Parental risk preferences and children's vaccination coverage.

This paper examines vaccine hesitancy from a behavioral economics perspective, focusing on how parental risk preferences, altruism, and vaccine distrust affect children's vaccination rates. A model of parental investment in children's health is developed and expanded using empirical data from WHO, UNICEF, the World Bank, and the Global Preferences Survey. The study utilizes a fractional response probit model to analyze data from 69 countries, accounting for both stringent and non-stringent vaccination policies. Results show that risk aversion, altruism, and trust are positively associated with vaccination coverage, with the impact varying by policy stringency. In countries with stringent policies, risk aversion is the most significant factor, while altruism and distrust are more influential in countries with less strict policies. However, the effects of these factors are modest, with income levels accounting for most cross-country differences. The study calls for further research using more recent, individual-level data. Highlights We develop a theoretical framework suggesting that parents with higher risk aversion and altruism are more likely to invest in their children's health, particularly in vaccination decisions, extending current literature insights. Our model is empirically tested using macro-level data on parental risk preferences and altruism from the Global Preferences Survey (GPS), combined with WHO and UNICEF vaccination coverage data for ten diseases in one-year-old children. The analysis reveals a positive association between parental risk aversion, altruism, and vaccination coverage across 69 countries, moderated by the stringency of national vaccination policies. In countries with stringent vaccination policies, risk aversion predominantly drives vaccination coverage, whereas in less stringent environments, altruism and vaccine distrust play a more significant role. Vaccination coverage is notably lower in low-income countries.