The Vaccination Kuznets Curve: Do vaccination rates rise and fall with income?

Abstract

This paper presents a new stylized fact about the relationship between income and childhood vaccination. It shows vaccination rates first rise but then fall as income increases. This pattern is observed in WHO country-level panel data, and in US county-level panel and individual-level repeated cross-section data. This data pattern suggests that both low and high-income parents are less likely to follow the standard vaccination schedule, and that such behavior is reflected in the vaccination rate at the population level. I provide several alternative explanations as to why we observe this data pattern, including avoidance measures, medical care, and social segregation.

Keywords: Avoidance; Childhood vaccination; Immunization; Income; Infectious disease; Medical care; NIS.