THE EFFECT OF CHILDHOOD MEASLES VACCINATION ON EDUCATIONAL ATTAINMENT: A MOTHER-FIXED-EFFECTS STUDY IN RURAL SOUTH AFRICA

Saturday, 16th of May 2015

THE EFFECT OF CHILDHOOD MEASLES VACCINATION ON EDUCATIONAL ATTAINMENT: A MOTHER-FIXED-EFFECTS STUDY IN RURAL SOUTH AFRICA

Anekwe TD¹, Newell ML², Tanser F³, Pillay D³, Bärnighausen T⁴.

Author information

• ¹USDA Economic Research Service, Washington, DC 20224, USA; Wellcome Trust Africa Centre for Health and Population Studies, Mtubatuba 3935, South Africa. Electronic address: anekwe@post.harvard.edu.
• ²Wellcome Trust Africa Centre for Health and Population Studies, Mtubatuba 3935, South Africa; University of Southampton, Southampton, UK.
• ³Wellcome Trust Africa Centre for Health and Population Studies, Mtubatuba 3935, South Africa.
• ⁴Wellcome Trust Africa Centre for Health and Population Studies, Mtubatuba 3935, South Africa; Harvard School of Public Health, Boston, MA 02115, USA.

Abstract below; full text is at http://www.sciencedirect.com/science/article/pii/S0264410X15005484

BACKGROUND:

Because measles vaccination prevents acute measles disease and morbidities secondary to measles, such as undernutrition, blindness, and brain damage, the vaccination may also lead to higher educational attainment. However, there has been little evidence to support this hypothesis at the population level. In this study, we estimate the effect of childhood measles vaccination and educational attainment among children born between 1995 and 2000 in South Africa.

METHODS AND FINDINGS:

We use data on measles vaccination status and school grade attainment among 4783 children. The data were collected by the Wellcome Trust Africa Center Demographic Information System, which is one of Africas largest health and demographic surveillance systems. It is located in a poor, predominantly rural, Zulu-speaking community in KwaZulu-Natal, South Africa. Using mother-fixed-effects regression, we compare the school grade attainment of siblings who are discordant in their measles vaccination status but share the same mother and household. This fixed-effects approach controls for confounding due to both observed and unobserved factors that do not vary between siblings, including sibling-invariant mother and household characteristics such as attitudes toward risk, conscientiousness, and aspirations for children. We further control for a range of potential confounders that vary between siblings, such as sex of the child, year of birth, mothers age at childs birth, and birth order. We find that measles vaccination is associated with 0.188 higher school grades per child (95% confidence interval, 0.0424-0.334; p=0.011).

CONCLUSIONS:

Measles vaccination increased educational attainment in this poor, largely rural community in South Africa. For every five to seven children vaccinated against measles, one additional school grade was gained. The presence of a measles vaccination effect in this community is plausible because (i) measles vaccination prevents complications including blindness, brain damage, and undernutrition; (ii) a large number of number of children were at risk of contracting measles because of the comparatively low measles vaccination coverage; and (iii) significant measles transmission occurred in South Africa during the study observation period. Our results demonstrate for the first time that measles vaccination affects human development not only through its previously established and significant effect on health but also through its effect on education.

Copyright © 2015. Published by Elsevier Ltd.