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Direct and Spillover Effects of Middle School Vaccination Requirements

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  • Christopher S. Carpenter
  • Emily C. Lawler

Abstract

We study the direct and spillover effects of state requirements that middle school youths obtain a tetanus, diphtheria, and pertussis (Tdap) booster prior to middle school entry. These mandates increased vaccine take-up by 29 percent and reduced pertussis (whooping cough) incidence in the population by a much larger 53 percent due to herd immunity effects. We also document cross-vaccine spillovers: the mandates increased adolescent vaccination for meningococcal disease and human papillomavirus (which is responsible for 98 percent of cervical cancers) by 8-34 percent, with particularly large effects for children from low SES households.

Suggested Citation

  • Christopher S. Carpenter & Emily C. Lawler, 2017. "Direct and Spillover Effects of Middle School Vaccination Requirements," NBER Working Papers 23107, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:23107
    Note: CH HC HE
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    References listed on IDEAS

    as
    1. A. Colin Cameron & Jonah B. Gelbach & Douglas L. Miller, 2008. "Bootstrap-Based Improvements for Inference with Clustered Errors," The Review of Economics and Statistics, MIT Press, vol. 90(3), pages 414-427, August.
    2. Timothy G. Conley & Christopher R. Taber, 2011. "Inference with "Difference in Differences" with a Small Number of Policy Changes," The Review of Economics and Statistics, MIT Press, vol. 93(1), pages 113-125, February.
    3. James G. MacKinnon & Matthew D. Webb, 2016. "Randomization Inference for Difference-in-Differences with Few Treated Clusters," Carleton Economic Papers 16-11, Carleton University, Department of Economics.
    4. 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.
    5. Emily Oster, 2016. "Does Disease Cause Vaccination? Disease Outbreaks and Vaccination Response," NBER Working Papers 22464, National Bureau of Economic Research, Inc.
    6. Douglas Almond & Janet Currie & Valentina Duque, 2017. "Childhood Circumstances and Adult Outcomes: Act II," NBER Working Papers 23017, National Bureau of Economic Research, Inc.
    7. repec:aph:ajpbhl:10.2105/ajph.2009.179341_1 is not listed on IDEAS
    8. Jonathan Gruber, 2001. "Introduction to "Risky Behavior among Youths: An Economic Analysis"," NBER Chapters,in: Risky Behavior among Youths: An Economic Analysis, pages 1-28 National Bureau of Economic Research, Inc.
    9. 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.
    10. 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.
    11. Jonathan Gruber, 2001. "Risky Behavior among Youths: An Economic Analysis," NBER Books, National Bureau of Economic Research, Inc, number grub01-1.
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    More about this item

    JEL classification:

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

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