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The spread of COVID-19 and the BCG vaccine: A natural experiment in reunified Germany

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  • Richard Bluhm
  • Maxim Pinkovskiy

Abstract

SummaryThe ‘BCG hypothesis' suggests that the Bacillus Calmette-Guérin (BCG) vaccine against tuberculosis limits the severity of COVID-19. We exploit the differential vaccination practices of East Germany and West Germany prior to reunification to test this hypothesis. Using a difference in regression discontinuities (RD-DD) design centred on the end of universal vaccination in the West, we find that differences in COVID-19 severity across cohorts in the East and West are insignificant or have the wrong sign. We document a sharp cross-sectional discontinuity in the severity of the disease, which we attribute to limited mobility across the long-gone border and which disappears when we control for social connectedness. Case and death data after the end of the first lockdown on 26 April does not display a discontinuity at the former border, suggesting that mobility (as opposed to BCG vaccination) played a major role during the initial outbreak.

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  • Richard Bluhm & Maxim Pinkovskiy, 2021. "The spread of COVID-19 and the BCG vaccine: A natural experiment in reunified Germany," The Econometrics Journal, Royal Economic Society, vol. 24(3), pages 353-376.
    • Handle: RePEc:oup:emjrnl:v:24:y:2021:i:3:p:353-376.
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    Cited by:

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    2. Pronkina, Elizaveta & Berniell, Inés & Fawaz, Yarine & Laferrère, Anne & Mira, Pedro, 2023. "The COVID-19 curtain: Can past communist regimes explain the vaccination divide in Europe?," Social Science & Medicine, Elsevier, vol. 321(C).
    3. Kim, Seonghoon & Koh, Kanghyock & Lyou, Wonjun, 2024. "The Effects of Patient Cost-Sharing on Adolescents' Healthcare Utilization and Financial Risk Protection: Evidence from South Korea," IZA Discussion Papers 16897, Institute of Labor Economics (IZA).
    4. Seonghoon Kim & Kanghyock Koh & Wonjun Lyou, 2024. "The effects of patient cost‐sharing on adolescents' healthcare utilization and financial risk protection: Evidence from South Korea," Economic Inquiry, Western Economic Association International, vol. 62(3), pages 1009-1023, July.
    5. Wei-Ju Su & Chia-Hsuin Chang & Jiun-Ling Wang & Shu-Fong Chen & Chin-Hui Yang, 2021. "COVID-19 Severity and Neonatal BCG Vaccination among Young Population in Taiwan," IJERPH, MDPI, vol. 18(8), pages 1-7, April.
    6. Ehlert, Andree, 2021. "The socio-economic determinants of COVID-19: A spatial analysis of German county level data," Socio-Economic Planning Sciences, Elsevier, vol. 78(C).
    7. Philipp Breidenbach & Timo Mitze, 2022. "Large-scale sport events and COVID-19 infection effects: evidence from the German professional football ‘experiment’," The Econometrics Journal, Royal Economic Society, vol. 25(1), pages 15-45.

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    Keywords

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    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J60 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - General

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