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It'll only hurt a second? Microeconomic determinants of who gets flu shots


  • John Mullahy


Appreciating how the propensity to be immunized against the flu depends on individual characteristics and environments is essential for policies regarding influenza control to be formulated sensibly. To this point, the literature has offered little documentation on the determinants of influenza immunization. Beyond epidemiology, there are important economic issues that must be addressed to understand this form of preventive care. One concerns the relationship between labour supply and immunization propensity: While it is relatively costly (in terms of time costs) for workers to obtain immunizations, workers also have relatively more to lose from being ill with the flu. Another concern not generally appreciated is the extent to which individuals' perceived risks of infection may affect their propensities to be immunized. The paper also attempts to shed light on these issues. The analysis uses data from the 1991 National Health Interview Survey. Immunization propensity displays expected patterns by age and health status, while the results with respect to race, household structure, income and insurance are somewhat more surprising and|or novel. The estimated labour supply and perceived risk effects suggest that some aspects of the economics of preventive care generally not considered in empirical work are important and merit further consideration. Copyright © 1999 John Wiley & Sons, Ltd.

Suggested Citation

  • John Mullahy, 1999. "It'll only hurt a second? Microeconomic determinants of who gets flu shots," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 9-24.
  • Handle: RePEc:wly:hlthec:v:8:y:1999:i:1:p:9-24 DOI: 10.1002/(SICI)1099-1050(199902)8:1<9::AID-HEC396>3.0.CO;2-X

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    References listed on IDEAS

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    Cited by:

    1. Pichler, Stefan & Ziebarth, Nicolas R., 2017. "The pros and cons of sick pay schemes: Testing for contagious presenteeism and noncontagious absenteeism behavior," Journal of Public Economics, Elsevier, vol. 156(C), pages 14-33.
    2. Maurer, Jürgen, 2009. "Who has a clue to preventing the flu? Unravelling supply and demand effects on the take-up of influenza vaccinations," Journal of Health Economics, Elsevier, vol. 28(3), pages 704-717, May.
    3. Stefan Pichler & Nicolas Ziebarth, 2016. "The Pros and Cons of Sick Pay Schemes: Testing for Contagious Presenteeism and Shirking Behavior," NBER Chapters,in: Social Insurance Programs (Trans-Atlantic Public Economic Seminar - TAPES) National Bureau of Economic Research, Inc.
    4. Nicolas Bouckaert & Erik Schokkaert, 2016. "Differing types of medical prevention appeal to different individuals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 317-337, April.
    5. Pichler, Stefan & Ziebarth, Nicolas R., 2015. "The Pros and Cons of Sick Pay Schemes: A Method to Test for Contagious Presenteeism and Shirking Behavior," IZA Discussion Papers 8850, Institute for the Study of Labor (IZA).
    6. Majo, M.C., 2010. "A microeconometric analysis of health care utilization in Europe," Other publications TiSEM 1cf5fd2f-8146-4ef8-8eb5-e, Tilburg University, School of Economics and Management.
    7. Xie, Jipan & Dow, William H., 2005. "Longitudinal study of child immunization determinants in China," Social Science & Medicine, Elsevier, vol. 61(3), pages 601-611, August.
    8. Meliyanni Johar & Denzil Fiebig & Marion Haas & Rosalie Viney, 2009. "Evaluating changes in women's attitudes towards cervical screening following a screening promotion campaign and a free vaccination program. CHERE Working Paper 2009/3," Working Papers 2009/3, CHERE, University of Technology, Sydney.
    9. Di Novi, Cinzia, 2013. "The indirect effect of fine particulate matter on health through individuals’ life-style," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 44(C), pages 27-36.
    10. Stephen T. Parente & David Salkever & Joan DaVanzo, 2003. "The Role of Consumer Knowledge of Insurance Benefits in the Demand for Preventative Health," NBER Working Papers 9912, National Bureau of Economic Research, Inc.
    11. Cinzia Di Novi, 2011. "Quality and Reputation: The Indirect Effect of Fine Particulate Matter on Health through Individuals' Life-style," DISCE - Quaderni dell'Istituto di Economia dell'Impresa e del Lavoro ieil0062, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    12. Tsutsui, Yoshiro & Benzion, Uri & Shahrabani, Shosh, 2012. "Economic and behavioral factors in an individual's decision to take the influenza vaccination in Japan," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 41(5), pages 594-602.
    13. Joseph Cook & Marc Jeuland & Brian Maskery & Donald Lauria & Dipika Sur & John Clemens & Dale Whittington, 2009. "Using private demand studies to calculate socially optimal vaccine subsidies in developing countries," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 28(1), pages 6-28.
    14. Rochelle Belkar & Denzil G. Fiebig & Marion Haas & Rosalie Viney, 2006. "Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 33-47.
    15. Graff Zivin, Joshua & Neidell, Matthew, 2009. "Days of haze: Environmental information disclosure and intertemporal avoidance behavior," Journal of Environmental Economics and Management, Elsevier, vol. 58(2), pages 119-128, September.
    16. Slade, Alexander N., 2012. "Health investment decisions in response to diabetes information in older Americans," Journal of Health Economics, Elsevier, vol. 31(3), pages 502-520.
    17. Carman, Katherine Grace & Kooreman, Peter, 2011. "Flu Shots, Mammograms, and the Perception of Probabilities," IZA Discussion Papers 5739, Institute for the Study of Labor (IZA).
    18. Kondo, Masahide & Hoshi, Shu-ling & Okubo, Ichiro, 2009. "Does subsidy work? Price elasticity of demand for influenza vaccination among the elderly in Japan," Health Policy, Elsevier, vol. 91(3), pages 269-276, August.
    19. Courtney J. Ward, 2014. "Influenza Vaccination Campaigns: Is an Ounce of Prevention Worth a Pound of Cure?," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 38-72, January.
    20. Matthew J. Neidell, 2008. "Information, Avoidance Behavior, and Health: The Effect of Ozone on Asthma Hospitalizations," NBER Working Papers 14209, National Bureau of Economic Research, Inc.
    21. Ciro Avitabile & Tullio Jappelli & Mario Padula, 2008. "Screening Tests, Information, and the Health-Education Gradient," CSEF Working Papers 187, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy, revised 28 Apr 2008.
    22. Chen, Keith & Lange, Fabian, 2008. "Education, Information, and Improved Health: Evidence from Breast Cancer Screening," IZA Discussion Papers 3548, Institute for the Study of Labor (IZA).
    23. John C. Eckalbar & Pete Tsournos & Walter L. Eckalbar, 2015. "Dynamics In An Sir Model When Vaccination Demand Follows Prior Levels Of Disease Prevalence," Advances in Complex Systems (ACS), World Scientific Publishing Co. Pte. Ltd., vol. 18(07n08), pages 1-27, November.
    24. Katherine Carman & Peter Kooreman, 2014. "Probability perceptions and preventive health care," Journal of Risk and Uncertainty, Springer, vol. 49(1), pages 43-71, August.

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    • I1 - Health, Education, and Welfare - - Health


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