Long-term Effects of India's Childhood Immunization Program on Earnings and Consumption Expenditure: Comment

TL;DR

This paper critically examines a study claiming India's childhood immunization program increased earnings and expenditure, arguing that observed effects are likely due to inflation, economic growth, and survey timing rather than the program itself.

Contribution

It highlights methodological issues in the original study, showing that the reported long-term effects may be confounded by external economic factors and survey timing.

Findings

Observed wage and expenditure increases are consistent with inflation and growth.

Control groups too old for vaccination showed similar increases.

Survey timing and economic trends likely explain the results.

Abstract

Summan, Nandi, and Bloom (2023), hereafter SNB, find that exposure during infancy to India's Universal Immunization Programme (UIP) increased wages and per-capita household expenditure in early adulthood. SNB regress these outcomes on a treatment indicator that depends upon year and district of birth while controlling for age at follow-up. Because year of birth and age are nearly collinear, SNB's identifying variation does not come from the staggered introduction of the UIP, but rather from the progression of time during the follow-up period. Within the 12-month follow-up period, those interviewed later were more likely to have been treated and, on average, reported higher wages and household expenditure. Wages and household expenditure, however, rose by at least as much in a control group composed of people too old to have been exposed as infants to the UIP as in the treated group. SNB's results are best explained by inflation, economic growth, and non-random survey sequencing during the follow-up survey period.