Targeted Vaccine Subsidies for Healthcare Workers

We study the public goods problem associated with vaccinations. The externality created by an infection is composed of two parts, the probability of infection and the marginal infections generated if infected. We argue that the key component in a successful vaccination strategy is the second of these items but that current public policy focuses on the first. We use a newly collected data set coupled with agent-based simulations to study the spread of influenza and other infectious diseases in hospitals. We estimate the marginal infections created by various worker groups in a hospital in order to prioritize vaccine allocations across different healthcare worker groups in times of vaccine shortages. One primary focus of this paper is identifying the individual hospital workers who are most important to vaccinate. Surprisingly, we find that many groups with patient care responsibilities, such as physicians, play a small role in spreading influenza while others, such as unit clerks, play a much larger role.