Working Paper: NBER ID: w23923
Authors: Jessamyn Schaller; Lisa Schulkind; Teny Maghakian Shapiro
Abstract: This paper examines the determinants of parental decisions about infant immunization. Using the exact timing of vaccination relative to birth, we estimate the effects of local pertussis outbreaks occurring in-utero and during the first two months of life on the likelihood of on-time initial immunization for pertussis and other immunizations. We find that parents respond to changes in perceived disease risk: pertussis outbreaks within a state increase the rate of on-time receipt of the pertussis vaccine at two months of age. This response is concentrated among low-socioeconomic status (SES) subgroups. In addition, we find that pertussis outbreaks increase the likelihood of immunization against other vaccine-preventable diseases. These spillover effects are almost as large the direct effects and are present only for vaccines that are typically given during the same visit as the pertussis vaccine, which suggests that healthcare access costs play an important role in parents' vaccination decisions.
Keywords: Infant Immunization; Disease Risk; Healthcare Access; Socioeconomic Status
JEL Codes: I01; I12; J13
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| pertussis outbreaks occurring in utero and during the first two months of life (J13) | likelihood of on-time initiation of the pertussis vaccine (DTP) (C41) |
| pertussis outbreaks occurring in utero and during the first two months of life (J13) | reduction in delays for on-time initiation of the pertussis vaccine (DTP) (C41) |
| pertussis outbreaks (J11) | likelihood of receiving other vaccines (e.g., polio and Hib) during the same visit (I19) |
| pertussis outbreaks (J11) | likelihood of delays in receiving vaccines recommended at separate visits (e.g., hepatitis B and MMR) (C41) |