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Political determinants of COVID-19 restrictions and vaccine rollouts: the case of regional elections in Italy and Spain

Arija Prieto, Pablo, Antonini, Marcello ORCID: 0000-0001-5816-2289, Ammi, Mehdi, Genie, Mesfin and Paolucci, Francesco (2024) Political determinants of COVID-19 restrictions and vaccine rollouts: the case of regional elections in Italy and Spain. Health Policy, 145. ISSN 0168-8510

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Identification Number: 10.1016/j.healthpol.2024.105082


The COVID-19 pandemic is one of the most significant public health crises in modern history, with considerable impacts on the policy frameworks of national governments. In response to the pandemic, non-pharmaceutical interventions (NPIs) and mass vaccination campaigns have been employed to protect vulnerable groups. Through the lens of Political Budget Cycle (PBC) theory, this study explores the interplay between incumbent electoral concerns and political dynamics in influencing the implementation of NPIs and vaccination rollout within the administrative regions of Italy and Spain during the period spanning June 2020 to July 2021. The results reveal that incumbents up for the next scheduled election are 5.8 % more likely to increase the stringency of containment measures than those that face a term limit. The findings also demonstrate that the seats of the incumbent and coalition parties in parliament and the number of parties in the coalition have a negative effect on both the efficiency of the vaccination rollout and the stringency of NPIs. Additionally, the competitiveness of the election emerges as an important predictor of the strictness of NPIs. Therefore, our results suggest that incumbents may strategically manipulate COVID-19 policy measures to optimize electoral outcomes. The study underscores the substantive influence of political incentives, competitive electoral environments, and government coalitions on policy formulation during health emergencies.

Item Type: Article
Official URL:
Additional Information: © 2024 The Authors
Divisions: Health Policy
Subjects: J Political Science > JF Political institutions (General)
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
JEL classification: D - Microeconomics > D7 - Analysis of Collective Decision-Making > D72 - Economic Models of Political Processes: Rent-Seeking, Elections, Legislatures, and Voting Behavior
I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy; Regulation; Public Health
Date Deposited: 31 May 2024 14:06
Last Modified: 20 Jul 2024 04:42

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