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Effectiveness of state-level vaccination mandates: Evidence from the varicella vaccine

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  • Abrevaya, Jason
  • Mulligan, Karen

Abstract

This paper utilizes longitudinal data on varicella (chickenpox) immunizations in order to estimate the causal effects of state-level school-entry and daycare-entry immunization mandates within the United States. We find significant causal effects of mandates upon vaccination rates among preschool children aged 19–35 months; these effects appear in the year of mandate adoption, peak two years after adoption, and show a minimal difference from the aggregate trend about six years after adoption. For a mandate enacted in 2000, the model and estimates imply that roughly 20% of the short-run increase in state-level immunization rates was caused by the mandate introduction. We find no evidence of differential effects for different socioeconomic groups. Combined with previous cost–benefit analyses of the varicella vaccine, the estimates suggest that state-level mandates have been effective from an economic standpoint.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:jhecon:v:30:y:2011:i:5:p:966-976
    DOI: 10.1016/j.jhealeco.2011.06.003
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    1. Seth M. Freedman & Daniel W. Sacks & Kosali I. Simon & Coady Wing, 2022. "Direct and indirect effects of vaccines: Evidence from COVID-19," NBER Working Papers 30550, National Bureau of Economic Research, Inc.
    2. Jelnov, Artyom & Jelnov, Pavel, 2022. "Vaccination policy and trust," Economic Modelling, Elsevier, vol. 108(C).
    3. Weiwei Chen & Mark Messonnier & Fangjun Zhou, 2018. "Factors associated with the pricing of childhood vaccines in the U.S. public sector," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 252-265, February.
    4. Hirani, Jonas Cuzulan & Wüst, Miriam, 2022. "Nurses and infant vaccination coverage," Journal of Economic Behavior & Organization, Elsevier, vol. 196(C), pages 402-428.
    5. 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.
    6. Hair, Nicole L. & Gruber, Anja & Urban, Carly, 2020. "Personal Belief Exemptions for School-Entry Vaccinations, Vaccination Rates, and Academic Achievement," IZA Discussion Papers 12978, IZA Network @ LISER.
    7. Melo, Vitor, 2022. "Intended and Unintended Effects of Nursing Home Isolation Measures," Working Papers 12244, George Mason University, Mercatus Center.
    8. 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.
    9. Barber, Andrew & West, Jeremy, 2022. "Conditional cash lotteries increase COVID-19 vaccination rates," Journal of Health Economics, Elsevier, vol. 81(C).
    10. 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.
    11. Hirani, Jonas Cuzulan & Wüst, Miriam, 2024. "Reminder design and childhood vaccination coverage," Journal of Health Economics, Elsevier, vol. 93(C).
    12. Riley K. Acton & Wenjia Cao & Emily E. Cook & Scott A. Imberman & Michael F. Lovenheim, 2022. "The Effect of Vaccine Mandates on Disease Spread: Evidence from College COVID-19 Mandates," NBER Working Papers 30303, National Bureau of Economic Research, Inc.
    13. 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).
    14. 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.
    15. Andreas Steinmayr & Manuel Rossi, 2022. "Vaccine-skeptic physicians and COVID-19 vaccination rates," Working Papers 2022-16, Faculty of Economics and Statistics, Universität Innsbruck.
    16. 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.
    17. Matilde Giaccherini & Joanna Kopinska & Gabriele Rovigatti, 2022. "Vax Populi: The Social Costs of Online Vaccine Skepticism," CESifo Working Paper Series 10184, CESifo.
    18. Dhaval Dave & Drew McNichols & Joseph J. Sabia, 2021. "The contagion externality of a superspreading event: The Sturgis Motorcycle Rally and COVID‐19," Southern Economic Journal, John Wiley & Sons, vol. 87(3), pages 769-807, January.
    19. Andreas Kucher, 2019. "Vaccination recommendations and timeliness - The German measles case," Discussion Paper Series 336, Universitaet Augsburg, Institute for Economics.
    20. Dhaval M. Dave & Andrew I. Friedson & Drew McNichols & Joseph J. Sabia, 2020. "The Contagion Externality of a Superspreading Event: The Sturgis Motorcycle Rally and COVID-19," NBER Working Papers 27813, National Bureau of Economic Research, Inc.
    21. Garrouste, Clémentine & Juet, Arthur & Samson, Anne-Laure, 2023. "Direct and crowding-out effects of a Hepatitis B vaccination campaign," Economics & Human Biology, Elsevier, vol. 51(C).
    22. Lenisa V. Chang, 2018. "Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy," Health Economics, John Wiley & Sons, Ltd., vol. 27(7), pages 1043-1062, July.
    23. 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).
    24. Nguyen, Manh-Hung & Hoang, Viet-Ngu & Nghiem, Son & Nguyen, Lan Anh, 2024. "The Dynamic and Heterogeneous Effects of COVID-19 Vaccination Mandates in the USA," TSE Working Papers 24-1598, Toulouse School of Economics (TSE).

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    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

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