Vaccines, Politics and Mandates: Can We See the Forest for the Trees?; Comment on “Convergence on Coercion: Functional and Political Pressures as Drivers of Global Childhood Vaccine Mandates”

Document Type : Commentary

Authors

1 Department of Paediatrics, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

2 Direction des risques biologiques et de la santé au travail, Institut national de santé publique du Québec, Québec, QC, Canada

Abstract

Under-vaccination is a complex problem that is not simple to address whether this is for routine childhood immunization or for coronavirus disease 2019 (COVID-19) vaccination. Vaccination mandates has been one policy instrument used to try to increase vaccine uptake. While the concept may appear straight forward there is no standard approach. The decision to shift to a more coercive mandated program may be influenced by both functional and/or political needs. With mandates there may be patient and/or public push back. Anti-mandate protests and increased public polarization has been seen with COVID-19 vaccine mandates. This may negatively impact on vaccine acceptance ie, be counterproductive, causing more harm than overall good in the longer term. We need a better understanding of the political and functional needs that drive policy change towards mandates as well as cases studies of the shorter- and longer-term outcomes of mandates in both routine and pandemic settings.

Keywords

Main Subjects


  1. Bustreo F, Okwo-Bele JM, Kamara L. World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality. Arch Dis Child. 2015;100 Suppl 1:S34-37. doi:1136/archdischild-2013-305693
  2. Decouttere C, De Boeck K, Vandaele N. Advancing sustainable development goals through immunization: a literature review. Global Health. 2021;17(1):95. doi:1186/s12992-021-00745-w
  3. Phadke VK, Bednarczyk RA, Salmon DA, Omer SB. Association between vaccine refusal and vaccine-preventable diseases in the United States: a review of measles and pertussis. JAMA. 2016;315(11):1149-1158. doi:1001/jama.2016.1353
  4. Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis. 2022;22(9):1293-1302. doi:1016/s1473-3099(22)00320-6
  5. MacDonald NE, Comeau J, Dubé È, et al. Royal Society of Canada COVID-19 report: enhancing COVID-19 vaccine acceptance in Canada. Facets. 2021;6(1):1184-1246.
  6. Budziszewski R, Thompson R, Lucido T, et al. Measuring the effectiveness of a car seat program in an urban, level one pediatric trauma center. Inj Epidemiol. 2021;8(Suppl 1):19. doi:1186/s40621-021-00313-1
  7. MacDonald NE, Harmon S, Dube E, et al. Mandatory infant & childhood immunization: rationales, issues and knowledge gaps. Vaccine. 2018; 36(39):5811-5818. doi:1016/j.vaccine.2018.08.042
  8. Harmon SHE, Faour DE, MacDonald NE, et al. Immunization governance: mandatory immunization in 28 Global NITAG Network countries. Vaccine. 2020;38(46):7258-7267. doi:1016/j.vaccine.2020.09.053
  9. Attwell K, Hannah A. Convergence on coercion: functional and political pressures as drivers of global childhood vaccine mandates. Int J Health Policy Manag. 2022. doi:34172/ijhpm.2022.6518
  10. Assefa Y, Woldeyohannes S, Cullerton K, Gilks CF, Reid S, Van Damme W. Attributes of national governance for an effective response to public health emergencies: lessons from the response to the COVID-19 pandemic. J Glob Health. 2022;12:05021. doi:7189/jogh.12.05021
  11. Flores A, Cole JC, Dickert S, et al. Politicians polarize and experts depolarize public support for COVID-19 management policies across countries. Proc Natl Acad Sci U S A. 2022;119(3):e2117543119. doi:1073/pnas.2117543119
  12. Martin S, Vanderslott S. “Any idea how fast ‘It’s just a mask!’ can turn into ‘It’s just a vaccine!’”: from mask mandates to vaccine mandates during the COVID-19 pandemic. Vaccine. 2021. doi:1016/j.vaccine.2021.10.031
  13. Pereira PS, da Silva Silveira A, Pereira A. Disinformation and conspiracy theories in the age of COVID-19. Front Sociol. 2020;5:560681. doi:3389/fsoc.2020.560681
  14. Bardosh K, de Figueiredo A, Gur-Arie R, et al. The unintended consequences of COVID-19 vaccine policy: why mandates, passports and restrictions may cause more harm than good. BMJ Glob Health. 2022;7(5):e008684. doi:1136/bmjgh-2022-008684
  15. MacDonald NE, Dube E, Comeau JL. Have vaccine hesitancy models oversimplified a complex problem to our detriment? The Adapted Royal Society of Canada vaccine uptake framework. Vaccine. 2022;40(29):3927-3930. doi:1016/j.vaccine.2022.05.052

Articles in Press, Corrected Proof
Available Online from 28 September 2022
  • Receive Date: 26 July 2022
  • Revise Date: 12 September 2022
  • Accept Date: 26 September 2022
  • First Publish Date: 28 September 2022