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Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy

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  • Lenisa V. Chang

Abstract

In the wake of strong, although later refuted, claims of a link between autism and the measles‐mumps‐rubella (MMR) vaccine, I examine whether fewer parents immunized or delayed vaccinations for their children and if there was a differential response by mother's education level. Using various controls and a differencing strategy that compares in MMR take‐up with other vaccines, I find that the MMR–autism controversy led to a decline in the immediate years and that there were negative spillovers onto other vaccines. I also find evidence that more highly educated mothers responded more strongly to the controversy either by not immunizing their children altogether or, to a lesser degree, delaying vaccination. Moreover, the educational gap was greater in states where there was greater media attention devoted to the controversy. This is consistent with the health allocative efficiency hypothesis whereby part of the education gradient in health outcomes is due to more‐educated individuals absorbing and responding to health information more quickly. However, unlike in the United Kingdom, where previous studies find that the gap was eliminated after the link was refuted, the evidence for the United States suggests that the educational gap persisted.

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  • 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.
  • Handle: RePEc:wly:hlthec:v:27:y:2018:i:7:p:1043-1062
    DOI: 10.1002/hec.3645
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    3. Martin Halla & Chia-Lun Liu & Jin-Tan Liu, 2019. "The Effect of Superstition on Health: Evidence from the Taiwanese Ghost Month," Economics working papers 2019-01, Department of Economics, Johannes Kepler University Linz, Austria.
    4. Schober, Thomas, 2020. "Effects of a measles outbreak on vaccination uptake," Economics & Human Biology, Elsevier, vol. 38(C).
    5. Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.
    6. 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).
    7. Vincenzo Carrieri & Leonardo Madio & Francesco Principe, 2019. "Vaccine hesitancy and (fake) news: Quasi‐experimental evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 28(11), pages 1377-1382, November.
    8. Brilli, Ylenia & Lucifora, Claudio & Russo, Antonio & Tonello, Marco, 2020. "Influenza vaccination behavior and media reporting of adverse events," Health Policy, Elsevier, vol. 124(12), pages 1403-1411.
    9. Shooshan Danagoulian & Daniel Grossman & David Slusky, 2022. "Health Care Following Environmental Disasters: Evidence from Flint," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 41(4), pages 1060-1089, September.
    10. Pelras, Charlotte & Renk, Andréa, 2023. "When sterilizations lower immunizations: The Emergency experience in India (1975–77)," World Development, Elsevier, vol. 170(C).
    11. Jichun Zhao & Hongbiao Wang & Jianxin Guo, 2021. "Smog Avoidance Investment While Improving Air Quality: Health Demand or Risk Aversion? Evidence from Cities in China," IJERPH, MDPI, vol. 18(15), pages 1-21, July.
    12. Blondel, Serge & Langot, François & Mueller, Judith E. & Sicsic, Jonathan, 2021. "Preferences and COVID-19 Vaccination Intentions," IZA Discussion Papers 14823, Institute of Labor Economics (IZA).
    13. Arthur Juet, 2023. "The Online Vaccination Debate : The Case of France," Working Papers hal-04053614, HAL.
    14. Qian, Mengcen & Chou, Shin-Yi & Lai, Ernest K., 2020. "Confirmatory bias in health decisions: Evidence from the MMR-autism controversy," Journal of Health Economics, Elsevier, vol. 70(C).
    15. Giulietti, Corrado & Vlassopoulos, Michael & Zenou, Yves, 2023. "When reality bites: Local deaths and vaccine take-up," European Economic Review, Elsevier, vol. 156(C).
    16. Hirani, Jonas Cuzulan & Wüst, Miriam, 2022. "Nurses and infant vaccination coverage," Journal of Economic Behavior & Organization, Elsevier, vol. 196(C), pages 402-428.
    17. Moussa, Ouattara Zieh & Takeuchi, Kenji, 2022. "Does searching online for vaccination information affect vaccination coverage? Evidence from Sub-Saharan African countries," Economics & Human Biology, Elsevier, vol. 47(C).
    18. Hirani, Jonas Lau-Jensen, 2021. "Inattention or reluctance? Parental responses to vaccination reminder letters," Journal of Health Economics, Elsevier, vol. 76(C).
    19. Claudio Deiana & Andrea Geraci & Gianluca Mazzarella & Fabio Sabatini, 2022. "Perceived risk and vaccine hesitancy: Quasi‐experimental evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 31(6), pages 1266-1275, June.
    20. Vincenzo Carrieri & Raffele Lagravinese & Giuliano Resce, 2021. "Predicting vaccine hesitancy from area‐level indicators: A machine learning approach," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 3248-3256, December.
    21. Tiantian Dai & Shenyi Jiang & Xiangbo Liu & Ang Sun, 2022. "The effects of a hypertension diagnosis on health behaviors: A two‐dimensional regression discontinuity analysis," Health Economics, John Wiley & Sons, Ltd., vol. 31(4), pages 574-596, April.
    22. Alice Dominici and Lisen Arnheim Dahlström, 2023. "Targeting vaccine information framing to recipients’ education: a randomized trial," Economics Working Papers EUI ECO 2023/02, European University Institute.

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