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Vaccination rates and COVID outcomes across U.S. states

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  • Barro, Robert J.

Abstract

Rates of COVID deaths, hospitalizations, and cases differ markedly across U.S. states, as do rates of vaccination. This study uses cross-state regressions to assess impacts of vaccinations on COVID outcomes. A number of familiar issues arise concerning cross-sectional regressions, including omitted variables, behavioral responses to vaccination, and reverse causation. The benefits from a field context and from the broad range of observed variations suggest the value from dealing with these issues. Results reveal sizable negative effects of vaccination on deaths, hospitalizations, and cases up to early December 2021, although vaccine efficacy seems to wane over time. The findings for deaths apply to all-cause excess mortality as well as COVID-related mortality. The estimates imply that one expected life saved requires 248 additional doses, with a marginal cost around $55000, far below typical estimates of the value of a statistical life. Results since December 2021 suggest smaller effects of vaccinations on deaths and, especially, hospitalizations and cases, possibly because of diminished effectiveness of vaccines against new forms of the virus, notably the omicron variant. A further possibility is that confidence engendered by vaccinations motivated individuals and governments to lessen non-pharmaceutical interventions, such as masking and social distancing.

Suggested Citation

  • Barro, Robert J., 2022. "Vaccination rates and COVID outcomes across U.S. states," Economics & Human Biology, Elsevier, vol. 47(C).
    • Handle: RePEc:eee:ehbiol:v:47:y:2022:i:c:s1570677x22000971
    DOI: 10.1016/j.ehb.2022.101201
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    1. Erkmen G Aslim & Wei Fu & Chia-Lun Liu & Erdal Tekin, 2024. "Vaccination Policy, Delayed Care and Health Expenditures," The Economic Journal, Royal Economic Society, vol. 134(664), pages 3096-3136.
    2. Rajeev K. Goel & Michael A. Nelson, 2024. "Ending COVID-19 vaccine apartheid through vaccine donations: the influence of supply chains," Journal of Economics and Finance, Springer;Academy of Economics and Finance, vol. 48(3), pages 592-613, September.
    3. Barro, Robert J., 2022. "Non-pharmaceutical interventions and mortality in U.S. cities during the great influenza pandemic, 1918–1919," Research in Economics, Elsevier, vol. 76(2), pages 93-106.
    4. James L. Doti, 2023. "The impact of vaccinations and chronic disease on COVID death rates," Journal of Bioeconomics, Springer, vol. 25(3), pages 239-269, December.
    5. Andrew Atkeson, 2023. "The Impact of Vaccines and Behavior on U.S. Cumulative Deaths from COVID-19," Staff Report 649, Federal Reserve Bank of Minneapolis.
    6. Timo Boppart & Karl Harmenberg & John Hassler & Per Krusell & Jonna Olsson, 2025. "Integrated epi‐econ assessment: Quantitative theory," Quantitative Economics, Econometric Society, vol. 16(1), pages 89-131, January.
    7. Gutiérrez, Emilio & Meriläinen, Jaakko & Ponce de León, Máximo, 2024. "Worth a shot? The political economy of government responsiveness in times of crisis," World Development, Elsevier, vol. 184(C).
    8. Kaba, Mustafa & Koyuncu, Murat & Schneider, Sebastian O. & Sutter, Matthias, 2024. "Social norms, political polarization, and vaccination attitudes: Evidence from a survey experiment in Turkey," European Economic Review, Elsevier, vol. 168(C).
    9. Zheng, Huanhuan, 2023. "Sovereign debt responses to the COVID-19 pandemic," Journal of International Economics, Elsevier, vol. 143(C).

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    • I1 - Health, Education, and Welfare - - Health

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