Providing free influenza vaccine to increase vaccination take-up and improve physical and mental health: evidence from China

Abstract

Introduction Compared to developed countries, influenza vaccines have lower popularity in developing countries and are generally not given much attention. This paper analyzes the effect of China's policy of providing free influenza vaccine for the population aged 60 and above on vaccination take-up and health outcomes. Methods Using nationwide survey data and combining differences across registered residence with differences across age cohorts included by the program. The identification strategy of difference-in-difference estimated the impact of free influenza vaccination policy on vaccination take-up, physical health, and mental health, and explore its impact mechanism. Results This policy can increase the influenza vaccination take-up among the older population by 23% points, and yields significant improvements in both physical and mental health. Crucially, due to the time interval between vaccination and investigation, these health benefits are not driven by the vaccine's direct biological protection, but rather arise through indirect behavioral and belief pathways. Specifically, the policy reduces the probability of reporting that health limits daily activities by 16.9% points, and increases the likelihood of feeling energetic by 28.1% points. Discussion The findings of this article provide experience for promoting influenza vaccine in developing countries and discover the indirect physical and mental health improvements that influenza vaccination may bring.