Mandatory Vaccination in Europe
Mandatory vaccination has been effective in maintaining high vaccination coverage in countries such as the United States. However, there are no peer-reviewed analyses of the association between mandates and both coverage and subsequent incidence of vaccine-preventable disease in Europe. Using data f...
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| Published in | Pediatrics (Evanston) Vol. 145; no. 2; p. 1 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Academy of Pediatrics
01.02.2020
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| Subjects | |
| Online Access | Get full text |
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| Summary: | Mandatory vaccination has been effective in maintaining high vaccination coverage in countries such as the United States. However, there are no peer-reviewed analyses of the association between mandates and both coverage and subsequent incidence of vaccine-preventable disease in Europe.
Using data from the European Centre for Disease Prevention and Control and the World Health Organization, we evaluated the relationship between country-level mandatory vaccination policies and (1) measles and pertussis vaccine coverage and (2) the annual incidence of these diseases in 29 European countries. Multivariate negative binomial and linear regression models were used to quantify these associations.
Mandatory vaccination was associated with a 3.71 (95% confidence interval [CI]: 1.68 to 5.74) percentage point higher prevalence of measles vaccination and a 2.14 (95% CI: 0.13 to 4.15) percentage point higher prevalence of pertussis vaccination when compared with countries that did not have mandatory vaccination. Mandatory vaccination was only associated with decreased measles incidence for countries without nonmedical exemptions (adjusted incidence rate ratio = 0.14; 95% CI: 0.05 to 0.36). We did not find a significant association between mandatory vaccination and pertussis incidence.
Mandatory vaccination and the magnitude of fines were associated with higher vaccination coverage. Moreover, mandatory vaccination was associated with lower measles incidence for countries with mandatory vaccination without nonmedical exemptions. These findings can inform legislative policies aimed at increasing vaccination coverage. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Ms Vaz conducted the literature search, created the figures, conducted data collection, analysis, and interpretation and was primarily responsible for the writing of the manuscript; Ms Ellingson assisted in the literature search, data analysis and interpretation, and writing and editing of the manuscript; Prof Weiss and Dr Jenness contributed to data analysis and interpretation and the editing of the manuscript; Dr Bardaji assisted in data interpretation and the editing of the final manuscript; Dr Bednarczyk contributed to the data analysis and interpretation and the writing and editing of the manuscript; Dr Omer conceptualized and designed the study and contributed to data analysis and interpretation, writing, and editing; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Ms Vaz’s current affiliation is Department of Epidemiology Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Dr Omer’s current affiliations are Department of Epidemiology of Microbial Diseases, School of Public Health; Department of Infectious Disease, School of Medicine; and Yale Institute of Global Health, Yale University, New Haven, CT. Ms Ellingson’s current affiliation is Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT. |
| ISSN: | 0031-4005 1098-4275 1098-4275 |
| DOI: | 10.1542/peds.2019-0620 |