Multigenerational Effects of Smallpox Vaccination

Abstract

Using Swedish register data spanning 250 years, we estimate multigenerational effects of smallpox vaccination on longevity and occupational achievements. Employing mother fixed-effects, difference-in-differences, and shift-share instrumental-variables designs, we find vaccination improves outcomes for three generations. We explore mechanisms through which benefits transmit across generations, finding evidence consistent with both improved health behaviors and epigenetic inheritance. Effects persist even in milder disease environments, demonstrating vaccination lasting benefits beyond epidemic contexts. These findings underscore the importance of accounting for multigenerational returns when evaluating early-life health interventions.