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Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design

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  • Humlum, Maria Knoth
  • Morthorst, Marius Opstrup
  • Thingholm, Peter Rønø

Abstract

We investigate the effects of introducing population-wide free-of-charge Human Papillomavirus (HPV) vaccination programs on the targeted adolescent cohorts and their siblings. For identification, we rely on regression discontinuity designs and high-quality Danish administrative data to exploit that date of birth determines program eligibility. We find that the programs increased the HPV vaccine take-up of both the targeted children (53.2 percentage points for girls and 36.0 percentage points for boys) and their older same-sex siblings (4.5 percentage points for sisters and 3.5 percentage points for brothers). We show that while the direct effects of the programs reduced HPV vaccine take-up inequality, the spillover effects, in contrast, contributed to an increase in vaccine take-up inequality highlighting the potential importance of spillover effects in the determination of distributional consequences of public health programs. Finally, we find some evidence of cross-vaccine spillovers.

Suggested Citation

  • Humlum, Maria Knoth & Morthorst, Marius Opstrup & Thingholm, Peter Rønø, 2024. "Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design," Journal of Health Economics, Elsevier, vol. 94(C).
    • Handle: RePEc:eee:jhecon:v:94:y:2024:i:c:s0167629623001200
    DOI: 10.1016/j.jhealeco.2023.102843
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    Keywords

    Health investments; Health behavior; Peer effects; Sibling spillovers; HPV; Vaccine; Health inequality;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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