Giving Teens a Boost?

This study provides the first quasi-experimental evidence on the effects of nonbinding vaccine recommendations targeted at high school–aged adolescents. Using data from the National Immunization Survey–Teen and the Centers for Disease Control’s disease surveillance system, I find that these simple recommendations significantly increased meningococcal vaccination rates among the targeted population by 21 percentage points, or 133 percent relative to the baseline mean, and substantially reduced meningococcal disease incidence in the population. I also provide evidence that the recommendations primarily affected vaccination rates through changes in provider behavior, and show that they exacerbated preexisting disparities in receipt of preventive care. In particular, groups with lower socioeconomic status, which had lower rates of vaccination and provider contact prior to the recommendation, were also less responsive to the policy.