Who Takes Advantage of Free Flu Shots? Examining the Effects of an Expansion in Coverage

Because of the high risk of costly complications (including death) and the externalities of contagious diseases, many countries provide free flu shots to certain populations free of charge. This paper examines the expansion of the free flu shot program in the Netherlands. This program expanded in 2008 to cover all individuals over the age of 60, instead of 65. We investigate the effectiveness of the expansion of the flu shot program and examine those factors that are likely to influence people to change their behavior. We find that the main barrier to take up of free flu shots in the Netherlands is labor force participation. Expansion of the program did little to change the behavior of those at increased risk due to co-morbidities, primarily because these individuals were already getting flu shots.