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Personal belief exemptions for school-entry vaccinations, vaccination rates, and academic achievement

Nicole L. Hair, Anja Gruber and Carly Urban

Journal of Health Economics, 2021, vol. 78, issue C

Abstract: Nonmedical exemptions from school-entry vaccine mandates are receiving increased policy and public health scrutiny. This paper examines how expanding the availability of exemptions influences vaccination rates in early childhood and academic achievement in middle school. We leverage 2003 legislation that granted personal belief exemptions (PBE) in Texas and Arkansas, two states that previously allowed exemptions only for medical or religious regions. We find that PBE decreased vaccination coverage among Black and low-income preschoolers by 16.1% and 8.3%, respectively. Furthermore, we find that those cohorts affected by the policy change in early childhood performed less well on standardized tests of academic achievement in middle school. Estimated effects on test scores were largest for Black students and economically disadvantaged students.

Keywords: Vaccination; State mandates; Nonmedical exemptions; Test scores (search for similar items in EconPapers)
JEL-codes: H75 I12 I18 I21 I24 I28 (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:78:y:2021:i:c:s0167629621000497

DOI: 10.1016/j.jhealeco.2021.102464

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Journal of Health Economics is currently edited by J. P. Newhouse, A. J. Culyer, R. Frank, K. Claxton and T. McGuire

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