University of Western Australia: Policy makers find vaccine mandates attractive for many reasons

A new study from The University of Western Australia which looked at the drivers behind new childhood vaccine mandates in different parts of the world found that governments reach for these policies because they are easy to implement and can help solve different types of problems.

“Vaccine hesitancy and refusal is a global problem with diverse local policy responses, which range from keeping vaccines as voluntary to mandating them.”

Associate Professor Katie Attwell
Associate Professor Katie Attwell, from UWA’s School of Social Sciences, is co-author of Convergence on coercion: functional and political pressures as drivers of global childhood vaccine mandates published in the International Journal of Health Policy and Management.

Associate Professor Attwell said the study looked to explore the drivers of enhanced vaccine mandates recently employed in Australia, Italy, France, and California.

“Vaccine hesitancy and refusal is a global problem with diverse local policy responses, which range from keeping vaccines as voluntary to mandating them,” Associate Professor Attwell said.

“Clearly, with the intense pressures governments are now facing, it is important to understand the tools they are using to reach and maintain high vaccine uptake, and of course this has huge lessons for COVID-19 vaccines too.”

Vaccine mandates

The four case studies used in the research – Australia, California, France and Italy – all increased the coerciveness of their childhood vaccine regimes between 2015 and 2017.

“While all are wealthy western democracies, there are lots of differences between them, including their ideologies, levels of governance, health system design, policy history, political culture, and recent epidemiological experiences,” Associate Professor Attwell said.

The paper found that practical and political pressures were the two key elements in government decisions to tighten vaccine rules.

“Policy-makers in France and Italy were primarily driven by operational challenges, with their vaccination programs coming under threat as their populations became less compliant,” Associate Professor Attwell said.

“While California and Australia didn’t face the same threats, pro-vaccine activists utilised local opportunities to heighten political pressure on decision makers to make vaccine refusal more difficult.”

The study found mandates were attractive for governments in all cases, whether they faced functional problems in governance or political pressure generated by media and activists.

“Mandates can help resolve systemic problems on the one hand and more local, minor or technical problems on the other, all without imposing onerous costs or policy complexity,” Associate Professor Attwell said. “However, these policies also come with risks, challenges, and unforeseen consequences.”


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