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Does disease cause vaccination? Disease outbreaks and vaccination response - PubMed

Does disease cause vaccination? Disease outbreaks and vaccination response

Emily Oster. J Health Econ. 2018 Jan.

Abstract

Parental fear of vaccines has limited vaccination rates in the United States. I test whether disease outbreaks increase vaccination using a new dataset of county-level disease and vaccination data. I find that pertussis (whooping cough) outbreaks in a county decrease the share of unvaccinated children entering kindergarten. These responses do not reflect changes in the future disease risk. I argue that these facts are best fit by a model in which individuals are both myopic and irrational. This suggests that better promotion of information about outbreaks could enhance the response.

Keywords: Pertussis outbreak; Vaccination.

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Figures

Figure 1:
Figure 1:. Pertussis Vaccination Rate Variation Across Space

Notes: These figures show the density of vaccination rates across counties in the 2010–2011 period. I average vaccination rates for 2010 and 2011 and drop the bottom 1% of counties.

Figure 2:
Figure 2:. Impact of Pertussis on Vaccination

Notes: This figure shows the relationship between pertussis outbreaks in year t – 1 and vaccination in year t. All points shown are regression coefficients from regressions with county and year fixed effects and population controls. Sub-figure (a) groups cases based on the average disease rate over the previous five years. Sub-figure (b) groups cases based on average case counts. 90% confidence intervals are shown.

Figure 3:
Figure 3:. Impact of Pertussis Cases on Google Searches

Notes: These figures show the impact of outbreaks on Google searches for four groups of terms: terms related to the disease, “pertussis vaccine” and related, “vaccine risks” and related and “vaccine and autism”. The graph maps out the impact in the month in which the cases occur, the following month, the month after and so on up to a year after the outbreak. All coefficients are from regressions which include state and month fixed effects. Sub-figure (a) shows the impact of a linear control for number of cases. Sub-figure (b) shows the impact of cases measured in standard deviations from the local mean.

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