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同胞溢出效应与疫苗接种选择:来自断点回归设计的证据

Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design
Journal of Health Economics · 2024 · Humlum, Maria Knoth、Morthorst, Marius Opstrup、Thingholm, Peter Rønø

中文摘要

我们研究了引入覆盖全民的免费人乳头瘤病毒 (HPV) 疫苗接种计划对目标青少年群体及其同胞的影响。在识别方面,我们依靠断点回归设计和高质量的丹麦行政数据,利用出生日期决定计划资格这一事实。我们发现,这些计划同时提高了目标儿童(女孩提高 53.2 个百分点,男孩提高 36.0 个百分点)及其年长同性同胞(姐妹提高 4.5 个百分点,兄弟提高 3.5 个百分点)的 HPV 疫苗接种率。我们表明,尽管这些计划的直接效应降低了 HPV 疫苗接种不平等,但溢出效应却相反地加剧了疫苗接种不平等,这凸显了溢出效应在决定公共卫生计划分配后果方面潜在的重要性。最后,我们发现了跨疫苗溢出效应的一些证据。

Abstract

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.
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