Effectiveness of vaccination recommendations versus mandates: Evidence from the hepatitis A vaccine.
I provide novel evidence on the effectiveness of two vaccination policies - simple non-binding recommendations to vaccinate versus mandates requiring vaccination prior to childcare or kindergarten attendance - in the context of the only disease whose institutional features permit a credible examination of both: hepatitis A. Using provider-verified immunization data I find that recommendations significantly increased hepatitis A vaccination rates among young children by at least 20 percentage points, while mandates increase rates by another 8 percentage points. These policies also significantly reduced population hepatitis A incidence. My results suggest a range of policy options for addressing suboptimally low population vaccination rates.
Vanderbilt University, Department of Economics, 2301 Vanderbilt Place, Nashville, TN 37235, United States. Electronic address: emily.c.lawler@vanderbilt.edu.
Emily C
EC
Lawler
D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006506:Hepatitis A / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000627:therapeutic use*; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D008297:Male; D037141:Mandatory Programs; D015397:Program Evaluation; D012572:School Health Services; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination / Q000592:standards*; D055815:Young Adult
D022362:Hepatitis A Vaccines
Difference-in-differences; Hepatitis A; State mandates; Vaccination