that receives either annual chemotherapy or chemotherapy and vaccine every T (e.g. every 5) years.

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Table 1.

Baseline parameters for the model.

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Figure 2.

Allele frequency in worms outside of the primary focus of resistance.

Resistance can be fully recessive (A–B) or fully dominant (C–D). Annual chemotherapy is administered to 50% of the host population and no vaccination. Simulation parameters in Table 1. A) If resistance is a recessive character the allele frequency follows two different time-dynamics depending on the the degree of host-population mixing ρ: i) for ρ smaller than 69%, it grows fast and plateaus at a level inversely related to the value of ρ; ii) for ρ equal to or larger than 69%, a slow initial growth is followed by an accelerated growth. B) Non-monotonic relation between the allele frequency after 20 annual chemotherapy rounds and ρ. The maximum allele frequency is observed when ρ is equal to 85%. C) If resistance is a dominant character, the allele frequency grows at a rate inversely related to ρ. D) Negative monotonic relationship between the allele frequency after 20 annual chemotherapy rounds and ρ. The maximum allele frequency is observed when ρ is equal to 1.99% (homogeneous mixing case).

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Figure 3.

Population-level vaccine effectiveness (VE), assuming that density dependence acts on the fecundity of established parasites, and that 50% of the host population is effectively vaccinated (Simulation parameters in Table 1).

Vaccines can reduce the host susceptibility to infection (A–B), by a proportion VS, or the female parasite reproductive rate (C–D), by a proportion VR, or the parasite lifespan (E–F), by a proportion VM. Vaccines reducing the parasite fecundity and vaccines reducing the parasite lifespan are more efficacious than vaccines reducing host susceptibility by the same proportion. Low reductions (<50%) in female reproductive rate have marginally higher impact than equal proportional reductions in adult worm lifespan. The impact on recessive alleles (A–C–D) grows with ρ, the degree of host-population mixing. The impact on dominant alleles increases with (B), decreases with (D) or is independent of (F) ρ, depending on the biological action of the vaccine.

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Figure 4.

Impact of multi-target vaccines.

Vaccines simultaneously reducing fecundity (VR) and susceptibility (VS) (panels A–B) or fecundity, susceptibility, and parasite life-span (VM) (panels C–D) have the greatest potential. In this example, it is assumed that the vaccine reduces by the same proportion female worm fecundity, host susceptibility, and parasite lifespan. A and C refer to recessive alleles, B and D refer to dominant alleles.

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