{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:07:42Z","timestamp":1788934062409,"version":"build-2803163510"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1883613","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:59:53Z","timestamp":1788933593000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Providing free influenza vaccine to increase vaccination take-up and improve physical and mental health: evidence from China"],"prefix":"10.3389","volume":"14","author":[{"given":"Yan","family":"Wang","sequence":"first","affiliation":[{"name":"School of Agricultural Economics and Rural Development, Renmin University of China","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1093\/qje\/qjw005","article-title":"Economic activity and the spread of viral diseases: evidence from high frequency data","volume":"131","author":"Adda","year":"2016","journal-title":"Q J Econ."},{"key":"B2","doi-asserted-by":"publisher","first-page":"3942","DOI":"10.1038\/s41467-022-31394-1","article-title":"The effect of COVID certificates on vaccine uptake, health outcomes, and the economy","volume":"13","author":"Oliu-Barton","year":"2022","journal-title":"Nat Commun."},{"key":"B3","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/S0140-6736(20)32657-X","article-title":"Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030: a modelling study","volume":"397","author":"Li","year":"2021","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2101021","DOI":"10.2807\/1560-7917.ES.2021.26.47.2101021","article-title":"Estimated number of deaths directly averted in people 60 years and older as a result of COVID-19 vaccination in the WHO European region, December 2020 to November 2021","volume":"26","author":"Mesl\u00e9","year":"2021","journal-title":"Eurosurveillance"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1285","DOI":"10.1016\/S0140-6736(17)33293-2","article-title":"Estimates of global seasonal influenza-associated respiratory mortality: a modelling study","volume":"391","author":"Iuliano","year":"2018","journal-title":"Lancet"},{"key":"B6","doi-asserted-by":"publisher","first-page":"126274","DOI":"10.1016\/j.vaccine.2024.126274","article-title":"Seasonal influenza vaccination: a global review of national policies in 194 WHO member states in 2022","volume":"42","author":"Goldin","year":"2024","journal-title":"Vaccine"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e2208110120","DOI":"10.1073\/pnas.2208110120","article-title":"Digital public health interventions at scale: the impact of social media advertising on beliefs and outcomes related to COVID vaccines","volume":"120","author":"Athey","year":"2023","journal-title":"Proc Natl Acad Sci."},{"key":"B8","doi-asserted-by":"publisher","first-page":"102832","DOI":"10.1016\/j.jhealeco.2023.102832","article-title":"Reminder design and childhood vaccination coverage","volume":"93","author":"Hirani","year":"2024","journal-title":"J Health Econ."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e2115126119","DOI":"10.1073\/pnas.2115126119","article-title":"A 680,000-person megastudy of nudges to encourage vaccination in pharmacies","volume":"119","author":"Milkman","year":"2022","journal-title":"Proc Natl Acad Sci."},{"key":"B10","doi-asserted-by":"publisher","first-page":"102899","DOI":"10.1016\/j.jhealeco.2024.102899","article-title":"Persistence and heterogeneity of the effects of educating mothers to improve child immunisation uptake: experimental evidence from Uttar Pradesh in India","volume":"96","author":"O'Neill","year":"2024","journal-title":"J Health Econ."},{"key":"B11","doi-asserted-by":"publisher","first-page":"104463","DOI":"10.1016\/j.euroecorev.2023.104463","article-title":"When reality bites: local deaths and vaccine take-up","volume":"156","author":"Giulietti","year":"2023","journal-title":"Eur Econ Rev."},{"key":"B12","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jhealeco.2017.10.003","article-title":"Does disease cause vaccination? 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