IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/22523.html
   My bibliography  Save this paper

Immunization and Moral Hazard: The HPV Vaccine and Uptake of Cancer Screening

Author

Listed:
  • Ali Moghtaderi
  • Avi Dor

Abstract

Immunization can cause moral hazard by reducing the cost of risky behaviors. In this study, we examine the effect of HPV vaccination for cervical cancer on participation in the Pap test, which is a diagnostic screening test to detect potentially precancerous and cancerous process. It is strongly recommended for women between 21-65 years old even after taking the HPV vaccine. A reduction in willingness to have a Pap test as a result of HPV vaccination would signal the need for public health intervention. The HPV vaccination is recommended for women age eleven to twelve for regular vaccination or for women up to age 26 not vaccinated previously. We present evidence that probability of vaccination changes around this threshold. We identify the effect of vaccination using a fuzzy regression discontinuity design, centered on the recommended vaccination threshold age. The results show no evidence of ex ante moral hazard in the short-run. Sensitivity analyses using alternative specifications and subsamples are in general agreement. The estimates show that women who have been vaccinated are actually more likely to have a Pap test in the short-run, possibly due to increased awareness of its benefits.

Suggested Citation

  • Ali Moghtaderi & Avi Dor, 2016. "Immunization and Moral Hazard: The HPV Vaccine and Uptake of Cancer Screening," NBER Working Papers 22523, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:22523
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w22523.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Jonathan Klick & Thomas Stratmann, 2007. "Diabetes Treatments and Moral Hazard," Journal of Law and Economics, University of Chicago Press, vol. 50(3), pages 519-538.
    2. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    3. Lídia Farré & Roger Klein & Francis Vella, 2013. "A parametric control function approach to estimating the returns to schooling in the absence of exclusion restrictions: an application to the NLSY," Empirical Economics, Springer, vol. 44(1), pages 111-133, February.
    4. Margolis, Jesse & Hockenberry, Jason & Grossman, Michael & Chou, Shin-Yi, 2014. "Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking," IZA Discussion Papers 8492, Institute of Labor Economics (IZA).
    5. Wilbert Van Der Klaauw, 2008. "Regression–Discontinuity Analysis: A Survey of Recent Developments in Economics," LABOUR, CEIS, vol. 22(2), pages 219-245, June.
    6. Ehrlich, Isaac & Becker, Gary S, 1972. "Market Insurance, Self-Insurance, and Self-Protection," Journal of Political Economy, University of Chicago Press, vol. 80(4), pages 623-648, July-Aug..
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Manuel Hoffmann & Roberto Mosquera & Adrian Chadi, 2019. "Vaccines at Work," TWI Research Paper Series 116, Thurgauer Wirtschaftsinstitut, Universität Konstanz.

    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. Yoichi Arai & Hidehiko Ichimura, 2018. "Simultaneous selection of optimal bandwidths for the sharp regression discontinuity estimator," Quantitative Economics, Econometric Society, vol. 9(1), pages 441-482, March.
    2. Aparicio Fenoll, Ainoa & Oppedisano, Veruska, 2012. "Fostering the Emancipation of Young People: Evidence from a Spanish Rental Subsidy," IZA Discussion Papers 6651, Institute of Labor Economics (IZA).
    3. Rajeev Dehejia, 2013. "The Porous Dialectic: Experimental and Non-Experimental Methods in Development Economics," WIDER Working Paper Series wp-2013-011, World Institute for Development Economic Research (UNU-WIDER).
    4. Nicolas Moreau & Elena Stancanelli, 2015. "Household Consumption at Retirement : A Regression Discontinuity Study on French Data," Annals of Economics and Statistics, GENES, issue 117-118, pages 253-276.
    5. Stancanelli, Elena G. F., 2012. "Spouses' Retirement and Hours Outcomes: Evidence from Twofold Regression Discontinuity with Differences-in-Differences," IZA Discussion Papers 6791, Institute of Labor Economics (IZA).
    6. Gaggero, A. & Gil, J. & Jiménez-Rubio, D. & Zucchelli, E., 2021. "Health information and lifestyle behaviours: the impact of a diabetes diagnosis," Health, Econometrics and Data Group (HEDG) Working Papers 21/02, HEDG, c/o Department of Economics, University of York.
    7. Frandsen, Brigham R. & Frölich, Markus & Melly, Blaise, 2012. "Quantile treatment effects in the regression discontinuity design," Journal of Econometrics, Elsevier, vol. 168(2), pages 382-395.
    8. Andrew E. Clark & Elena Stancanelli, 2016. "Individual Well-Being and the Allocation of Time Before and After the Boston Marathon Terrorist Bombing," PSE Working Papers hal-01302843, HAL.
    9. Luciana Juvenal & Paulo Santos Monteiro, 2024. "Risky Gravity," Journal of the European Economic Association, European Economic Association, vol. 22(4), pages 1590-1627.
    10. Elena Stancanelli & Arthur van Soest, 2012. "Joint Leisure Before and After Retirement : a double Regression Discontinuity Approach," Université Paris1 Panthéon-Sorbonne (Post-Print and Working Papers) halshs-00768901, HAL.
    11. Guido W. Imbens & Jeffrey M. Wooldridge, 2009. "Recent Developments in the Econometrics of Program Evaluation," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 5-86, March.
    12. Ou, Dongshu, 2010. "To leave or not to leave? A regression discontinuity analysis of the impact of failing the high school exit exam," Economics of Education Review, Elsevier, vol. 29(2), pages 171-186, April.
    13. Andrew Gelman & Guido Imbens, 2019. "Why High-Order Polynomials Should Not Be Used in Regression Discontinuity Designs," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(3), pages 447-456, July.
    14. Dehejia Rajeev, 2015. "Experimental and Non-Experimental Methods in Development Economics: A Porous Dialectic," Journal of Globalization and Development, De Gruyter, vol. 6(1), pages 47-69, June.
    15. Benjamin Schünemann & Michael Lechner & Conny Wunsch, 2015. "Do Long-Term Unemployed Workers Benefit from Targeted Wage Subsidies?," German Economic Review, Verein für Socialpolitik, vol. 16(1), pages 43-64, February.
    16. Laura Hospido & Gema Zamarro, 2014. "Retirement patterns of couples in Europe," IZA Journal of European Labor Studies, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 3(1), pages 1-18, December.
    17. Jeffrey Smith & Arthur Sweetman, 2016. "Viewpoint: Estimating the causal effects of policies and programs," Canadian Journal of Economics, Canadian Economics Association, vol. 49(3), pages 871-905, August.
    18. Stefano Gagliarducci & M. Daniele Paserman, 2012. "Gender Interactions within Hierarchies: Evidence from the Political Arena," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 79(3), pages 1021-1052.
    19. Dhaval Dave & Robert Kaestner, 2009. "Health insurance and ex ante moral hazard: evidence from Medicare," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 367-390, December.
    20. Entorf, Horst, 2012. "Expected recidivism among young offenders: Comparing specific deterrence under juvenile and adult criminal law," European Journal of Political Economy, Elsevier, vol. 28(4), pages 414-429.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:nbr:nberwo:22523. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    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.