  India has had an established universal immunization program since 1985 and
immunization services are available for free in healthcare facilities. Despite
this, India has one of the lowest vaccination rates globally and contributes to
the largest pool of under-vaccinated children in the world. Why is the
vaccination rate low in India? This paper explores the importance of historical
events in shaping India's current vaccination practices. We examine India's
aggressive family planning program implemented during the period of emergency
rule in the 1970s, under which millions of individuals were sterilized. We find
that greater exposure to the forced sterilization policy has had negative
effects on the current vaccination rate. We explore the mechanism and find that
institutional delivery and antenatal care are low in states where policy
exposure is high. Finally, we examine the consequence of lower vaccination
suggesting that child mortality is currently high in states with greater
sterilization exposure. Together, the evidence suggests that the forced
sterilization policy has had a persistent effect on health-seeking behavior in
India.
