Year of Award


Document Type


Degree Type

Master of Arts (MA)

Degree Name


Department or School/College


Committee Chair

Katrina Mullan, Ph.D.

Commitee Members

Katrina Mullan, Amanda Dawsey, Sophia Newcomer


immunization, adolescent, pharmacy, preventive care, vaccination


University of Montana

Subject Categories

Economics | Health Economics


Pharmacy-based immunization (PBI) has been heralded as a barrier-reducing way to immunize Americans and reach public health targets. PBI programs vary by state; some states prohibit vaccinating children in pharmacies while others allow pharmacists to prescribe and immunize persons of any age. There is concern that liberal PBI programs may boost vaccination rates at the cost of well-child visits. Parents may see PBI as an alternative to preventive well-check visits at a doctor’s office rather than as a complement, particularly for adolescents. This paper estimates the effect of state vaccination policies on individual adolescent 11–12-year-old well-checks using probit regression for a binary outcome indicating well-check with fixed-effects for age and state. Estimates from the preferred model indicate moderately strong evidence that PBI decreases the probability an adolescent in a state with PBI receives her well-check by 4.5 percentage points compared to a child in a state without PBI. Secondary analysis indicates PBI does not increase the probability an adolescent received her Tdap or meningococcal vaccinations on time. These findings suggest PBI distances adolescents from the doctor and does not increase immunization timeliness.



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