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<p>As part of global measles‑eradication efforts, this study estimates how natural disasters disrupt routine immunisation by analysing the effect of Pakistan’s 2010 mega‑floods on measles vaccination among children aged 0–24 months. Geocoded flood‑severity indicators are merged with microdata from three waves (i.e., 2008-09, 2010-11, 2012-13) of the Pakistan Social and Living Standards Measurement (PSLM) household survey to construct a quasi‑natural experiment. A difference‑in‑differences model identifies the immediate impacts of flood exposure on vaccine uptake. Measles coverage in flood-affected districts declined by 5.7% points compared to unaffected areas, with the steepest losses recorded in rural communities, where a reduction of 16.84% points was observed for toddlers aged 2 years. The setback was gender-differentiated: vaccination rates for girls declined more sharply than those for boys. Heterogeneity analysis reveals that household socio-economic status, mother education, and family size moderated these effects. These findings underscore the need for disaster‑resilient immunisation strategies, particularly gender‑sensitive outreach in flood‑prone rural areas, to prevent post‑crisis measles resurgence and protect vulnerable children.</p>

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Children’s Health at Risk: Impact of Flooding on Measles Vaccination in Pakistan

  • 期刊论文

  • 发表日期：

    2025年11月17日

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  • Riaz Ahmed,
  • Kafeel Sarwar,
  • Fouzia Yasmin,
  • Muhammad Ayyoub,
  • Waseem Barkat

摘要

As part of global measles‑eradication efforts, this study estimates how natural disasters disrupt routine immunisation by analysing the effect of Pakistan’s 2010 mega‑floods on measles vaccination among children aged 0–24 months. Geocoded flood‑severity indicators are merged with microdata from three waves (i.e., 2008-09, 2010-11, 2012-13) of the Pakistan Social and Living Standards Measurement (PSLM) household survey to construct a quasi‑natural experiment. A difference‑in‑differences model identifies the immediate impacts of flood exposure on vaccine uptake. Measles coverage in flood-affected districts declined by 5.7% points compared to unaffected areas, with the steepest losses recorded in rural communities, where a reduction of 16.84% points was observed for toddlers aged 2 years. The setback was gender-differentiated: vaccination rates for girls declined more sharply than those for boys. Heterogeneity analysis reveals that household socio-economic status, mother education, and family size moderated these effects. These findings underscore the need for disaster‑resilient immunisation strategies, particularly gender‑sensitive outreach in flood‑prone rural areas, to prevent post‑crisis measles resurgence and protect vulnerable children.