IDEAS home Printed from https://ideas.repec.org/a/eee/ehbiol/v47y2022ics1570677x22000892.html
   My bibliography  Save this article

Convincing the “Herd” of immunity: Lessons from smallpox vaccination in 19th century Germany

Author

Listed:
  • Mühlhoff, Katharina

Abstract

Although vaccination is a cost-effective way to control infectious diseases, it is often met with popular resistance. Studying smallpox in 19th century Germany, this paper explores how economic incentives contribute to this phenomenon. The paper adds to the literature by combining mathematical epidemiology and unpublished archival evidence from two German states - Baden and Wurttemberg. The two states are an intriguing case because their initial conditions and vaccination laws were similar. Despite this, Baden experienced lower smallpox prevalence and higher vaccination uptake than Wurttemberg. The epidemiological model predicts that incentives to vaccinate decline rapidly when immunization reduces prevalence. The archival evidence reveals that Baden offset this decline by creating a public vaccination system which reduced costs for vaccinees and vaccinators alike. This suggests that the high fixed costs of centralized immunization policies can be compensated by economies of scale and popular acceptance.

Suggested Citation

  • Mühlhoff, Katharina, 2022. "Convincing the “Herd” of immunity: Lessons from smallpox vaccination in 19th century Germany," Economics & Human Biology, Elsevier, vol. 47(C).
    • Handle: RePEc:eee:ehbiol:v:47:y:2022:i:c:s1570677x22000892
    DOI: 10.1016/j.ehb.2022.101193
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1570677X22000892
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.ehb.2022.101193?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Philipp Ager & Casper Worm Hansen & Peter Sandholt Jensen, 2018. "Fertility and Early-Life Mortality: Evidence from Smallpox Vaccination in Sweden," Journal of the European Economic Association, European Economic Association, vol. 16(2), pages 487-521.
    2. Wooyoung Lim & Pengfei Zhang, 2020. "Herd immunity and a vaccination game: An experimental study," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-16, May.
    3. Sara Lowes & Eduardo Montero, 2021. "The Legacy of Colonial Medicine in Central Africa," American Economic Review, American Economic Association, vol. 111(4), pages 1284-1314, April.
    4. Mark Gersovitz & Jeffrey S. Hammer, 2004. "The Economical Control of Infectious Diseases," Economic Journal, Royal Economic Society, vol. 114(492), pages 1-27, January.
    5. Olga Krylova & David J D Earn, 2020. "Patterns of smallpox mortality in London, England, over three centuries," PLOS Biology, Public Library of Science, vol. 18(12), pages 1-27, December.
    6. Bonu, Sekhar & Rani, Manju & Baker, Timothy D., 2003. "The impact of the national polio immunization campaign on levels and equity in immunization coverage: evidence from rural North India," Social Science & Medicine, Elsevier, vol. 57(10), pages 1807-1819, November.
    7. Blume, Stuart, 2006. "Anti-vaccination movements and their interpretations," Social Science & Medicine, Elsevier, vol. 62(3), pages 628-642, February.
    8. Verelst, Frederik & Willem, Lander & Kessels, Roselinde & Beutels, Philippe, 2018. "Individual decisions to vaccinate one's child or oneself: A discrete choice experiment rejecting free-riding motives," Social Science & Medicine, Elsevier, vol. 207(C), pages 106-116.
    9. Mark Gersovitz & Jeffrey S. Hammer, 2003. "Infectious Diseases, Public Policy, and the Marriage of Economics and Epidemiology," The World Bank Research Observer, World Bank, vol. 18(2), pages 129-157.
    10. Gauri, Varun & Khaleghian, Peyvand, 2002. "Immunization in Developing Countries: Its Political and Organizational Determinants," World Development, Elsevier, vol. 30(12), pages 2109-2132, December.
    11. Courtney J. Ward, 2014. "Influenza Vaccination Campaigns: Is an Ounce of Prevention Worth a Pound of Cure?," American Economic Journal: Applied Economics, American Economic Association, vol. 6(1), pages 38-72, January.
    12. Brito, Dagobert L. & Sheshinski, Eytan & Intriligator, Michael D., 1991. "Externalities and compulsary vaccinations," Journal of Public Economics, Elsevier, vol. 45(1), pages 69-90, June.
    13. Colvin, Christopher L. & McLaughlin, Eoin, 2021. "Death, demography and the denominator: Age-adjusted Influenza-18 mortality in Ireland," Economics & Human Biology, Elsevier, vol. 41(C).
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hoffmann, Manuel & Mosquera, Roberto & Chadi, Adrian, 2019. "Vaccines at Work," VfS Annual Conference 2019 (Leipzig): 30 Years after the Fall of the Berlin Wall - Democracy and Market Economy 203661, Verein für Socialpolitik / German Economic Association.
    2. Josselin Thuilliez & Nouhoum Touré, 2024. "Opinions and vaccination during an epidemic," Post-Print hal-04490900, HAL.
    3. Na Hao & Gervan Fearon, 2009. "Government Funding Policy Towards Communicable Diseases," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(2), pages 121-134, June.
    4. Stéphane Mechoulan, 2007. "Market structure and communicable diseases," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 40(2), pages 468-492, May.
    5. Sabine Liebenehm & Bernard Bett & Cristobal Verdugo & Mohamed Said, 2016. "Optimal Drug Control under Risk of Drug Resistance – The Case of African Animal Trypanosomosis," Journal of Agricultural Economics, Wiley Blackwell, vol. 67(2), pages 510-533, June.
    6. Thuilliez, Josselin & Touré, Nouhoum, 2024. "Opinions and vaccination during an epidemic," Journal of Mathematical Economics, Elsevier, vol. 111(C).
    7. Rowthorn, Robert & Toxvaerd, Flavio, 2012. "The Optimal Control of Infectious Diseases via Prevention and Treatment," CEPR Discussion Papers 8925, C.E.P.R. Discussion Papers.
    8. Telalagic, S., 2012. "Optimal Treatment of an SIS Disease with Two Strains," Cambridge Working Papers in Economics 1229, Faculty of Economics, University of Cambridge.
    9. Josselin Thuilliez & Nouhoum Touré, 2024. "Opinions and vaccination during an epidemic," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) hal-04490900, HAL.
    10. Goodkin-Gold, Matthew & Kremer, Michael & Snyder, Christopher M. & Williams, Heidi, 2022. "Optimal vaccine subsidies for endemic diseases," International Journal of Industrial Organization, Elsevier, vol. 84(C).
    11. Railey, Ashley F. & Marsh, Thomas L., 2017. "Diagnostic Testing and Vaccine Matching: FMD in Tanzania," 2017 Annual Meeting, July 30-August 1, Chicago, Illinois 258386, Agricultural and Applied Economics Association.
    12. Chanel, Olivier & Luchini, Stéphane & Massoni, Sébastien & Vergnaud, Jean-Christophe, 2011. "Impact of information on intentions to vaccinate in a potential epidemic: Swine-origin Influenza A (H1N1)," Social Science & Medicine, Elsevier, vol. 72(2), pages 142-148, January.
    13. Toxvaerd, Flavio, 2010. "Recurrent Infection and Externalities in Prevention," CEPR Discussion Papers 8112, C.E.P.R. Discussion Papers.
    14. La Torre, Davide & Liuzzi, Danilo & Marsiglio, Simone, 2021. "Epidemics and macroeconomic outcomes: Social distancing intensity and duration," Journal of Mathematical Economics, Elsevier, vol. 93(C).
    15. Michael Kremer & Christopher M. Snyder, 2018. "Preventives Versus Treatments Redux: Tighter Bounds on Distortions in Innovation Incentives with an Application to the Global Demand for HIV Pharmaceuticals," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 53(1), pages 235-273, August.
    16. Goyal, Sanjeev & Vigier, Adrien, 2015. "Interaction, protection and epidemics," Journal of Public Economics, Elsevier, vol. 125(C), pages 64-69.
    17. Barrett, Scott & Hoel, Michael, 2007. "Optimal disease eradication," Environment and Development Economics, Cambridge University Press, vol. 12(5), pages 627-652, October.
    18. Seabright, Paul & Mesnard, Alice, 2008. "Migration and The Equilibrium Prevalence of Infectious Diseases," CEPR Discussion Papers 6651, C.E.P.R. Discussion Papers.
    19. Peter Juul Egedesø & Casper Worm Hansen & Peter Sandholt Jensen, 2020. "Preventing the White Death: Tuberculosis Dispensaries," The Economic Journal, Royal Economic Society, vol. 130(629), pages 1288-1316.
    20. Momota, Akira & Tabata, Ken & Futagami, Koichi, 2005. "Infectious disease and preventive behavior in an overlapping generations model," Journal of Economic Dynamics and Control, Elsevier, vol. 29(10), pages 1673-1700, October.

    More about this item

    Keywords

    Health externalities; Vaccination; Smallpox; Vaccine resistance; Regulation; Historical institutions;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • N33 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - Europe: Pre-1913
    • N43 - Economic History - - Government, War, Law, International Relations, and Regulation - - - Europe: Pre-1913

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:ehbiol:v:47:y:2022:i:c:s1570677x22000892. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/622964 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.