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Childhood vaccination improves schooling among India's adults, shows study

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22 May 2020
Childhood vaccination improves schooling among India's adults, shows study

Routine childhood vaccination is one of the most successful measures taken by countries across the world to prevent diseases and reduce mortality. According to the World Health Organization (WHO), persistent efforts towards immunisation have resulted in curbing and eradicating life-threatening illnesses and averting 2-3 million deaths every year globally. Studies have shown that apart from these direct benefits, vaccines also have indirect benefits like better cognition and academic success. Adding to this body of evidence is a recent study that explores how childhood vaccination among children in India has impacted the level of education attained by them as adults.

The study was carried out by researchers at the Center for Disease Dynamics, Economics & Policy (CDDEP), Washington and New Delhi, Sam Houston State University, Johns Hopkins Bloomberg School of Public Health, Harvard T.H. Chan School of Public Health and Princeton Environmental Institute.

"We have examined the broader cognitive and schooling benefits of vaccines at the national level in India. Our study is the first to analyse schooling outcomes among adults rather than children and adolescents," says Dr Arindam Nandi, a senior Fellow at CDDEP.

The study, published in the journal Social Science & Medicine, was funded by the Bill and Melinda Gates Foundation and in part by the Value of Vaccination Research Network (VoVRN).

In India, the Universal Immunisation Programme (UIP) was implemented during 1985-1990 and covered 353 districts. Under this programme, infants were immunised against vaccine-preventable diseases such as measles, tuberculosis, polio and tetanus. In this study, the researchers looked at the education level attained among individuals who were vaccinated under this programme to determine if vaccines affected their educational attainment.

The researchers obtained data from the Universal Immunisation Programme to categorise individuals into two groups. The first group, containing individuals born before the implementation of the programme (i.e., 1980-1984), formed the control group. Those born during 1985-1995 formed the intervention group. They then combined this data with the information from the National Family Health Survey, India (NFHS)-4 of 2015-2016. This survey contains comprehensive information on family health and welfare, including reproductive health, maternal care, child health, and nutrition practices adopted by a sample of households in 640 districts of India.

The researchers considered a sample set of 1,10,067 individuals living in the same neighbourhood of the district since birth, aged between 20-36 years as on 2015-2016. The analysis was also done on different subsets of samples based on gender (men/women); marital status of women; caste (General/SC or ST/OBC); location (rural/urban), and income levels. The study used statistical models, which considered the influences of age, sex, marital status, relationship to head of the household and others. It analysed the two groups based at various levels— village/city, district and state.

The researchers found that vaccinated individuals gained 0.18 - 0.29 additional schooling years—about two to three months—compared to individuals who were not vaccinated under the programme. Studies in the past have shown that vaccines can prevent recurrent infections and improve child health and cognitive capability, which in turn can lead to more schooling. Across India, people who had been vaccinated have completed more years of schooling than people who had not been vaccinated.

Married and unmarried women, who were vaccinated, gained about 5 months of schooling, and immunised adults, aged between 18-54 years, showed attaining more years of education than those who were not. The additional schooling could impact the wages of individuals, say the researchers, as men's wage increased by 4-6%, while women earned 5-8% more with education. The researchers claim that with childhood vaccination, education attainment in adults can be increased by 10%.

"Vaccines are among the cheapest and most effective tools for preventing infections in children," says Dr Nandi, emphasising the need for universal coverage of vaccines. "We know that undernutrition, infections, and inadequate nurturing during the first 2-3 years of life can have lasting adverse effects on health, cognition, schooling, and economic outcomes. Therefore, holistic child development policies should include universal coverage of routine vaccines," he signs off.

This article has been run past the researchers, whose work is covered, to ensure accuracy.