Childhood Vaccinations and Adult Schooling Attainment: Long-Term Evidence from India’s Universal Immunisation Programme
Posted: 9 May 2019
Date Written: April 26, 2019
Routine childhood vaccines are among the most cost-effective life-saving interventions. In addition, vaccines could reduce stunting and thereby improve health and other outcomes in later life. However, evidence on such long-term benefits remain inadequate. In this study, we examined the associations between India’s routine childhood vaccination program – known as the Universal Immunisation Programme (UIP) – 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 of individuals who were born when or after the UIP was implemented in their districts (intervention group) with those who were born before the UIP (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 than the control group. In subgroup analyses, positive associations between the UIP and schooling grades were observed among women and among rural, urban, and richer households.
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