Sibling spillovers and the choice to get vaccinated: Evidence from a regression discontinuity design

We investigate the effects of introducing population-wide free-of-charge Human Papillomavirus (HPV) vaccination programs on the targeted adolescent cohorts and their siblings. For identification, we rely on regression discontinuity designs and high-quality Danish administrative data to exploit that date of birth determines program eligibility. We find that the programs increased the HPV vaccine take-up of both the targeted children (53.2 percentage points for girls and 36.0 percentage points for boys) and their older same-sex siblings (4.5 percentage points for sisters and 3.5 percentage points for brothers). We show that while the direct effects of the programs reduced HPV vaccine take-up inequality, the spillover effects, in contrast, contributed to an increase in vaccine take-up inequality highlighting the potential importance of spillover effects in the determination of distributional consequences of public health programs. Finally, we find some evidence of cross-vaccine spillovers.

How first-language instruction transfers to majority-language skills

With an increasing number of immigrant children in many countries, questions of how to prepare them for further education become highly salient. Few studies have examined the effect of first-language instruction on children's engagement in school and how that may later transfer into better majority-language outcomes. A randomized controlled trial in Denmark (n = 230) took an asset-based approach to students' cultural and linguistic backgrounds. We found that first-language instruction of majority-language learners (average age 7.1 years) reduced their behavioural problems in school and increased their school satisfaction and their parents' engagement. We saw no immediate effect on their spoken first-language skills, but one year after the intervention ended, their reading skills in the majority language were substantially improved. Half of this improvement could be explained by reduced behavioural problems. The results thereby indicate that an asset-based approach to students' linguistic and cultural backgrounds can help to ensure that first-language instruction transfers into majority-language skills.

Vaccine Hesitancy and Differential Susceptibility to Media Coverage: A Critical Documentary Led to Substantial Reductions in Human Papillomavirus Vaccine Uptake in Denmark

OBJECTIVES

To investigate whether negative media coverage of the human papillomavirus (HPV) vaccine led to a decrease in the uptake of the first dose of the HPV vaccine (HPV1) in Denmark and, importantly, whether some groups of individuals were more susceptible to negative media coverage.

METHODS

We measured HPV vaccine uptake of 12-year-old girls born in 2001 to 2004 using Danish administrative data. A quasi-experimental design was employed to assess whether a documentary that was critical of the HPV vaccine and aired in March 2015 affected HPV uptake.

RESULTS

The documentary led to a quick and substantial decrease in the monthly propensity to vaccinate, which dropped 3 percentage points-or about 50%-in response to the documentary. Responses differed substantially across subgroups, and girls from families with high socioeconomic status (SES) were more susceptible to the negative media coverage.

CONCLUSIONS

Susceptibility to negative media coverage varied substantially across subgroups, highlighting the need for policy makers to appropriately target and differentiate initiatives to improve vaccine compliance rates.

Common Danish standards in prescribing medication for children and adolescents with ADHD

Assessing whether symptoms of attention-deficit hyperactivity disorder (ADHD) in children are age-inappropriate is essential. Hence, comparing children within one school grade is problematic and the risk of applying relative standards is inherent. Being young-for-grade increases the likelihood of receiving medication in countries with high prevalence of ADHD medication. We test the same hypothesis in a cohort of 418,396 children and find no difference between children who are young-for-grade and old-for-grade. The Danish system, with its restrictive approach to medication and clear diagnostic guidelines seems to have avoided a systematic bias of ADHD medication in young children reported in other countries.