Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, United States.
University of Colorado at Boulder, United States.
J Health Econ. 2021 Jul;78:102464. doi: 10.1016/j.jhealeco.2021.102464. Epub 2021 Apr 24.
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.
非医学豁免学校入学疫苗接种要求正受到政策和公共卫生部门的更多关注。本文研究了扩大豁免范围如何影响儿童早期的疫苗接种率和中学的学业成绩。我们利用了 2003 年的立法，该立法在德克萨斯州和阿肯色州授予了个人信仰豁免（PBE），这两个州之前只允许因医疗或宗教原因获得豁免。我们发现，PBE 分别使黑人儿童和低收入学龄前儿童的疫苗接种率下降了 16.1%和 8.3%。此外，我们发现，受该政策变化影响的儿童在中学的标准化学术成就测试中的表现较差。对黑人和经济弱势群体学生的估计影响最大。
