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Disease outbreaks, healthcare utilization, and on-time immunization in the first year of life

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  • Schaller, Jessamyn
  • Schulkind, Lisa
  • Shapiro, Teny

Abstract

This paper examines the determinants of parental decisions about infant immunization. Using the exact timing of vaccination relative to birth, we estimate the effects of local pertussis outbreaks occurring in utero and during the first two months of life on the likelihood of on-time initial immunization for pertussis and other diseases. We find that parents respond to changes in perceived disease risk: pertussis outbreaks within a state increase the rate of on-time receipt of the pertussis vaccine at two months of age, particularly among low-socioeconomic status (SES) subgroups. In addition, we find that pertussis outbreaks increase the likelihood of immunization against other vaccine-preventable diseases. Spillover effects in low-SES subgroups are as large as direct effects and are present only for vaccines given during the same visit as the pertussis vaccine, which suggests that provider contact may be a key factor in infant vaccination decisions in poor families.

Suggested Citation

  • Schaller, Jessamyn & Schulkind, Lisa & Shapiro, Teny, 2019. "Disease outbreaks, healthcare utilization, and on-time immunization in the first year of life," Journal of Health Economics, Elsevier, vol. 67(C).
    • Handle: RePEc:eee:jhecon:v:67:y:2019:i:c:s0167629617308986
    DOI: 10.1016/j.jhealeco.2019.05.009
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    References listed on IDEAS

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    1. Oster, Emily, 2018. "Does disease cause vaccination? Disease outbreaks and vaccination response," Journal of Health Economics, Elsevier, vol. 57(C), pages 90-101.
    2. Ronsaville, D.S. & Hakim, R.B., 2000. "Well child care in the United States: Racial differences in compliance with guidelines," American Journal of Public Health, American Public Health Association, vol. 90(9), pages 1436-1443.
    3. Lenisa V. Chang, 2016. "The Effect Of State Insurance Mandates On Infant Immunization Rates," Health Economics, John Wiley & Sons, Ltd., vol. 25(3), pages 372-386, March.
    4. Chu, S.Y. & Barker, L.E. & Smith, P.J., 2004. "Racial/ethnic disparities in preschool immunizations: United States, 1996-2001," American Journal of Public Health, American Public Health Association, vol. 94(6), pages 973-977.
    5. Christopher S. Carpenter & Emily C. Lawler, 2019. "Direct and Spillover Effects of Middle School Vaccination Requirements," American Economic Journal: Economic Policy, American Economic Association, vol. 11(1), pages 95-125, February.
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    Citations

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    Cited by:

    1. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2021. "When Reality Bites: Local Deaths and Vaccine Take-Up," GLO Discussion Paper Series 999, Global Labor Organization (GLO).
    2. Duquette, Nicolas, 2020. "Heard immunity: effective persuasion for a future COVID-19 vaccine," SocArXiv jwvsp, Center for Open Science.
    3. Bouckaert, Nicolas & Gielen, Anne C. & Van Ourti, Tom, 2020. "It runs in the family – Influenza vaccination and spillover effects," Journal of Health Economics, Elsevier, vol. 74(C).
    4. Masahiro Shoji & Susumu Cato & Takashi Iida & Kenji Ishida & Asei Ito & Kenneth Mori McElwain, 2022. "Variations in Early-Stage Responses to Pandemics: Survey Evidence from the COVID-19 Pandemic in Japan," Economics of Disasters and Climate Change, Springer, vol. 6(2), pages 235-258, July.
    5. Alexander Karaivanov & Dongwoo Kim & Shih En Lu & Hitoshi Shigeoka, 2022. "COVID-19 vaccination mandates and vaccine uptake," Nature Human Behaviour, Nature, vol. 6(12), pages 1615-1624, December.
    6. Anikó Bíró & Ágnes Szabó-Morvai, 2021. "Mass media coverage and vaccination uptake: evidence from the demand for meningococcal vaccinations in Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 887-903, August.
    7. Shoji, Masahiro & Cato, Susumu & Iida, Takashi & Ishida, Kenji & Ito, Asei & McElwain, Kenneth, 2020. "COVID-19 and Social Distancing in the Absence of Legal Enforcement: Survey Evidence from Japan," MPRA Paper 101968, University Library of Munich, Germany.
    8. Hirani, Jonas Cuzulan & Wüst, Miriam, 2023. "Reminder Design and Childhood Vaccination Coverage," IZA Discussion Papers 15877, Institute of Labor Economics (IZA).
    9. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2023. "When reality bites: Local deaths and vaccine take-up," European Economic Review, Elsevier, vol. 156(C).
    10. Hofmann, Sarah, 2023. "Disease perception and preventive behavior: The vaccination response to local measles outbreaks," Social Science & Medicine, Elsevier, vol. 331(C).

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    More about this item

    Keywords

    Immunizations; Vaccinations; Infant health; Public health; Disease; Health care;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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