Childhood vaccinations and the demand for children: Long-term evidence from India

Abstract

Childhood vaccinations can increase population growth in the short term by improving the survival rates of young children. Over the long run, reductions in child mortality rates are associated with lower demand for children and lower fertility rates (known as “demographic transition”). Vaccination programs could potentially aid demographic transition by lowering child mortality and improving future health, schooling, and labor market outcomes of vaccinated mothers, but these long-term demographic benefits remain untested. We address this major gap in the literature by examining the associations of India’s national childhood vaccination program (the Universal Immunization Programme or UIP) with future demand for children. We combine data on the district-wise rollout of UIP during 1985–1990 with fertility preference data of 625,000 adult women from the National Family Health Survey of India 2015–2016. We include women who were born five years before and after the rollout period (1980–1995) and were cohabiting with a partner at the time of the survey. We divide these 20–36-year-old women into two groups: those who were exposed to UIP at birth (treatment group) and those who were born before the program (control group). After controlling for individual- and household-level factors and age and district fixed effects, treatment group women are 2% less likely to have at least one child and want 2% fewer children in their lifetime as compared with the control group. The negative associations with at least one childbirth are larger for more educated and richer women, while the associations with desired number of children is larger for uneducated and poorer women.