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The spread of COVID-19 and the BCG vaccine: A natural experiment in reunified Germany

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  • Richard Bluhm
  • Maxim Pinkovskiy

Abstract

SummaryThe ‘BCG hypothesis' suggests that the Bacillus Calmette-Guérin (BCG) vaccine against tuberculosis limits the severity of COVID-19. We exploit the differential vaccination practices of East Germany and West Germany prior to reunification to test this hypothesis. Using a difference in regression discontinuities (RD-DD) design centred on the end of universal vaccination in the West, we find that differences in COVID-19 severity across cohorts in the East and West are insignificant or have the wrong sign. We document a sharp cross-sectional discontinuity in the severity of the disease, which we attribute to limited mobility across the long-gone border and which disappears when we control for social connectedness. Case and death data after the end of the first lockdown on 26 April does not display a discontinuity at the former border, suggesting that mobility (as opposed to BCG vaccination) played a major role during the initial outbreak.

Suggested Citation

  • Richard Bluhm & Maxim Pinkovskiy, 2021. "The spread of COVID-19 and the BCG vaccine: A natural experiment in reunified Germany," The Econometrics Journal, Royal Economic Society, vol. 24(3), pages 353-376.
  • Handle: RePEc:oup:emjrnl:v:24:y:2021:i:3:p:353-376.
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    File URL: http://hdl.handle.net/10.1093/ectj/utab006
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    as
    1. Lalive, Rafael, 2008. "How do extended benefits affect unemployment duration A regression discontinuity approach," Journal of Econometrics, Elsevier, vol. 142(2), pages 785-806, February.
    2. repec:clg:wpaper:2013-20 is not listed on IDEAS
    3. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    4. Sebastian Calonico & Matias D. Cattaneo & Max H. Farrell & Rocío Titiunik, 2019. "Regression Discontinuity Designs Using Covariates," The Review of Economics and Statistics, MIT Press, vol. 101(3), pages 442-451, July.
    5. Sascha O. Becker & Lukas Mergele & Ludger Woessmann, 2020. "The Separation and Reunification of Germany: Rethinking a Natural Experiment Interpretation of the Enduring Effects of Communism," Journal of Economic Perspectives, American Economic Association, vol. 34(2), pages 143-171, Spring.
    6. Matthew D. Webb, 2023. "Reworking wild bootstrap‐based inference for clustered errors," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 56(3), pages 839-858, August.
    7. Sebastian Calonico & Matias D. Cattaneo & Rocio Titiunik, 2014. "Robust Nonparametric Confidence Intervals for Regression‐Discontinuity Designs," Econometrica, Econometric Society, vol. 82, pages 2295-2326, November.
    8. Wolf, Nikolaus & Eckardt, Matthias, 2020. "Covid-19 across European Regions: the Role of Border Controls," CEPR Discussion Papers 15178, C.E.P.R. Discussion Papers.
    9. Michael Bailey & Rachel Cao & Theresa Kuchler & Johannes Stroebel & Arlene Wong, 2018. "Social Connectedness: Measurement, Determinants, and Effects," Journal of Economic Perspectives, American Economic Association, vol. 32(3), pages 259-280, Summer.
    10. Alberto Alesina & Nicola Fuchs-Schündeln, 2007. "Goodbye Lenin (or Not?): The Effect of Communism on People," American Economic Review, American Economic Association, vol. 97(4), pages 1507-1528, September.
    11. Sebastian Calonico & Matias D Cattaneo & Max H Farrell, 2020. "Optimal bandwidth choice for robust bias-corrected inference in regression discontinuity designs [Econometric methods for program evaluation]," The Econometrics Journal, Royal Economic Society, vol. 23(2), pages 192-210.
    12. Santamaria, Marta, 2020. "Reshaping Infrastructure: Evidence from the division of Germany," The Warwick Economics Research Paper Series (TWERPS) 1244, University of Warwick, Department of Economics.
    13. Fuchs-Schündeln, N. & Hassan, T.A., 2016. "Natural Experiments in Macroeconomics," Handbook of Macroeconomics, in: J. B. Taylor & Harald Uhlig (ed.), Handbook of Macroeconomics, edition 1, volume 2, chapter 0, pages 923-1012, Elsevier.
    14. Alberto Alesina & Nicola Fuchs-Schundeln, 2005. "Good bye Lenin (or not?): The effect of Communism on people's preferences," Harvard Institute of Economic Research Working Papers 2076, Harvard - Institute of Economic Research.
    15. Melissa Dell, 2010. "The Persistent Effects of Peru's Mining Mita," Econometrica, Econometric Society, vol. 78(6), pages 1863-1903, November.
    16. Manasi Deshpande, 2016. "Does Welfare Inhibit Success? The Long-Term Effects of Removing Low-Income Youth from the Disability Rolls," American Economic Review, American Economic Association, vol. 106(11), pages 3300-3330, November.
    17. James G. MacKinnon & Matthew D. Webb, 2017. "Wild Bootstrap Inference for Wildly Different Cluster Sizes," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 32(2), pages 233-254, March.
    18. Amy Wesolowski & Elisabeth zu Erbach-Schoenberg & Andrew J. Tatem & Christopher Lourenço & Cecile Viboud & Vivek Charu & Nathan Eagle & Kenth Engø-Monsen & Taimur Qureshi & Caroline O. Buckee & C. J. , 2017. "Multinational patterns of seasonal asymmetry in human movement influence infectious disease dynamics," Nature Communications, Nature, vol. 8(1), pages 1-9, December.
    19. Andrew Gelman & Guido Imbens, 2019. "Why High-Order Polynomials Should Not Be Used in Regression Discontinuity Designs," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(3), pages 447-456, July.
    20. Keele, Luke J. & Titiunik, Rocío, 2015. "Geographic Boundaries as Regression Discontinuities," Political Analysis, Cambridge University Press, vol. 23(1), pages 127-155, January.
    21. Santamaria, Marta, 2020. "Reshaping Infrastructure : Evidence from the division of Germany," CAGE Online Working Paper Series 456, Competitive Advantage in the Global Economy (CAGE).
    22. Solomon Hsiang & Daniel Allen & Sébastien Annan-Phan & Kendon Bell & Ian Bolliger & Trinetta Chong & Hannah Druckenmiller & Luna Yue Huang & Andrew Hultgren & Emma Krasovich & Peiley Lau & Jaecheol Le, 2020. "The effect of large-scale anti-contagion policies on the COVID-19 pandemic," Nature, Nature, vol. 584(7820), pages 262-267, August.
    23. Yang He & Otávio Bartalotti, 2020. "Wild bootstrap for fuzzy regression discontinuity designs: obtaining robust bias-corrected confidence intervals [Using Maimonides’ rule to estimate the effect of class size on scholastic achievemen," The Econometrics Journal, Royal Economic Society, vol. 23(2), pages 211-231.
    24. Douglas Almond & Janet Currie, 2011. "Killing Me Softly: The Fetal Origins Hypothesis," Journal of Economic Perspectives, American Economic Association, vol. 25(3), pages 153-172, Summer.
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    Cited by:

    1. Reinhold Kosfeld & Timo Mitze & Johannes Rode & Klaus Wälde, 2021. "The Covid‐19 containment effects of public health measures: A spatial difference‐in‐differences approach," Journal of Regional Science, Wiley Blackwell, vol. 61(4), pages 799-825, September.
    2. Pronkina, Elizaveta & Berniell, Inés & Fawaz, Yarine & Laferrère, Anne & Mira, Pedro, 2023. "The COVID-19 curtain: Can past communist regimes explain the vaccination divide in Europe?," Social Science & Medicine, Elsevier, vol. 321(C).
    3. Wei-Ju Su & Chia-Hsuin Chang & Jiun-Ling Wang & Shu-Fong Chen & Chin-Hui Yang, 2021. "COVID-19 Severity and Neonatal BCG Vaccination among Young Population in Taiwan," IJERPH, MDPI, vol. 18(8), pages 1-7, April.
    4. Ehlert, Andree, 2021. "The socio-economic determinants of COVID-19: A spatial analysis of German county level data," Socio-Economic Planning Sciences, Elsevier, vol. 78(C).
    5. Philipp Breidenbach & Timo Mitze, 2022. "Large-scale sport events and COVID-19 infection effects: evidence from the German professional football ‘experiment’ [Semiparametric difference-in-differences estimators]," The Econometrics Journal, Royal Economic Society, vol. 25(1), pages 15-45.

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    More about this item

    Keywords

    COVID-19; BCG vaccine; Germany; mobility; SIR model with commuting flows;
    All these keywords.

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J60 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - General

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