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The effect of childhood measles vaccination on educational attainment: a mother-fixed-effects study in rural South Africa

The effect of childhood measles vaccination on educational attainment: a mother-fixed-effects study in rural South Africa
The effect of childhood measles vaccination on educational attainment: a mother-fixed-effects study in rural South Africa
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 causal effect of childhood measles vaccination on educational attainment among children born between 1995 and 2000 in South Africa.

METHODS AND FINDINGS:

We use longitudinal data on measles vaccination status and school grade attainment among 4783 children. The data were collected by the Wellcome Trust Africa Centre Demographic Information System (ACDIS), which is one of Africa's largest health and demographic surveillance systems. ACDIS 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, mother's age at child's birth, and birth order. We find that measles vaccination on average increases school grade attainment by 0.188 grades (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 measles 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 the community where this study took place during the study observation period. Our results demonstrate for the first time that measles vaccination affects human development not only through its health effects but also through its effects on education.
childhood measles vaccination, educational attainment, mother fixed-effects study
1-7
Anekwe, T.D.
b2df7fb9-dc81-411c-bddf-c6e7ac17a12a
Newell, M.L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Tanser, F.
b4ce79a2-0bf2-4021-89ad-0e759e2e2fc8
Pillay, D.
f5be10ef-edf2-46b9-9c80-61d6a6ed7ce4
Anekwe, T.D.
b2df7fb9-dc81-411c-bddf-c6e7ac17a12a
Newell, M.L.
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Tanser, F.
b4ce79a2-0bf2-4021-89ad-0e759e2e2fc8
Pillay, D.
f5be10ef-edf2-46b9-9c80-61d6a6ed7ce4

Anekwe, T.D., Newell, M.L., Tanser, F. and Pillay, D. (2015) The effect of childhood measles vaccination on educational attainment: a mother-fixed-effects study in rural South Africa. Vaccine, 1-7. (PMID:25936663)

Record type: Article

Abstract

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 causal effect of childhood measles vaccination on educational attainment among children born between 1995 and 2000 in South Africa.

METHODS AND FINDINGS:

We use longitudinal data on measles vaccination status and school grade attainment among 4783 children. The data were collected by the Wellcome Trust Africa Centre Demographic Information System (ACDIS), which is one of Africa's largest health and demographic surveillance systems. ACDIS 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, mother's age at child's birth, and birth order. We find that measles vaccination on average increases school grade attainment by 0.188 grades (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 measles 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 the community where this study took place during the study observation period. Our results demonstrate for the first time that measles vaccination affects human development not only through its health effects but also through its effects on education.

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More information

Accepted/In Press date: 20 April 2015
e-pub ahead of print date: 30 April 2015
Keywords: childhood measles vaccination, educational attainment, mother fixed-effects study
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 379721
URI: https://eprints.soton.ac.uk/id/eprint/379721
PURE UUID: ba7cf9bd-5f5f-4edf-b6ee-dd9355ae1851
ORCID for M.L. Newell: ORCID iD orcid.org/0000-0002-1074-7699

Catalogue record

Date deposited: 18 Aug 2015 10:23
Last modified: 06 Jun 2018 12:24

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Contributors

Author: T.D. Anekwe
Author: M.L. Newell ORCID iD
Author: F. Tanser
Author: D. Pillay

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