Principal Investigator: Dr Ioannis Laliotis
Research team: Dr Dimitrios Minos
Duration: April 2025 – May 2026
Overview
The objective of this project is to examine the impact of market-driven economic incentives on vaccination uptake in a low-trust society, using Greece as a case study. Specifically, the research aims to assess the causal relationship between external economic shocks and public health behavior, focusing on how changes in travel policies influenced vaccination rates, and consequently employment, during the summer of 2021. The study will investigate the broader implications of this shift, particularly on public health outcomes and labor market dynamics in tourism-dependent regions. A key focus will be on how increased demand for tourism-related services affected vaccine hesitancy, especially among working-age individuals who were incentivised to vaccinate in order to formally participate in the labor market.
This research holds significant relevance for public health and policy design. By understanding how market forces can indirectly boost vaccination rates, the findings offer valuable insights for developing strategies that extend beyond direct government interventions.The study’s results could inform policymakers on the potential of leveraging economic incentives in addressing vaccine hesitancy, especially in societies where institutional trust is low. Furthermore, by linking vaccination behavior to labor market participation, the project highlights the economicdimensions of public health decisions, offering a more comprehensive understanding of how individuals respond to policy changes that affect both health and employment.
The significance of this research lies in its novel approach. Unlike traditional studies that focus on targeted incentive programs, this project evaluates the impact of naturally occurring, market-shaped incentives, providing fresh insights into behavioral responses within public health contexts. The use of a real-world policy change—the UK government’s decision to lift quarantine requirements for fully vaccinated travelers—creates a natural experiment that allows for a robust evaluation of causal impacts. Ultimately, the research contributes to a broader understanding of how economic pressures influence public health behaviors in low-trust societies, with findings that may be applicable in similar contexts beyond Greece.
The project is expected to lead to a number of academic outputs, including:
- Working Paper 1: “Economic incentives and vaccination uptake”.
- Working Paper 2: “The labour market impacts of vaccination uptake: Evidence from a natural experiment”.
The core research question of this is how market-driven economic incentives, shaped by exogenous policy changes, influence vaccination uptake in low-trust societies, and what the broader implications for public health and labor market outcomes are. To address it, the project leverages a natural experiment created by the UK government's policy change on July 9, 2021, which lifted the 10-day quarantine requirement for fully vaccinated travelers returning from “amber-list” countries, including Greece. This exogenous variation in travel guidance provides a quasi-experimental setting that allows for causal inference using a difference-in-differences (DiD) approach. Under this framework, we will identify how externally shaped economic incentives impacted vaccination uptake and assess the resulting public health and labor market effects. Specifically, we will examine how the policy shift influenced vaccination rates in Greek regions heavily dependent on tourism—particularly the Southern Aegean, Ionian Islands, and Crete—relative to mainland areas less exposed to UK tourism, which serve as the control group.
In addition to the DiD framework, and depending on our confidential data applications to Greek authorities, we will employ a regression discontinuity design (RDD) to analyse the impact of age-specific government-imposed rewards and fines on vaccination behavior and COVID-19 case counts. This will allow us to investigate whether individuals near specific age cut-offs responded differently to economic incentives. Furthermore, we will extend the DiD analysis to explore labor market dynamics, comparing employment levels in treated and control regions (as well as detailed sectors and occupations) before and after the policy change.
The research will utilise a combination of administrative and survey data from multiple sources to ensure a comprehensive analysis. Baseline estimations will rely on data from the National Public Health Organization (EODY), providing daily counts of COVID-19 cases and vaccinations disaggregated by age and region. To map tourism flows and measure exposure to the UK market, we will use data from the Border Survey (Bank of Greece) and the Greek Tourism Confederation (SETE), which offer detailed insights into international arrivals by destination and country of origin. We will also make use of publicly available Google Trends data to examine how the search intensity for holidays in Greece changed after the UK government announcement, as well as we will collect and analyse detailed international flights data to compare flights from UK to Greece before and after the 10th of July, 2021. For labor market outcomes, we will use data from the National Social Security Fund (EFKA) which tracks employees and their employers over time from January 2016 to December 2021. Additionally, we will incorporate data from the panel version of the quarterly Labour Force Survey provided by the Hellenic Statistical Authority (ELSTAT) to capture broader labor market trends and individual employment trajectories.
By combining these methodological approaches and diverse data sources, the project aims to make a significant contribution to the literature on economic incentives and public health behavior. It offers a novel perspective by focusing on market-shaped incentives rather than direct government interventions and aligns with the Hellenic Observatory’s commitment to research that bridges economic, social, and policy-driven questions within Greece and the wider region.
This study forms part of our wider research within our Economy & Public Policy cluster.
Funding: funded by the Hellenic Observatory - Centre for Research on Contemporary Greece and Cyprus (HOC Research Fund)
Research Team
Principal investigator
Ioannis Laliotis, University of Patras and Affiliate, HO Centre
Co-investigator
Dimitrios Minos, Research Associate, Economy & Public Policy