The Determinants of Early Childhood Immunization

Each year 2.1 million children in the United States 19 to 35 months of age have not received the fully recommended schedule of vaccinations. Most under-vaccinated children come from poor, minority, and single-mother households; however, a growing number of affluent parents are deciding not to vaccinate their children. The drop in immunization rates in the United States has contributed to the widespread reemergence of a number of vaccine-preventable diseases and has left the country vulnerable to outbreaks of other serious diseases. While the correlates of immunizations have been well studied in the public health literature, none of these studies have established a causal link. The goal of this project is to study the determinants of early childhood immunization in the United States. Specifically, we assess the causal effects of economic shocks and disease outbreaks on vaccination rates and explore how these relationships differ by race and socioeconomic status. Understanding the determinants of childhood vaccination will allow for the development of directed policies to improve vaccination rates among populations most at-risk.