ArticleThe quarterly journal of economics2024
Social Signaling and Childhood Immunization: A Field Experiment in Sierra Leone.
Article in The quarterly journal of economics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Impact of community masking on COVID-19: A cluster-randomized trial in Bangladesh.Science (New York, N.Y.) · 2022Trial
- Effect of vaccine reminder and tracker bracelets on routine childhood immunization coverage and timeliness in urban Pakistan (2017-18): a randomized controlled trial.BMC public health · 2020Trial
- Eliciting health beliefs: Difficulties and solutions.PloS one · 2026Article
- Incentives in immunisation campaigns in low- and middle-income countries: a scoping review mapping evidence on effectiveness and unintended consequences.BMJ global health · 2025Article
- Trends and inequalities in full immunization coverage among two-year-olds in Sierra Leone, 2008-2019.PloS one · 2025Article
- "Don't you plan on voting?" The motives and effects of peer pressure in voter mobilization.Quarterly journal of political science · 2025Article
- Healthcare Appointments as Commitment Devices.Economic journal (London, England) · 2025Article
- Social Signaling and Childhood Immunization: A Field Experiment in Sierra Leone.The quarterly journal of economics · 2024Article
- Evaluation of a national program to distribute free face masks in Uganda: Evidence from Mbale District.PloS one · 2024Article
- Worth Your Weight: Experimental Evidence on the Benefits of Obesity in Low-Income Countries.The American economic review · 2023Article
- Social and financial incentives for overcoming a collective action problem.Journal of development economics · 2023Article
- Improving the timeliness and completeness of childhood vaccination through color-coded bracelets: a pilot study among Fulani tribe populations in Nigeria.Journal of public health in Africa · 2023Article
- Article
- Sociocultural determinants of global mask-wearing behavior.Proceedings of the National Academy of Sciences of the United States of America · 2022Article
- Behavioral Economics in the Epidemiology of the COVID-19 Pandemic: Theory and Simulations.International journal of environmental research and public health · 2022Article
- COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries.Nature medicine · 2021Article
- Messages that increase COVID-19 vaccine acceptance: Evidence from online experiments in six Latin American countries.PloS one · 2021Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article explores the use of social signaling as a policy tool to sustainably affect childhood immunization. In a 26-month field experiment with public clinics in Sierra Leone, I introduce a verifiable signal-in the form of color-coded bracelets-given to children upon timely completion of the first four or all five required vaccinations. Signals increase parents' belief in the visibility of their actions and knowledge of other children's vaccine status. The impact of signals varies significantly with the cost and perceived benefits of the action. There are no discernible effects on timely and complete immunization when the signal is linked to an easier-to-complete vaccine with low perceived benefits, and large positive effects when the signal is linked to a costlier-to-achieve vaccine with high perceived benefits. Parents adjust their behavior nine months before realizing the social image benefit, demonstrating the motivational strength of signaling incentives. Of substantive policy importance, bracelets increase full immunization at one year of age by 9 percentage points, with impacts persisting at two years of age. At a marginal cost of US$24.7 per fully immunized child, social signals can be as cost-effective as financial or in-kind incentives.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.