Socio-Economic Differentials in Mortality Reduction Associated with Measles Vaccination: Evidence from Matlab, Bangladesh

Saifuddin Ahmed, Johns Hopkins University
Michael Koenig, Johns Hopkins University

Studies convincingly show that measles vaccination reduces overall childhood mortality, nearly as much as 40% or higher. There is, however, a strong socio-economic differential in the mortality impact of measles vaccination intervention, with the poorest and most vulnerable children disproportionately benefiting in terms of improved survival. Using longitudinal data from rural Bangladesh this paper evaluates the mortality reduction resulting from targeted measles vaccination in different socio-economic group. Our results show that measles vaccination of poorer children (lowest 20% on a socio-economic status scale) reduces mortality by 34%, compared to only 3% among the upper 20 percentile children. Overall, immunization of the lowest 30% children is equivalent to the vaccination of upper 70% in reducing overall mortality. The paper also compares population attributable fractions (PAF) of childhood mortality reduction by vaccination in different socio-economic groups. The results make a compelling argument for targeted vaccination in settings where coverage rates are low.