Sibling Spillovers and the Choice to Get Vaccinated: Evidence from a Regression Discontinuity Design

TY - JOUR

T1 - Sibling Spillovers and the Choice to Get Vaccinated

T2 - Evidence from a Regression Discontinuity Design

AU - Humlum, Maria Knoth

AU - Morthorst, Marius Opstrup

AU - Thingholm, Peter Rønø

PY - 2024/3

Y1 - 2024/3

N2 - We investigate the effects of introducing population-wide free-of-charge Human Papillomavirus (HPV) vaccination programs on the targeted adolescent cohorts and their siblings. For identification, we rely on regression discontinuity designs and high-quality Danish administrative data to exploit that date of birth determines program eligibility. We find that the programs increased the HPV vaccine take-up of both the targeted children (53.2 percentage points for girls and 36.0 percentage points for boys) and their older same-sex siblings (4.5 percentage points for sisters and 3.5 percentage points for brothers). We show that while the direct effects of the programs reduced HPV vaccine take-up inequality, the spillover effects, in contrast, contributed to an increase in vaccine take-up inequality highlighting the potential importance of spillover effects in the determination of distributional consequences of public health programs. Finally, we find some evidence of cross-vaccine spillovers.

AB - We investigate the effects of introducing population-wide free-of-charge Human Papillomavirus (HPV) vaccination programs on the targeted adolescent cohorts and their siblings. For identification, we rely on regression discontinuity designs and high-quality Danish administrative data to exploit that date of birth determines program eligibility. We find that the programs increased the HPV vaccine take-up of both the targeted children (53.2 percentage points for girls and 36.0 percentage points for boys) and their older same-sex siblings (4.5 percentage points for sisters and 3.5 percentage points for brothers). We show that while the direct effects of the programs reduced HPV vaccine take-up inequality, the spillover effects, in contrast, contributed to an increase in vaccine take-up inequality highlighting the potential importance of spillover effects in the determination of distributional consequences of public health programs. Finally, we find some evidence of cross-vaccine spillovers.

KW - HPV

KW - Health behavior

KW - Health inequality

KW - Health investments

KW - Peer effects

KW - Sibling spillovers

KW - Vaccine

UR - https://www.scopus.com/pages/publications/85182376761

U2 - 10.1016/j.jhealeco.2023.102843

DO - 10.1016/j.jhealeco.2023.102843

M3 - Journal article

C2 - 38211459

SN - 0167-6296

VL - 94

JO - Journal of Health Economics

JF - Journal of Health Economics

M1 - 102843

ER -