Optimal control of a multi-scale immuno-influenza A transmission model with viral load-dependent infection

Influenza A is a highly contagious respiratory illness that spreads globally and results in millions of cases worldwide. The transmission rate and mortality rate of influenza in the population are determined by the load of the influenza A virus. In this study, we have developed a multi-scale immuno-influenza model considering incomplete vaccine immunity. We have calculated the basic reproduction numbers for both immunological and epidemiological models. Additionally, we have examined the stability of the disease-free equilibrium and the existence of the endemic equilibrium at the population level. To assess the cost-effectiveness of antiviral therapy at an individual level and vaccination at a population level, we have formulated an optimal control problem. The objective of this problem is to minimize both the number of influenza cases and the cost of vaccination. To solve this optimal control problem, we have employed the Ekeland variational principle. Furthermore, we have designed a global forward and backward sweep algorithm to estimate the impact of antiviral treatment on reducing influenza transmission among humans. Our findings indicate that the use of antiviral treatment significantly reduces viral loads in individuals. However, it may also increase the potential risk at the population level. Therefore, vaccination against influenza is the most effective option from a public health perspective.