New Evidence from California
Open Access DepositedEffects of a Vaccine Mandate on Health and School Outcomes
This dissertation evaluates the impact of California’s 2016 vaccine mandate, Senate Bill 277 (SB277), which eliminated non-medical exemptions for school-entry immunization requirements. Specifically, it empirically assesses the mandate’s effects on health and school outcomes, using a unique dataset of county-level vaccination rates and incidence data on vaccine-preventable diseases (VPDs), as well as a school-level dataset on chronic absenteeism. The dissertation follows a three-essay format. The first essay examines trends in pertussis and measles cases of California before and after the mandate, along with associations with immunization coverage rates. It also provides detailed documentation on the immunization coverage and VPD prevalence by each California county. The second essay applies a difference-in-differences (DiD) approach and a synthetic control methodology to causally estimate the mandate’s impact on vaccination coverage and the prevalence of two VPDs
measles and pertussis. The third essay analyzes school-level chronic absenteeism rates resulting from the mandate’s implementation, using a DiD design. The findings reveal an improvement in immunization coverage, a reduction in disease burden, and a decline in chronic absenteeism associated with the implementation of the 2016 California vaccine mandate. Together, these results suggest that repealing non-medical exemptions for school-entry vaccination is an effective policy tool to mitigate public health risks and reduce chronic school absenteeism.
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