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Childhood vaccinations and adult schooling attainment: Long-term evidence from India's Universal Immunization Programme

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  • Nandi, Arindam
  • Kumar, Santosh
  • Shet, Anita
  • Bloom, David E.
  • Laxminarayan, Ramanan

Abstract

Routine childhood vaccines are among the most cost-effective life-saving interventions. In addition, vaccines have been linked with reduced stunting and improved health and other outcomes in later life. However, evidence on such long-term benefits remain inadequate. In this study, we examined the associations between the initiation and implementation of the Universal Immunization Programme (UIP) in India and schooling attainment among adults. We obtained district-level data on the rollout of the UIP in 1985–1990 and matched those with data from the National Family Health Survey of India, 2015–2016. Adults who were born in the five years before and after the rollout period (1980–1995) and always lived in the same location were included in the analysis (n=109,908). We employed household, village or city ward, district, and state fixed-effects linear regression models, which incorporated a wide range of socioeconomic and demographic indicators and community-level infrastructure, amenities, and access to healthcare. We compared schooling attainment in years among individuals who were born during or after the UIP was implemented in their districts (intervention group) with those who were born before UIP implementation (control group). In household fixed-effects analysis, intervention group adults attained 0.18 (95% confidence interval [CI]: 0.02, 0.33; p<0.05) more schooling grades as compared with control group adults from the same household. In village or city ward, district, and state fixed-effects analysis, intervention group adults attained 0.23 (95% CI: 0.13, 0.32; p<0.001), 0.29 (95% CI: 0.19, 0.38; p<0.001), and 0.25 (95% CI: 0.1, 0.39; p<0.01) additional schooling grades, respectively, compared to the control group. In subgroup analyses, positive associations between UIP implementation and schooling grades were observed among women and among rural, urban, and richer households. Our results support the association of vaccines with improved school attainment.

Suggested Citation

  • Nandi, Arindam & Kumar, Santosh & Shet, Anita & Bloom, David E. & Laxminarayan, Ramanan, 2020. "Childhood vaccinations and adult schooling attainment: Long-term evidence from India's Universal Immunization Programme," Social Science & Medicine, Elsevier, vol. 250(C).
    • Handle: RePEc:eee:socmed:v:250:y:2020:i:c:s0277953620301040
    DOI: 10.1016/j.socscimed.2020.112885
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    1. Chuard, Caroline & Schwandt, Hannes & Becker, Alex & Haraguchi, Masahiko, 2022. "Economic vs. Epidemiological Approaches to Measuring the Human Capital Impacts of Infectious Disease Elimination," IZA Discussion Papers 15420, Institute of Labor Economics (IZA).
    2. Gudrun Østby & Olga Shemyakina & Andreas Forø Tollefsen & Henrik Urdal & Marijke Verpoorten, 2021. "Public Health and Armed Conflict: Immunization in Times of Systemic Disruptions," Population and Development Review, The Population Council, Inc., vol. 47(4), pages 1143-1177, December.
    3. Nandi, Arindam & Summan, Amit & Ngô, Thoại D. & Bloom, David E., 2024. "Childhood vaccinations and the demand for children: Long-term evidence from India," World Development, Elsevier, vol. 182(C).
    4. Hamid R. Oskorouchi & Alfonso Sousa-Poza & David E. Bloom, 2020. "The Long-Term Cognitive and Schooling Effects of Childhood Vaccinations in China," NBER Working Papers 27217, National Bureau of Economic Research, Inc.
    5. Nandi, Arindam & Haberland, Nicole & Ngo, Thoai D., 2023. "The impact of primary schooling expansion on adult educational attainment, literacy, and health: Evidence from India’s Sarva Shiksha Abhiyan," International Journal of Educational Development, Elsevier, vol. 102(C).

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