Personal Belief Exemptions for School-Entry Vaccinations, Vaccination Rates, and Academic Achievement

Nicole L. Hair (), Anja Gruber () and Carly Urban ()
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Nicole L. Hair: University of South Carolina
Anja Gruber: University of Colorado, Boulder
Carly Urban: Montana State University

No 12978, IZA Discussion Papers from Institute of Labor Economics (IZA)

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 the 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 mathematics and English Language Arts test scores were largest for black students, especially those residing in economically disadvantaged counties.

Keywords: nonmedical exemptions; state mandates; vaccination; test scores (search for similar items in EconPapers)
JEL-codes: H75 I12 I18 I21 I24 I28 (search for similar items in EconPapers)
Pages: 43 pages
Date: 2020-02
New Economics Papers: this item is included in nep-hea and nep-ure
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Published - published in: Journal of Health Economics, 2021, 78, 102464

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