Direct and Spillover Effects of Middle School Vaccination Requirements
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.
Lawler acknowledges support from the Vanderbilt Economics Department’s Walter M. Noel Dissertation Fellowship. We thank Amanda Faulkner and Sandra Roush at the CDC for help with morbidity data. We thank Lenisa Chang, Monica Deza, Marie Griffin, Mike Lovenheim, Bill Schaffner, Lisa Schulkind, Sebastian Tello-Trillo, and seminar participants at the 2016 APPAM Fall Research Conference, the University of Cincinnati, Colorado State University, and Vanderbilt University for helpful comments. All errors are our own. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.
Christopher S. Carpenter & Emily C. Lawler, 2019. "Direct and Spillover Effects of Middle School Vaccination Requirements," American Economic Journal: Economic Policy, vol 11(1), pages 95-125.