A recently released study in Pediatrics shows that more than 1 in 10 children don’t receive their vaccinations as scheduled by their doctor, and likely as scheduled by the American Academy of Pediatrics. There are indicators that race and class have some bearing on whether parents follow the recommended schedule, but also a strong sense that the decision not to follow a schedule is often made before birth of the child. This may seem unsurprising to some, as often parents discuss and establish how they are going to raise a child before it’s brought into the world, but from an economic standpoint, kind of flies in the face of treating a vaccination as an investment. I am careful, in my research, to include controls for things like current medical insurance or medicaid assistance when it comes to measuring a similar outcome. As economists, it makes sense to assume that the marginal decision of taking the child to the doctor at any given scheduled checkup is subject to financial constraints. But if those decisions are made before the child is even born, then perhaps marginal analysis isn’t the correct way of approaching the problem.