Economic experiments have shown that free riding behavior in vaccination decisions was indifferent to changes in the risk and severity of the disease being targeted by the vaccine ( Ibuka, Li, Vietri, Chapman, & Galvani, 2014). This change in intention despite self-reported motivations unrelated to local vaccination rates is consistent with free riding.įree riding as a theory explaining vaccination uptake has been very broadly applied to both new and established vaccines. Researchers have documented that among church members reporting religious, safety or philosophical objections to vaccination, vaccine hesitancy and intention improved following a local outbreak of Measles ( Kennedy, 2008). For example, parents may state that they refuse vaccination because of religious or personal belief but if we observe that these refusals are more likely to be sought when disease risk is low, then economists would posit that this is evidence for free riding. Rather, the theory posits that a variety of motivations/intentions may be explained by free riding simply because externalities associated with high local vaccinations rates inhibit the incentives for individuals to vaccinate-regardless of whether individuals are conscious of the influence caused by the externalities. Results inform whether the broad assumption of free riding as a significant behavioral influence applies to HPV vaccination uptake.įree riding theory is agnostic to the underlying parental intentions and motivations for vaccination decisions. We undertake one of the first empirical studies examining evidence for or against free riding behavior in HPV vaccination uptake. Free riding may occur simply because vaccination reduces feedback that would otherwise signal risks incentivizing individuals to become vaccinated. Further, awareness of the local rate and its impact on risk, is not a necessary condition for free riding to occur ( Cornes & Sandler, 1996). For vaccinations, the free rider problem arises when increasing local vaccination rates reduce disease risk and, if unvaccinated individuals are aware of the local vaccination rate, then they may have less incentive to decide to vaccinate ( Boulier et al., 2007). The free-rider problem is key to economic theories explaining public good provision. once Maria has been vaccinated, she cannot exclude others from benefitting from her decision) to all community members. the benefits from Maria having been vaccinated do not deplete as additional people come in contact with Maria, also benefitting from her vaccination) and non-exclusive benefits (i.e. Vaccinations are considered a public good because they provide non-rival benefits (i.e. The current prevailing theory for understanding spatial patterns of vaccination comes from economics and focuses on the role of local vaccination rates. In contrast, economists have focused on the role of community-level vaccination rates ( Boulier, Datta, & Goldfarb, 2007 Geoffard & Philipson, 1997), but have typically overlooked the role of individual beliefs and social influences. However, these theories typically do not consider the role of community-level vaccination rates in changing individuals' incentives to become vaccinated. Health behavior researchers have proposed theories that focused on individual's intention, beliefs and motivations (e.g., Brewer & Fazekas, 2007). The potential importance of spatial patterns in vaccination uptake in understanding how policy might influence vaccination rates for non-mandatory vaccines, such as the human papillomavirus (HPV) vaccine, are largely unaddressed by prevailing theories of vaccine uptake.īecause vaccination is important both at individual and community levels, there have been many efforts to understand an individual's vaccination decisions and the resulting population-level patterns of vaccination. For example, geographic clustering of individuals refusing to vaccinate despite governmental mandates has been linked to outbreaks of measles, a disease once considered eradicated in developed countries ( Ferris, 1/28/15). Due to the method of transmitting communicable diseases, gains from effective vaccination programs are inherently geographic in nature and are not necessarily distributed evenly across space.
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