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Vaccines and Verdicts: How Smallpox Court Decisions Affect Anti-Vaccine Discourse and Mortality

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  • Paul Brehm
  • Martin Saavedra

Abstract

We estimate the effect of compulsory vaccination court decisions on anti-vaccine discourse and mortality. We measure anti-vaccine discourse using language in American newspapers. Using human-classified training data and machine learning techniques, we predict anti-vaccine discourse for nearly 48,000 newspaper pages. Staggered difference-in-differences estimates show that anti-vaccine discourse increased for a period of two years after pro-vaccine state-level Supreme Court decisions before returning to baseline. Regression-discontinuity-in-time estimates yield similar findings following the Jacobson v. Massachusetts US Supreme Court decision. While compulsory vaccinations increase anti-vaccine discourse, mandates appear to remain effective, and we estimate that smallpox mortality rates fell in the wake of pro-vaccine decisions.

Suggested Citation

  • Paul Brehm & Martin Saavedra, 2025. "Vaccines and Verdicts: How Smallpox Court Decisions Affect Anti-Vaccine Discourse and Mortality," The Economic Journal, Royal Economic Society, vol. 135(668), pages 1229-1260.
    • Handle: RePEc:oup:econjl:v:135:y:2025:i:668:p:1229-1260.
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    File URL: http://hdl.handle.net/10.1093/ej/ueae118
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