IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp12978.html
   My bibliography  Save this paper

Personal Belief Exemptions for School-Entry Vaccinations, Vaccination Rates, and Academic Achievement

Author

Listed:
  • Hair, Nicole L.

    (University of South Carolina)

  • Gruber, Anja

    (University of Colorado, Boulder)

  • Urban, Carly

    (Montana State University)

Abstract

Nonmedical exemptions from school-entry vaccine mandates are receiving increased policy and public health scrutiny. This paper examines how expanding the availability of exemptions influences vaccination rates in early childhood and academic achievement in middle school. We leverage 2003 legislation that granted personal belief exemptions (PBE) in Texas and Arkansas, two states the previously allowed exemptions only for medical or religious regions. We find that PBE decreased vaccination coverage among black and low-income preschoolers by 16.1% and 8.3%, respectively. Furthermore, we find that those cohorts affected by the policy change in early childhood performed less well on standardized tests of academic achievement in middle school. Estimated effects on mathematics and English Language Arts test scores were largest for black students, especially those residing in economically disadvantaged counties.

Suggested Citation

  • Hair, Nicole L. & Gruber, Anja & Urban, Carly, 2020. "Personal Belief Exemptions for School-Entry Vaccinations, Vaccination Rates, and Academic Achievement," IZA Discussion Papers 12978, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp12978
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp12978.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    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. Chris T Bauch & Samit Bhattacharyya, 2012. "Evolutionary Game Theory and Social Learning Can Determine How Vaccine Scares Unfold," PLOS Computational Biology, Public Library of Science, vol. 8(4), pages 1-12, April.
    3. Lawler, Emily C., 2017. "Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine," Journal of Health Economics, Elsevier, vol. 52(C), pages 45-62.
    4. Anderberg, Dan & Chevalier, Arnaud & Wadsworth, Jonathan, 2011. "Anatomy of a health scare: Education, income and the MMR controversy in the UK," Journal of Health Economics, Elsevier, vol. 30(3), pages 515-530, May.
    5. Adam Isen & Maya Rossin-Slater & W. Reed Walker, 2017. "Every Breath You Take—Every Dollar You’ll Make: The Long-Term Consequences of the Clean Air Act of 1970," Journal of Political Economy, University of Chicago Press, vol. 125(3), pages 848-902.
    6. Sarah R. Cohodes & Daniel S. Grossman & Samuel A. Kleiner & Michael F. Lovenheim, 2016. "The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 727-759.
    7. Abrevaya, Jason & Mulligan, Karen, 2011. "Effectiveness of state-level vaccination mandates: Evidence from the varicella vaccine," Journal of Health Economics, Elsevier, vol. 30(5), pages 966-976.
    8. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    9. Chelsea J. Richwine & Avi Dor & Ali Moghtaderi, 2019. "Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines," NBER Working Papers 25847, National Bureau of Economic Research, Inc.
    10. Kenneth Y. Chay & Jonathan Guryan & Bhashkar Mazumder, 2009. "Birth Cohort and the Black-White Achievement Gap: The Roles of Access and Health Soon After Birth," NBER Working Papers 15078, National Bureau of Economic Research, Inc.
    11. Hilary Hoynes & Diane Whitmore Schanzenbach & Douglas Almond, 2016. "Long-Run Impacts of Childhood Access to the Safety Net," American Economic Review, American Economic Association, vol. 106(4), pages 903-934, April.
    12. Jessamyn Schaller & Lisa Schulkind & Teny Maghakian Shapiro, 2017. "The Effects of Perceived Disease Risk and Access Costs on Infant Immunization," NBER Working Papers 23923, National Bureau of Economic Research, Inc.
    13. 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.
    14. Sarah Miller & Laura R. Wherry, 2019. "The Long-Term Effects of Early Life Medicaid Coverage," Journal of Human Resources, University of Wisconsin Press, vol. 54(3), pages 785-824.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hair, Nicole L. & Gruber, Anja & Urban, Carly, 2021. "Personal belief exemptions for school-entry vaccinations, vaccination rates, and academic achievement," Journal of Health Economics, Elsevier, vol. 78(C).
    2. Brilli, Ylenia & Lucifora, Claudio & Russo, Antonio & Tonello, Marco, 2020. "Vaccination take-up and health: Evidence from a flu vaccination program for the elderly," Journal of Economic Behavior & Organization, Elsevier, vol. 179(C), pages 323-341.
    3. Huang, Wei & Liu, Hong, 2023. "Early childhood exposure to health insurance and adolescent outcomes: Evidence from rural China," Journal of Development Economics, Elsevier, vol. 160(C).
    4. Humlum, Maria Knoth & Morthorst, Marius Opstrup & Thingholm, Peter Rønø, 2022. "Sibling Spillovers and the Choice to Get Vaccinated: Evidence from a Regression Discontinuity Design," IZA Discussion Papers 15109, Institute of Labor Economics (IZA).
    5. Hoffmann, Manuel & Mosquera, Roberto & Chadi, Adrian, 2019. "Vaccines at Work," VfS Annual Conference 2019 (Leipzig): 30 Years after the Fall of the Berlin Wall - Democracy and Market Economy 203661, Verein für Socialpolitik / German Economic Association.
    6. Andrew Goodman-Bacon, 2016. "The Long-Run Effects of Childhood Insurance Coverage: Medicaid Implementation, Adult Health, and Labor Market Outcomes," NBER Working Papers 22899, National Bureau of Economic Research, Inc.
    7. Chelsea J. Richwine & Avi Dor & Ali Moghtaderi, 2019. "Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines," NBER Working Papers 25847, National Bureau of Economic Research, Inc.
    8. Churchill, Brandyn F., 2021. "How important is the structure of school vaccine requirement opt-out provisions? Evidence from Washington, DC's HPV vaccine requirement," Journal of Health Economics, Elsevier, vol. 78(C).
    9. Sansone, Dario, 2019. "Pink work: Same-sex marriage, employment and discrimination," Journal of Public Economics, Elsevier, vol. 180(C).
    10. Carpenter, Christopher S. & Churchill, Brandyn F. & Marcus, Michelle, 2023. "Bad lighting: Effects of youth indoor tanning prohibitions," Journal of Health Economics, Elsevier, vol. 88(C).
    11. Chloe N. East & Sarah Miller & Marianne Page & Laura R. Wherry, 2023. "Multigenerational Impacts of Childhood Access to the Safety Net: Early Life Exposure to Medicaid and the Next Generation's Health," American Economic Review, American Economic Association, vol. 113(1), pages 98-135, January.
    12. Garrett Anstreicher & Jason Fletcher & Owen Thompson, 2022. "The Long Run Impacts of Court-Ordered Desegregation," NBER Working Papers 29926, National Bureau of Economic Research, Inc.
    13. 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.
    14. Stefan Pichler & Katherine Wen & Nicolas R. Ziebarth, 2021. "Positive Health Externalities of Mandating Paid Sick Leave," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 715-743, June.
    15. Fang, Guanfu & Zhu, Ying, 2022. "Long-term impacts of school nutrition: Evidence from China’s school meal reform," World Development, Elsevier, vol. 153(C).
    16. Janet Currie, 2020. "Child health as human capital," Health Economics, John Wiley & Sons, Ltd., vol. 29(4), pages 452-463, April.
    17. Corey White, 2021. "Measuring Social and Externality Benefits of Influenza Vaccination," Journal of Human Resources, University of Wisconsin Press, vol. 56(3), pages 749-785.
    18. Petter Lundborg & Dan-Olof Rooth & Jesper Alex-Petersen, 2022. "Long-Term Effects of Childhood Nutrition: Evidence from a School Lunch Reform [The Long-run Impact of Cash Transfers to Poor Families]," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 89(2), pages 876-908.
    19. Li, Yajuan & Palma, Marco A., 2017. "Health Insurance and College Enrollment: Evidence from a Natural Experiment of the Affordable Care Act Dependent Coverage Mandate," 2017 Annual Meeting, July 30-August 1, Chicago, Illinois 258490, Agricultural and Applied Economics Association.
    20. Andreas Kucher, 2019. "Vaccination recommendations and timeliness - The German measles case," Discussion Paper Series 336, Universitaet Augsburg, Institute for Economics.

    More about this item

    Keywords

    vaccination; state mandates; nonmedical exemptions; test scores;
    All these keywords.

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I21 - Health, Education, and Welfare - - Education - - - Analysis of Education
    • I24 - Health, Education, and Welfare - - Education - - - Education and Inequality
    • I28 - Health, Education, and Welfare - - Education - - - Government Policy

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp12978. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.