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A study led by The University of Western Australia has compared different mandatory vaccination policies across five countries – Australia, France, Germany, Italy, and the US (the states of California and Washington) – to better understand the conditions informing the adoption of the policies and how they motivate people to vaccinate.

The research paper “Recent vaccine mandates in the United States, Europe and Australia: A comparative study” is published in Vaccine by Elsevier (Authors Katie Attwell, Mark C. Navin, Pier Luigi Lopalco, Christine Jestin, Sabine Reiter, Saad B. Omer).

In response to recent outbreaks of vaccine-preventable diseases and global concerns around vaccine refusal, several high-income countries adopted or reformed vaccine mandate policies. The effectiveness of different approaches is complex and reliant on many factors including pre-existing vaccination schemes, the use of incentives or punishments and how willing governments are to enforce them.

Dr Katie Attwell, senior lecturer in UWA’s School of Social Sciences, said governments were introducing mandates to address vaccine refusal by people who feared the ingredients, distrusted authorities or did not regard vaccination as compatible with their parenting practices. However, an important part of considering the appropriateness of vaccine mandates was looking at general population access, affordability and convenience of services and complacency.

“Mandates with exemptions can motivate people who might otherwise be complacent to seek out vaccines, but mandates without exemptions attempt to prevent parents from refusing by imposing consequences,” Dr Attwell said.

“These consequences can differ greatly based on how the schemes were previously set up and whether populations support imposing negative consequences on vaccine refusers.”

The study found that jurisdictions went about considering and imposing mandates in different ways. France adopted a lengthy consultative process with the population, including qualitative and quantitative studies, while Italy’s previous government put an emergency decree in place in a very short space of time. Australia’s approach involved some consultation via Federal Parliament but was nothing like the French experience.

There was also a range of different options available. For example, California and Washington brought in policies requiring parents refusing vaccines to consult with health professionals before being allowed to avoid negative consequences for refusal. Meanwhile Australia abolished this kind of policy in favour of imposing negative consequences on all vaccine refusers. Californian legislators subsequently followed suit.

“This study gave us the opportunity to better understand what “mandatory” means and how it works in different settings,” Dr Attwell said.

“It’s also interesting to see how it has been employed very recently in response to governments worrying about vaccine refusal and disease outbreaks.”

“A collaboration between researchers and government from all the jurisdictions in the study made this kind of analysis possible, without the barriers of language or being excluded from understanding how policies operate locally.”

Media references

Jess Reid (UWA Media and Public Relations Advisor) 08 6488 6876