Dynamic Impact of the Ebola Epidemic on Childhood Immunization

This paper shows that, contrary to prior literature, the Ebola epidemic can increase childhood immunization rates. I construct a conceptual model in which shocks to health awareness, such as an epidemic, increase direct benefits, social signaling benefits, and also costs of obtaining vaccination. This implies that in countries with close to zero additional costs of immunization due to the epidemic, demand for childhood immunization should increase in periods following the epidemic. I test this hypothesis through a triple difference-in-difference method and find that the treatment effect of the Ebola epidemic on childhood immunization is positive and statistically significant in Mali and Nigeria. A positive treatment effect implies that the Ebola epidemic resulted in an increase in the difference of differences in trends across urban and rural areas in between Ebola outbreak and non-outbreak regions. The estimated treatment effects amount to approximately 7-24% points depending on vaccination and country. Such results are robust to using cluster wild bootstrap procedures and dropping survey year cohorts. I also find suggestive evidence that the treatment effects are long lasting.