Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/339337 
Year of Publication: 
2026
Series/Report no.: 
Working Paper No. 153
Publisher: 
Università Cattolica del Sacro Cuore, Dipartimento di Economia e Finanza (DISCE), Milano
Abstract: 
Vaccine hesitancy is a crucial public health issue worldwide. In this paper, we evaluate the causal impact of a vaccination-based access restriction policy on vaccine uptake by exploiting the introduction of the EU Digital COVID-19 Certificate at the country level. We compare two countries, Italy and Spain, which-despite using the Certificate as a prerequisite for many daily activities-experienced different adoption patterns. In Spain, the Certificate was introduced regionally, temporarily suspended by the Courts, and later reintroduced in several regions. In Italy, it was introduced in June 2021 and progressively expanded, culminating in mandatory vaccination for individuals aged over 50. We test the impact of the Certificate on vaccination rates using a Sharp Regression Kink Design, identifying changes in the slope of vaccination rates around the announcements by the two governments relative to the introduction of the Certificate. We find that the digital COVID-19 Certificate increased vaccinations in Italy in a range spanning from 3 to 11 percent. In Spain, by contrast, only the reintroduction seems to have been able to affect vaccinations. This result for Spain is also supported by a Difference-in-Differences model, exploiting the staggered reintroduction of the Certificate at the regional level.
Subjects: 
vaccine hesitancy
Digital COVID-19 Certificate
Sharp Regression Kink Design
JEL: 
I12
I18
Document Type: 
Working Paper

Files in This Item:
File
Size





Items in EconStor are protected by copyright, with all rights reserved, unless otherwise indicated.