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Democracy and vaccination uptake - a complex friendship
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Government.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Democracies are generally thought to be better able to handle the provision of public goods than non-democracies. However, vaccines are a type of public good where we might expect this dynamic not to apply. Generally, a high vaccination uptake is net-profitable for the state above a certain level of national wealth, given losses of tax income to disease and health care expenditures. At the same time, democracies may be suspected to be less likely to use coercive means to achieve the goal of high uptake. This leads to the hypothesis that at least among rich countries, democracies may fare worse in terms of vaccination uptake.

In this paper, I test this proposal using a cross-country panel of WHO uptake data. I test both traditional panel models, as well as an IV-approach using regional democratization waves as an instrument for own-country democracy. With both approaches, the theoretical prediction appears to hold up: rich non-democracies do indeed achieve higher uptake than rich democracies.

National Category
Political Science
Identifiers
URN: urn:nbn:se:uu:diva-311017OAI: oai:DiVA.org:uu-311017DiVA: diva2:1058390
Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2016-12-20
In thesis
1. Essays on the collective action dilemma of vaccination
Open this publication in new window or tab >>Essays on the collective action dilemma of vaccination
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Vaccines famously possess positive externalities that make them susceptible to the collective action dilemma: when I get vaccinated, I protect not only myself, but also those who I might otherwise have infected. Thus, some people will have an incentive to free ride on the immunity of others. In a population of rational agents, the critical level of vaccination uptake required for herd immunity will therefore be difficult to attain in the long run, which poses difficulties for disease eradication.

In this doctoral dissertation, I explore different implications of the collective action dilemma of vaccination, and different ways of ameliorating it. First: given that coercion or force could solve the dilemma, and democracies may be less likely to engage in policies that violate the physical integrity of citizens, democracies may also be at a disadvantage compared to non-democracies when securing herd immunity. In essay I, I show that this is, empirically, indeed the case. Barring the use of extensive coercion therefore necessitates other solutions.

In essay II, I highlight the exception to individual rationality found in other-regarding motivations such as altruism. Our moral psychology has likely evolved to take other's welfare into account, but the extent of our prosocial motivations vary: a wider form of altruism that encompasses not just family or friends, but strangers, is likely to give way to a more narrow form when humans pair-bond and have children. This dynamic is shown to apply to the sentiments underlying vaccination behavior as well: appeals to the welfare of society of getting vaccinated have positive effects on vaccination propensity, but this effect disappears in people with families and children. On this demographic, appeals to the welfare of close loved ones instead appears to have large effects.

In essay III, I investigate whether the prosocial motivations underlying vaccination behavior are liable to be affected by motivation crowding - that is, whether they are crowded out when introducing economic incentives to get vaccinated. I find that on average, economic incentives do not have adverse effects, but for a small minority of highly prosocially motivated people, they might.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 47 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 134
Keyword
vaccines, collective action, democracy, rationality, altruism
National Category
Political Science
Research subject
Political Science
Identifiers
urn:nbn:se:uu:diva-311020 (URN)978-91-554-9785-9 (ISBN)
Public defence
2017-03-24, Brusewitz-salen, Statsvetenskapliga institutionen, Gamla Torget 2, Uppsala, 13:15 (English)
Opponent
Supervisors
Available from: 2017-01-31 Created: 2016-12-20 Last updated: 2017-02-01

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