IDEAS home Printed from https://ideas.repec.org/p/twi/respas/0116.html
   My bibliography  Save this paper

Vaccines at Work

Author

Listed:
  • Manuel Hoffmann
  • Roberto Mosquera
  • Adrian Chadi

Abstract

Influenza imposes substantial costs worldwide in terms of human lives and productivity losses. Vaccination could be a cost-effective way to reduce these costs for firms and public health institutions, but low take-up rates, particularly of working adults, and vaccination unintendingly causing moral hazard may decrease its benefits. We ran a natural field experiment in cooperation with a major bank in Ecuador where we modified a company-wide vaccination campaign. Experimentally manipulating incentives to participate in this health intervention allows us to study peer effects with organizational data and to determine the personal consequences of being randomly encouraged to take part in the campaign. We find that assigning employees to get vaccinated during the workweek increased take-up by 112% compared to employees assigned to the weekend, which indicates that reducing opportunity costs plays an important role to increase vaccination rates. Peer take-up also increased individual take-up significantly. Contrary to the company's expectations, we find that the effect of vaccination on health outcomes is a precise zero with no measurable health externalities from coworkers. Using a dataset of administrative records on sickness diagnoses and employee surveys, we find evidence consistent with vaccination causing moral hazard, which could decrease the effectiveness of vaccination.

Suggested Citation

  • Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.
  • Handle: RePEc:twi:respas:0116
    as

    Download full text from publisher

    File URL: https://www.twi-kreuzlingen.ch/wp-content/uploads/2019/03/TWI-RPS-116-Hoffmann-Mosquera-Chadi.pdf
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Ryoko Sato & Yoshito Takasaki, 2019. "Psychic vs. Economic Barriers to Vaccine Take-Up: Evidence from a Field Experiment in Nigeria," World Bank Economic Review, World Bank Group, vol. 33(3), pages 622-642.
    2. Liran Einav & Amy Finkelstein & Stephen P. Ryan & Paul Schrimpf & Mark R. Cullen, 2013. "Selection on Moral Hazard in Health Insurance," American Economic Review, American Economic Association, vol. 103(1), pages 178-219, February.
    3. Belot, Michèle & James, Jonathan & Nolen, Patrick, 2016. "Incentives and children's dietary choices: A field experiment in primary schools," Journal of Health Economics, Elsevier, vol. 50(C), pages 213-229.
    4. Jonathan Klick & Thomas Stratmann, 2007. "Diabetes Treatments and Moral Hazard," Journal of Law and Economics, University of Chicago Press, vol. 50, pages 519-538.
    5. Ziebarth, Nicolas R. & Karlsson, Martin, 2010. "A natural experiment on sick pay cuts, sickness absence, and labor costs," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 1108-1122, December.
    6. Geoffard, Pierre-Yves & Philipson, Tomas, 1997. "Disease Eradication: Private versus Public Vaccination," American Economic Review, American Economic Association, vol. 87(1), pages 222-230, March.
    7. Michael Kremer & Edward Miguel, 2007. "The Illusion of Sustainability," The Quarterly Journal of Economics, Oxford University Press, vol. 122(3), pages 1007-1065.
    8. Corey White, 2018. "Measuring the Social and Externality Benefits of Influenza Vaccination," Working Papers 1803, California Polytechnic State University, Department of Economics.
    9. David S. Lee, 2009. "Training, Wages, and Sample Selection: Estimating Sharp Bounds on Treatment Effects," Review of Economic Studies, Oxford University Press, vol. 76(3), pages 1071-1102.
    10. Anderson, Michael L., 2008. "Multiple Inference and Gender Differences in the Effects of Early Intervention: A Reevaluation of the Abecedarian, Perry Preschool, and Early Training Projects," Journal of the American Statistical Association, American Statistical Association, vol. 103(484), pages 1481-1495.
    11. Hoffman, Elizabeth & McCabe, Kevin & Smith, Vernon L, 1996. "Social Distance and Other-Regarding Behavior in Dictator Games," American Economic Review, American Economic Association, vol. 86(3), pages 653-660, June.
    12. Robert Nuscheler & Kerstin Roeder, 2016. "To Vaccinate or to Procrastinate? That is the Prevention Question," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1560-1581, December.
    13. John A. List & Robert D. Metcalfe & Michael K. Price & Florian Rundhammer, 2017. "Harnessing Policy Complementarities to Conserve Energy: Evidence from a Natural Field Experiment," NBER Working Papers 23355, National Bureau of Economic Research, Inc.
    14. Sam Peltzman, 2011. "Offsetting Behavior, Medical Breakthroughs, and Breakdowns," Journal of Human Capital, University of Chicago Press, vol. 5(3), pages 302-341.
    15. Bronchetti, Erin Todd & Huffman, David B. & Magenheim, Ellen, 2015. "Attention, intentions, and follow-through in preventive health behavior: Field experimental evidence on flu vaccination," Journal of Economic Behavior & Organization, Elsevier, vol. 116(C), pages 270-291.
    16. 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.
    17. Liran Einav & Amy Finkelstein, 2017. "Moral Hazard in Health Insurance: What We Know and How We Know It," NBER Working Papers 24055, National Bureau of Economic Research, Inc.
    18. Margolis, Jesse & Hockenberry, Jason & Grossman, Michael & Chou, Shin-Yi, 2014. "Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking," IZA Discussion Papers 8492, Institute of Labor Economics (IZA).
    19. Charles F. Manski, 1993. "Identification of Endogenous Social Effects: The Reflection Problem," Review of Economic Studies, Oxford University Press, vol. 60(3), pages 531-542.
    20. repec:uwp:jhriss:v:53:y:2018:i:1:p:71-122 is not listed on IDEAS
    21. Hendrik Schmitz & Ansgar Wübker, 2011. "What determines influenza vaccination take‐up of elderly Europeans?," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1281-1297, November.
    22. Auld, M. Christopher, 2003. "Choices, beliefs, and infectious disease dynamics," Journal of Health Economics, Elsevier, vol. 22(3), pages 361-377, May.
    23. List, John A. & Samek, Anya Savikhin, 2015. "The behavioralist as nutritionist: Leveraging behavioral economics to improve child food choice and consumption," Journal of Health Economics, Elsevier, vol. 39(C), pages 135-146.
    24. George A. Akerlof & Rachel E. Kranton, 2000. "Economics and Identity," The Quarterly Journal of Economics, Oxford University Press, vol. 115(3), pages 715-753.
    25. David R. Just & Joseph Price, 2013. "Using Incentives to Encourage Healthy Eating in Children," Journal of Human Resources, University of Wisconsin Press, vol. 48(4), pages 855-872.
    26. Aline Bütikofer & Meghan M. Skira, 2018. "Missing Work Is a Pain: The Effect of Cox-2 Inhibitors on Sickness Absence and Disability Pension Receipt," Journal of Human Resources, University of Wisconsin Press, vol. 53(1), pages 71-122.
    27. repec:wly:hlthec:v:27:y:2018:i:7:p:1043-1062 is not listed on IDEAS
    28. Doleac, Jennifer & Mukherjee, Anita, 2018. "The Moral Hazard of Lifesaving Innovations: Naloxone Access, Opioid Abuse, and Crime," IZA Discussion Papers 11489, Institute of Labor Economics (IZA).
    29. Peltzman, Sam, 1975. "The Effects of Automobile Safety Regulation," Journal of Political Economy, University of Chicago Press, vol. 83(4), pages 677-725, August.
    30. Jessamyn Schaller & Lisa Schulkind & Teny Maghakian Shapiro, 2017. "The Effects of Perceived Disease Risk and Access Costs on Infant Immunization," NBER Working Papers 23923, National Bureau of Economic Research, Inc.
    31. Alma Cohen & Liran Einav, 2003. "The Effects of Mandatory Seat Belt Laws on Driving Behavior and Traffic Fatalities," The Review of Economics and Statistics, MIT Press, vol. 85(4), pages 828-843, November.
    32. 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.
    33. Brito, Dagobert L. & Sheshinski, Eytan & Intriligator, Michael D., 1991. "Externalities and compulsary vaccinations," Journal of Public Economics, Elsevier, vol. 45(1), pages 69-90, June.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Keywords

    Health Intervention; Flu Vaccination; Sickness-Related Absence; Field Experiment; Random Encouragement Design; Moral Hazard; Technology Adoption;

    JEL classification:

    • D90 - Microeconomics - - Micro-Based Behavioral Economics - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J01 - Labor and Demographic Economics - - General - - - Labor Economics: General
    • N36 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Latin America; Caribbean

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:twi:respas:0116. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Gregor Walter). General contact details of provider: http://edirc.repec.org/data/twikrch.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.