Association for Public Policy Analysis & Management

Relative to their more privileged peers, socially disadvantaged children perform less well on common indicators of academic success, including literacy, standardized test scores, high school completion rates, and college enrollment and completion rates. These patterns persist into adulthood, ultimately contributing to established inequities in employment, earnings and wealth, and crime and incarceration, among other major life outcomes

Socioeconomic gaps in academic achievement mirror well-documented disparities in childhood health and health care. Health plays a critical role in children’s cognitive development and academic performance. Healthy students are more likely to attend school, better able to focus in class and, ultimately, better equipped to learn. Our work explores the potential for public health policy – through the amelioration of childhood health inequities – to support state efforts to narrow achievement gaps.

We focus on one, relatively simple, public health intervention that has had a tremendous impact on the health of American youth: routine childhood immunization. Specifically, we examine whether state laws establishing vaccination requirements for school children mitigate racial disparities in vaccine coverage and, thereby, narrow persistent gaps in academic achievement.

While every state requires that children be vaccinated for protection against certain diseases, the timing of mandate adoption and the extent to which mandates reflect national guidelines can vary significantly state-to-state. We pursue a difference-in-differences approach, leveraging recent state legislation. Our research design essentially compares (1) children entering kindergarten in a post-mandate versus pre-mandate academic year and, within a kindergarten cohort, (2) children attending school in a state with a new vaccine mandate versus a state with no change in school-entry immunization laws.

This study combines information on state vaccination laws with data from the National Immunization Surveys (NIS) and the Stanford Education Data Archive (SEDA). The NIS are conducted by the CDC to monitor vaccination coverage among children at national, state, and selected local levels. The SEDA provides yearly estimates of the average math and English Language Arts test scores of students in grades 3 through grade 8 in every public school district in the United States (2009-2015) and a range of data on educational conditions and contexts.

Consistent with prior research, we find that the implementation of a vaccine mandate improves coverage levels among school-age children. Further, we document the potential for school-entry immunization requirements to reduce disparities in coverage between white and non-white students. After establishing a first stage effect, we test whether school-entry vaccine mandates narrow achievement gaps between black and white students. Our results suggest that vaccine mandates disproportionately improve the academic performance of socially disadvantaged children (low-income, non-white children have historically low coverage levels).

If efforts to close the achievement gap are to be successful, it is important to understand how larger social forces – including established health and health care disparities – influence the ability of schools to shape educational outcomes. Our project is the first to consider the causal effect of school-entry vaccination requirements on standardized tests of academic achievement.