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Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine

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  • Lawler, Emily C.

Abstract

I provide novel evidence on the effectiveness of two vaccination policies – simple non-binding recommendations to vaccinate versus mandates requiring vaccination prior to childcare or kindergarten attendance – in the context of the only disease whose institutional features permit a credible examination of both: hepatitis A. Using provider-verified immunization data I find that recommendations significantly increased hepatitis A vaccination rates among young children by at least 20 percentage points, while mandates increase rates by another 8 percentage points. These policies also significantly reduced population hepatitis A incidence. My results suggest a range of policy options for addressing suboptimally low population vaccination rates.

Suggested Citation

  • 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.
    • Handle: RePEc:eee:jhecon:v:52:y:2017:i:c:p:45-62
    DOI: 10.1016/j.jhealeco.2017.01.002
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    References listed on IDEAS

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    1. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799, Elsevier.
    2. 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.
    3. Bialek, S.R. & Thoroughman, D.A. & Hu, D. & Simard, E.P. & Chattin, J. & Cheek, J. & Bell, B.P., 2004. "Hepatitis A incidence and hepatitis A vaccination among American Indians and Alaska Natives, 1990-2001," American Journal of Public Health, American Public Health Association, vol. 94(6), pages 996-1001.
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    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    State mandates; Hepatitis A; Difference-in-differences; Vaccination;
    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

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