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

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Article number112885
JournalSocial Science and Medicine
Volume250
DOIs
StatePublished - Apr 2020

Keywords

  • Child development
  • India
  • Schooling attainment
  • UIP
  • Universal Immunization Programme
  • Vaccine

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

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