The Effects of Prenatal Exposure to Seasonal Influenza on Life Course Outcomes in the United States

Seasonal influenza is a common infectious disease that jeopardizes the health of pregnant women and may harm fetal development. I investigate the impacts of in utero exposure to seasonal influenza over the life course using nearly fifty years of flu season data in the U.S. I exploit state and time variation in influenza-related mortality, a proxy for disease severity in the local environment that reflects random mutations in the flu virus. I first find adverse effects on health at birth, including decreased birth weight and increased risk of congenital anomalies. I then show that prenatal exposure to the seasonal flu decreased childhood school attendance, high school educational attainment, and labor force participation, and increased adult disability. A policy simulation based on these estimates suggests substantial past and future returns to expanding influenza vaccination