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Ann N Y Acad Sci. 2019 Aug;1449(1):70-82. doi: 10.1111/nyas.14127. Epub 2019 Jun 10.

Haemophilus influenzae type b vaccination and anthropometric, cognitive, and schooling outcomes among Indian children.

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Center for Disease Dynamics, Economics and Policy, Washington, DC.
School of Public Policy and Department of Economics, University of California, Riverside, California.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Center for Disease Dynamics, Economics and Policy, New Delhi, India.
Princeton Environmental Institute, Princeton University, Princeton, New Jersey.


Haemophilus influenzae type b (Hib) affects 337,000 Indian children every year. A vaccine against Hib was introduced in 2011 as part of the pentavalent vaccine and scaled up nationwide. This study investigated the associations between Hib vaccination and child anthropometry, cognition, and schooling outcomes in India. We used longitudinal survey data and employed propensity score matching to control for observed systematic differences between children who reported receipt or nonreceipt of Hib vaccine before age 6 years (n = 1824). Z-scores of height-for-age (HAZ) and BMI-for-age (BMIZ), percentage scores of English, mathematics, reading, and Peabody Picture Vocabulary tests, and attained schooling grade of children were examined. Hib-vaccinated children had 0.25 higher HAZ, scored 4.09 percentage points (pp) higher on the English test and 4.78 pp higher on the mathematics test, and attained 0.16 more schooling grades than Hib-unvaccinated children at age 11-12 years. At age 14-15 years, they had 0.18 higher HAZ, scored 3.63 pp higher on the reading test and 3.22 pp higher on the mathematics test, and attained 0.15 more schooling grades than Hib-unvaccinated children. The findings indicate potential long-term health, cognitive, and schooling benefits of the Hib vaccine, subject to the effect of unobserved confounding factors.


Haemophilus influenzae; Hib vaccine; India; child development; young lives

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