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Immunization and Moral Hazard: The HPV Vaccine and Uptake of Cancer Screening

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  • Ali Moghtaderi
  • Avi Dor

Abstract

Immunization can cause moral hazard by reducing the cost of risky behaviors. In this study, we examine the effect of HPV vaccination for cervical cancer on participation in the Pap test, which is a diagnostic screening test to detect potentially precancerous and cancerous process. It is strongly recommended for women between 21-65 years old even after taking the HPV vaccine. A reduction in willingness to have a Pap test as a result of HPV vaccination would signal the need for public health intervention. The HPV vaccination is recommended for women age eleven to twelve for regular vaccination or for women up to age 26 not vaccinated previously. We present evidence that probability of vaccination changes around this threshold. We identify the effect of vaccination using a fuzzy regression discontinuity design, centered on the recommended vaccination threshold age. The results show no evidence of ex ante moral hazard in the short-run. Sensitivity analyses using alternative specifications and subsamples are in general agreement. The estimates show that women who have been vaccinated are actually more likely to have a Pap test in the short-run, possibly due to increased awareness of its benefits.

Suggested Citation

  • Ali Moghtaderi & Avi Dor, 2016. "Immunization and Moral Hazard: The HPV Vaccine and Uptake of Cancer Screening," NBER Working Papers 22523, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:22523
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    References listed on IDEAS

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    1. Jonathan Klick & Thomas Stratmann, 2007. "Diabetes Treatments and Moral Hazard," Journal of Law and Economics, University of Chicago Press, vol. 50(3), pages 519-538.
    2. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    3. Lídia Farré & Roger Klein & Francis Vella, 2013. "A parametric control function approach to estimating the returns to schooling in the absence of exclusion restrictions: an application to the NLSY," Empirical Economics, Springer, vol. 44(1), pages 111-133, February.
    4. 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).
    5. Wilbert Van Der Klaauw, 2008. "Regression–Discontinuity Analysis: A Survey of Recent Developments in Economics," LABOUR, CEIS, vol. 22(2), pages 219-245, June.
    6. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-648, July-Aug..
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    Cited by:

    1. Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.

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    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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