In Vaccines we Trust? The Effects of Anti-vaccine Propaganda on Immunization: Evidence from Pakistan∗

In July 2011, the Pakistani public unexpectedly learnt that the CIA had conducted a fake vaccination campaign as part of the operations to capture Osama Bin Laden. This episode was extensively used by Taliban groups to discredit the health system and vaccination campaigns. We implement a Difference-in-Differences strategy to document the effect of the disclosure of this information on demand for health services. We use survey data to compare vaccination rates before and after the disclosure of this information, across regions with different levels of electoral support for Islamist groups. Our results suggest that the disclosure of information on the fake vaccination campaign had a substantial negative effect on immunization rates: a one standard deviation increase in support for Islamist groups lead to a 9 to 13% decline in immunization rates over the sample mean. Our results are consistent with the hypothesis that the disclosure of the vaccination ruse eroded the degree of trust in medical services, and consequently, lead parents to actively refuse the use of formal medicine and vaccines, in particular. ∗We would like to thank Manuel Arellano, Diego Puga, Nancy Qian, Pascaline Dupas, Nathan Nunn, Guillermo Caruana, Jishnu Das, Michael Callen, and, Pamela Campa for valuable suggestions. We also thank seminar participants at NEUDC2016, CEMFI PhD workshop, Oxford University, Political Economy of Development Workshop at Warwick University. The present draft is a revised version of the Master’s Thesis presented by Andreas Stegmann in partial fulfillment of the 2013-2015 Master in Economics and Finance at CEMFI. Monica gratefully acknowledges financial support from Ramón y Cajal Grant (RYC-2013-14307). Monica Martinez-Bravo; email: [email protected]. Andreas Stegmann; email: [email protected].