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Background  Armed conflicts can have severe adverse effects on population health, both directly and indirectly, through the destruction of health care systems. This paper evaluates the causal effect of the Boko Haram insurgency in northeastern Nigeria on the vaccination rate.    Methods  By matching children’s birth months and the months of armed conflict, we evaluate the effect of armed conflict on the vaccination rate of children. We use two datasets: the Nigeria Demographic and Health Survey (DHS) for vaccinations and the Uppsala Conflict Data Program (UCDP) Georeferenced Event Dataset (UCDP GED) for armed-conflict events.    Results  We find a large negative effect of conflict events on the likelihood of vaccination; if an armed conflict occurs within 10 km from where a child resides, the odds that child receives any vaccination are 47.2% lower. Odds ratio for BCG and DPT1 is 0.55 and 0.52 respectively. We also find that armed conflicts have more impact among the non-educated population than among the educated.    Conclusion  Overall, armed conflicts had a devastating effect on the vaccination of young children who were born at the time of these conflicts in northeastern Nigeria. A reduced vaccination rate puts the vulnerable population in affected areas at risk of contracting vaccine-preventable diseases.

Effect of armed conflict on vaccination: evidence from the Boko haram insurgency in northeastern Nigeria