We evaluate the impact of government-mandated proof of vaccination requirements for access to public venues and non-essential businesses on COVID-19 vaccine uptake. We find that the announcement of a mandate is associated with a rapid and significant surge in new vaccinations (a more than 60% increase in weekly first doses), using the variation in the timing of these measures across Canadian provinces in a difference-in-differences approach. Time-series analysis for each province and for France, Italy and Germany corroborates this finding. Counterfactual simulations using our estimates suggest the following cumulative gains in the vaccination rate among the eligible population (age 12 and over) as of 31 October 2021: up to 5 percentage points (p.p.) (90% confidence interval, 3.9-5.8) for Canadian provinces, adding up to 979,000 (425,000-1,266,000) first doses in total for Canada (5 to 13 weeks after the provincial mandate announcements); 8 p.p. (4.3-11) for France (16 weeks post-announcement); 12 p.p. (5-15) for Italy (14 weeks post-announcement) and 4.7 p.p. (4.1-5.1) for Germany (11 weeks post-announcement). 

/pdf/covid-19-vaccination-mandates-and-vaccine-uptake-36sfq3ra.pdf

COVID-19 vaccination mandates and vaccine uptake

We estimate the impact of government-mandated proof of vaccination requirements for access to public venues and non-essential businesses on COVID-19 vaccine uptake. We use event-study and difference-in-differences approaches exploiting the variation in the timing of these measures across Canadian provinces. We find that the announcement of a vaccination mandate is associated with large increase in new first-dose vaccinations in the first week (more than 50% on average) and the second week (more than 100%) immediately following the announcement. The estimated effect starts waning about six weeks past the announcement. Counterfactual simulations using our estimates suggest that these mandates have led to about 289,000 additional first-dose vaccinations in Canada as of September 30, 2021, which is 1 to 8 weeks after the policy announcements across the different provinces. Time-series analysis corroborates our results for Canada, and we further estimate that national vaccine mandates in three European countries also led to large gains in first-dose vaccinations (7+ mln in France, 4+ mln in Italy and 1+ mln in Germany, 7 to 12 weeks after the policy announcements). NOTE: The reported numbers may change with more data. Please see updated version when available. Note on data availabilityThe proof of vaccination mandates that we analyze in this paper are recent policies, as several Canadian provinces announced the mandates not long before the current sample end date September 30, 2021. As more data become available and we include them in our analysis, our estimate of the average effect of a mandate announcement on vaccine uptake may change. For example, to the extent that the large increase in first dose vaccinations we observe may include intertemporal substitution (people receiving the vaccine sooner than otherwise intended), the estimated net gain in vaccinations (people who otherwise would not have become immunized), relative to the no-mandate counterfactual, could be overstated. On the other hand, we expect our estimates for the initial increase in first doses (the first two weeks after the announcement) not to be affected much by the additional data. Lastly, many of the announced mandates are coming into force at the time of writing, which could provide an additional increase in vaccinations that we intend to analyze.

https://medrxiv.org/content/10.1101/2021.10.21.21265355v1.full.pdf

COVID-19 Vaccination Mandates and Vaccine Uptake

In 2021, the Biden Administration issued mandates requiring COVID-19 vaccinations for U.S. federal employees and contractors and for some healthcare and private sector workers. These mandates have been challenged in court; some have been halted or delayed. However, their costs and benefits have not been rigorously appraised. This study helps fill that gap. We estimate the direct costs and health-related benefits that would have accrued if these vaccination requirements had been implemented as intended. Compared with the January 2022 vaccination rates, we find that the mandates could have led to 15 million additional vaccinated individuals, increasing the overall proportion of the fully vaccinated U.S. population from 64% to 68%. The associated net benefits depend on the subsequent evolution of the pandemic-information unavailable ex ante to analysts or policymakers. In scenarios involving the emergence of a novel, more transmissible variant, against which vaccination and previous infection offer moderate protection, the estimated net benefits are potentially large. They reach almost $20,000 per additional vaccinated individual, with more than 20,000 total deaths averted over the 6-month period assessed. In scenarios involving a fading pandemic, existing vaccination-acquired or infection-acquired immunity provides sufficient protection, and the mandates' benefits are unlikely to exceed their costs. Thus, mandates may be most useful when the consequences of inaction are catastrophic. However, we do not compare the effects of mandates with alternative policies for increasing vaccination rates or for promoting other protective measures, which may receive stronger public support and be less likely to be overturned by litigation. 

/pdf/the-benefits-and-costs-of-u-s-employer-covid-19-vaccine-25ttntdf.pdf

The benefits and costs of U.S. employer COVID‐19 vaccine mandates

Here we investigate public preferences for coronavirus disease 2019 (COVID-19) certificates in the Netherlands, and whether these preferences differ between subgroups in the population.A survey including a discrete choice experiment was administered to 1500 members of the adult population of the Netherlands. Each participant was asked to choose between hypothetical COVID-19 certificates that differed in seven attributes: the starting date, and whether the certificate allowed gathering with multiple people, shopping without appointment, visiting bars and restaurants, visiting cinemas and theatres, attending events, and practising indoor sports. Latent class models (LCMs) were used to determine the attribute relative importance and predicted acceptance rate of hypothetical certificates.Three classes of preference patterns were identified in the LCM. One class a priori opposed a certificate (only two attributes influencing preferences), another class was relatively neutral and included all attributes in their decision making, and the final class was positive towards a certificate. Respondents aged > 65 years and those who plan to get vaccinated were more likely to belong to the latter two classes. Being allowed to shop without appointment and to visit bars and restaurants was most important to all respondents, increasing predicted acceptance rate by 12 percentage points.Preferences for introduction of a COVID-19 certificate are mixed. A certificate that allows for shopping without appointment and visiting bars and restaurants is likely to increase acceptance. The support of younger citizens and those who plan to get vaccinated seems most sensitive to the specific freedoms granted by a COVID-19 certificate. 

/pdf/public-preferences-for-introducing-a-covid-19-certificate-a-1gw17ice.pdf

Public Preferences for Introducing a COVID-19 Certificate: A Discrete Choice Experiment in the Netherlands

Recent studies have been analyzing and measuring the efficacy of the use of financial incentives to increase the Covid-19 vaccine uptake. To the best of our knowledge, this paper is the only study available in the literature that aims to measure the effect of financial incentives on vaccine rates among children. This paper explores the effects of a specific financial incentive on parents’ vaccination decisions for their children. Using data from a regional practice, where students aged 12 and older received $50 gift cards per Covid-19 vaccination dose, we use various methodologies (synthetic control, linear regression, and difference-in-differences) to approximate the effects of financial incentives on vaccine rates. Our analysis reveals that gift cards increase vaccination rates by 2.64–4.23 percentage points from a baseline rate of 38 percent, concluding that financial incentives, in conjunction with other incentives and policies, can be considered to increase the rate of vaccines for 12- to 17-year-olds. 

/pdf/children-vaccines-and-financial-incentives-1cdyk5r0.pdf

Children, vaccines, and financial incentives


 In the COVID-19 pandemic, governments have used various interventions,1,2 including COVID certificates as proof of vaccination, recovery, or a recent negative test, required for individuals to access shops, restaurants, and education or workplaces.3 While arguments for and against COVID certificates have focused on reducing transmission and ethical concerns,4,5 the effect of the certificates on vaccine uptake, public health, and the economy requires investigation. We construct counterfactuals based on innovation diffusion theory6 and validate them with econometric methods7 to evaluate the impact of incentives created by COVID certificates in France, Germany, and Italy. We estimate that from their announcement during summer 2021 to the end of the year, the intervention led to increased vaccine uptake in France of 13.0 (95% CI 9.7–14.9) percentage points (p.p.) of the total population, in Germany 6.2 (2.6–6.9) p.p., and in Italy 9.7 (5.4–12.3) p.p.; averted an additional 3,979 (3,453–4,298) deaths in France (i.e., 31.7%), 1,133 (-312–1,358) in Germany (5.6%), and 1,331 (502–1,794) in Italy (14.0%); and prevented gross domestic product (GDP) losses of €6.0 (5.9–6.1) billion in France, €1.4 (1.3–1.5) billion in Germany, and €2.1 (2.0–2.2) billion in Italy. Notably, the application of COVID certificates substantially reduced the pressure on intensive care units (ICUs) and, in France, averted surpassing the occupancy levels where prior lockdowns were instated. Overall, our findings are more substantial than predicted8 and may help to inform decisions about when and how to employ COVID certificates to increase vaccination and thus avoid stringent interventions, such as closures, curfews, and lockdowns, with large social and economic consequences.

The effect of COVID certificates on vaccine uptake, public health, and the economy

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The effect of COVID certificates on vaccine uptake, public health, and the economy