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

J Health Econ. 2021 Jul:78:102464. doi: 10.1016/j.jhealeco.2021.102464. Epub 2021 Apr 24.

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: Nonmedical exemptions; State mandates; Test scores; Vaccination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Success*
  • Child, Preschool
  • Humans
  • Schools
  • Vaccination
  • Vaccination Coverage
  • Vaccines*

Substances

  • Vaccines