Direct and Spillover Effects of Middle School Vaccination Requirements
Christopher S. Carpenter
Emily C. Lawler
- American Economic Journal: Economic Policy (Forthcoming)
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 significantly increased Tdap vaccine take-up and reduced pertussis (whooping cough) incidence by about 32 percent. We also document cross-vaccine spillovers: the mandates significantly increased adolescent vaccination rates for meningococcal disease and human papillomavirus (HPV) – which is responsible for 98 percent of cervical cancers – by 8-34 percent, with particularly large effects for children from low SES households. We find important roles for both parents and providers in generating these spillovers.
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