scholarly journals Individual preferences for voluntary vs. mandatory vaccination policies: an experimental analysis

Author(s):  
Nicolas W Meier ◽  
Robert Böhm ◽  
Lars Korn ◽  
Cornelia Betsch

Abstract Background More and more countries are discussing the introduction of mandatory vaccination policies. Yet, little is known about individuals’ actual preferences for voluntary vs. mandatory vaccination policies, and the psychological processes underlying such preferences. Objective of the present research was to investigate the development of individual preferences for voluntary and mandatory vaccination policies. Methods We conducted a controlled laboratory study (N = 168) using a repeated interactive vaccination game with decision-contingent monetary incentives. In each round, participants decided in favour of either a voluntary or a mandatory vaccination policy, followed by the vaccination decision (voluntary policy) or vaccination (mandatory policy) which both resulted in actual (financial) consequences. Results We observe large heterogeneity in participants’ preferences for the voluntary vs. mandatory policy. Under voluntary vaccination, the preference for the mandatory policy increased with decreasing vaccination rates (and increasing risk of infection). In contrast, experiencing vaccine-adverse events under mandatory vaccination increased the preference for the voluntary policy. The latter effect was larger for individuals with a negative (vs. positive) attitude toward vaccination. Overall, as individuals gathered experiences under both the voluntary and the mandatory policy, the preference for voluntary vaccination policy increased over time. Conclusions Individuals are more willing to accept mandatory vaccination policies when vaccination rates are low. In the long run, the occurrence of vaccine-adverse events may spark opposition to mandatory vaccination.

2019 ◽  
Author(s):  
Nicolas Meier ◽  
Robert Böhm ◽  
Lars Korn ◽  
Cornelia Betsch

Background: More and more countries are discussing the introduction of mandatory vaccinationpolicies. Yet, little is known about individuals’ actual preferences for voluntary vs. mandatory vaccination policies, and the psychological processes underlying such preferences. Objective of the present research was to investigate the development of individual preferences for voluntary and mandatory vaccination policies.Methods: We conducted a controlled laboratory study (N = 168) using a repeated interactive vaccination game with decision-contingent monetary incentives. In each round, participants decided in favour of either a voluntary or a mandatory vaccination policy, followed by the vaccination decision (voluntary policy) or vaccination (mandatory policy) which both resulted in actual (financial) consequences.Results: We observe large heterogeneity in participants’ preferences for the voluntary vs. mandatory policy. Under voluntary vaccination, the preference for the mandatory policy increased with decreasing vaccination rates (and increasing risk of infection). In contrast, experiencing vaccine- adverse events under mandatory vaccination increased the preference for the voluntary policy. The latter effect was larger for individuals with a negative (vs. positive) attitude towards vaccination. Overall, as individuals gathered experiences under both the voluntary and the mandatory policy, the preference for voluntary vaccination policy increased over time.Conclusions: Individuals are more willing to accept mandatory vaccination policies when vaccination rates are low. In the long run, the occurrence of vaccine-adverse events may spark opposition to mandatory vaccination policy.


2012 ◽  
Vol 33 (1) ◽  
pp. 63-70 ◽  
Author(s):  
Kathleen Quan ◽  
David M. Tehrani ◽  
Linda Dickey ◽  
Eugene Spiritus ◽  
Denise Hizon ◽  
...  

Background.Assessing the relative success of serial strategies for increasing healthcare personnel (HCP) influenza vaccination rates is important to guide hospital policies to increase vaccine uptake.Objective.To evaluate serial campaigns that include a mandatory HCP vaccination policy and to describe HCP attitudes toward vaccination and reasons for declination.Design.Retrospective cohort study.Methods.We assessed the impact of serial vaccination campaigns on the proportions of HCP who received influenza vaccination during die 2006–2011 influenza seasons. In addition, declination data over these 5 seasons and a 2007 survey of HCP attitudes toward vaccination were collected.Results.HCP influenza vaccination rates increased from 44.0% (2,863 of 6,510 HCP) to 62.9% (4,037 of 6,414 HCP) after institution of mobile carts, mandatory declination, and peer-to-peer vaccination efforts. Despite maximal attempts to improve accessibility and convenience, 27.2% (66 of 243) of die surveyed HCP were unwilling to wait more than 10 minutes for a free influenza vaccination, and 23.3% (55 of 236) would be indifferent if they were unable to be vaccinated. In this context, institution of a mandatory vaccination campaign requiring unvaccinated HCP to mask during the influenza season increased rates of compliance to over 90% and markedly reduced the proportion of HCP who declined vaccination as a result of preference.Conclusions.A mandatory influenza vaccination program for HCP was essential to achieving high vaccination rates, despite years of intensive vaccination campaigns focused on increasing accessibility and convenience. Mandatory vaccination policies appear to successfully capture a large portion of HCP who are not opposed to receipt of die vaccine but who have not made vaccination a priority.Infect Control Hosp Epidemiol 2012;33(1):63-70


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Vanderslott ◽  
T Marks

Abstract Background Mandatory vaccination is becoming an increasingly important policy intervention for governments trying to address low vaccination rates. However, the evidence about which countries have mandatory vaccination policy worldwide and discussions surrounding their impact has largely been limited to high-income countries. While many recent publications discuss the issue, none provide a comprehensive list. This is an obvious gap in the discussion about the merits of introducing mandatory vaccination into countries. Methods We draw on extensive desk-based research analysing a mixture of sources, including national, regional, and international vaccination policy reports, international health institution websites, ministry of health websites, and media reports. We supplemented this material by contacting a variety of health authorities, such as PAHO and the WHO as well as country's ministries of health. Results We have compiled the first comprehensive list of vaccination policies worldwide, covering 149 countries. This list indicates whether a country has a mandatory vaccination policy and the strictness of the mandate on a scale ranging across four levels. We provide an overview of the state of mandatory vaccination across different countries, set out the general trends and issues, and engage into a discussion about why, how, and where mandatory vaccination is put in place. We also provide several case studies, which highlight the limitations of vaccine mandates because other factors such as exemptions, penalties or enforcement play an important role in their actual effect on immunisation rates. Conclusions Our key finding is that the majority of low- and middle- income countries have mandatory vaccination policies but low vaccination rates because of problems with vaccine supply, delivery, and access.


2010 ◽  
Vol 19 (3) ◽  
pp. 283-289 ◽  
Author(s):  
PETER DOSHI ◽  
AKIRA AKABAYASHI

The ethical tension in childhood vaccination policies is often framed as one of balancing the value of choice with the duty to protect. Because infectious diseases spread from person to person, unvaccinated children are usually described as putting others around them at risk, violating a perceived right to be protected from harm. Editors of Lancet Infectious Diseases recently argued against mandatory vaccination, reminding us that the resort to mandatory vaccination as a means of achieving high vaccination rates is still very much a topic of Western vaccine debates. The nation of Japan offers an interesting case study in childhood vaccination policy, as it has an entirely voluntary (opt-in) system that achieves high vaccination rates. In this paper, we offer an overview of Japanese childhood vaccine policy, suggest some ways to contextualize and understand how a voluntary system achieves high vaccination rates, and speculate on what the future of Japanese vaccination policymaking and government–public relations may hold.


2020 ◽  
Vol 29 (20) ◽  
pp. 1186-1191
Author(s):  
Paula Flanagan ◽  
Maura Dowling ◽  
Georgina Gethin

Background: Preventing seasonal influenza is a public health priority but, although the benefits of vaccinating healthcare workers (HCWs) are emphasised, seasonal influenza vaccine uptake rates remain low. Voluntary vaccination policies have been less successful in achieving high vaccine uptake when compared to mandatory policies and the persistently low vaccine uptake among HCWs has fuelled debate on whether mandatory vaccination programmes should be implemented in the interest of patient safety. Aim: This study explored nurses' views on mandatory vaccination policy for seasonal influenza. Methods: A self-selected sample (n=35) of qualified nurses working in two large hospital sites in Ireland participated in five focus groups. Data were analysed using Braun and Clarke's framework. Findings: Two themes were identified: (1) mixed views on mandatory vaccination and (2) leave nurses to make their own choice on vaccination. Conclusion: This study provides an understanding of nurses' views regarding mandatory vaccination policy for seasonal influenza and highlights that individual choice and autonomy are crucial for vaccine acceptance.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Rizzi ◽  
K Attwell ◽  
V Casigliani

Abstract Background This paper explores conflictual policy transfer in Italian vaccination policy 2007-2018. The region of Veneto formally suspended mandatory vaccination in 2007. Soon after, declining vaccination rates across the country sparked a public health crisis. Emilia Romagna adopted a new vaccine mandate for early education, which the national government adopted in 2017. Each policy decision invoked collaboration and contestation between governments. In showing the conflictual aspects of intra-state policy transfer, we offer lessons for multi-level health governance of contested issues. Methods We used qualitative documentary analysis of parliamentary transcripts, legislation and government reports, supplemented with semi-structured key informant interviews, using the coding software NVivo 12. We applied theoretical and conceptual scholarship to develop an analytical framework drawing out the key mechanisms through which contestation and conflict take place. Results Italian regional and national governments employed three key mechanisms to forcibly transfer or resist vaccination policy: ideas, evidence, and law. Ideas included “the nation”, “herd immunity” and “science.” Evidence included coverage rates and explanations of changes over time. Protagonists of Italy's coercive policy transfers used the law to claim and challenge authority. Contestations occurred in political and bureaucratic spheres. Discrepant historical and evidentiary narratives emerged between levels of government that had injected significant resources into acquiring or defending governance of vaccination policy. Conclusions Scholarship has predominantly considered coercive policy transfer at a supra-national or inter-state level. We demonstrate the political blood-spilling within a country when divergent regional policies become contested in a situation of national crisis. 'Evidence' and 'law' can be open to differing interpretations, with 'ideas' shaping the context in which policies prevail.


2022 ◽  
pp. 152660282110687
Author(s):  
Pawel Latacz ◽  
Bartlomiej Lasocha ◽  
Brzegowy Pawel ◽  
Popiela Tadeusz ◽  
Simka Marian

Purpose: Although a majority of cervical artery dissections can be managed conservatively, patients presenting with cerebral embolization or significant stenosis require a more aggressive approach. However, complications associated with endovascular repair are quite frequent and optimal interventional technique still remains to be established. Materials and methods: The aim of this post hoc survey was to analyze results of endovascular treatments for symptomatic dissections of the internal carotid and vertebral arteries, which were performed under protection and with the use of double-layer mesh stents. During endovascular procedure catheters, stents and protection systems were tailored according to the angioarchitecture of dissection, particularly to its location, length and coexisting stenotic or aneurysmatic lesions. We evaluated retrospectively midterm and late results of endovascular treatment of 25 patients presenting with symptomatic dissection of cervical arteries, including 11 patients with dissections of intracranial segments of the internal carotid artery. Follow-ups were scheduled 1, 3 and 6 after the procedure, and then every 6 months. Control computed tomography (CT) or digital subtraction angiography (DSA) arteriographies were performed 1–6 months and 12 months after endovascular repair. Results: There were no periprocedural major adverse events. All patients completed the 12-month follow-up. There were neither fatalities nor new neurologic adverse events at the 30-day follow-up, and no such adverse events during long-term follow-up. At 12-month follow-up, in all patients, angiographies revealed patent stents, full coverage of lesions by stents and complete thrombotic closure of the pseudoaneurysms. Conclusions: A tailored endovascular management of symptomatic dissection of cervical arteries is safe and efficient, also in a long run.


2022 ◽  
Vol 8 ◽  
Author(s):  
Mohammed Khaled Al-Hanawi ◽  
Noor Alshareef ◽  
Rehab H. El-Sokkary

Background: Since development of the first COVID-19 vaccine, the landscape of public confidence in these vaccines is uncertain. Building confidence is crucial for better preparedness of future pandemics. Following the mandatory COVID-19 vaccination policy in the country, the aim of this study was to examine whether the Saudi public feels relieved post-vaccination and to identify the factors predicting such relief.Methods: An online cross-sectional survey was conducted in July 2021 among COVID-19 vaccine recipients in Saudi Arabia. A multivariable logistic regression analysis was employed to examine and identify the variables associated with feeling relieved post-vaccination.Results: Most of the respondents (66%) stated feeling more relieved post-vaccination. Male gender [adjusted odds ratio (AOR): 1.380; 95% confidence interval (CI): 0.981–1.943], being a student (AOR: 3.902; 95% CI: 1.674–9.096), and received two doses of the vaccine (AOR: 2.278; 95% CI: 1.630–3.182) were associated with feeling more relieved after getting vaccinated. Respondents who were anxious about the vaccine before receiving it (AOR: 0.220; 95% CI: 0.160–0.302), and experienced a severe reaction after vaccination (AOR: 0.288; 95% CI: 0.165–0.504) had lower odds of feeling relieved post-vaccination. Respondents who relied on social media as the main source of vaccine-related information and those having no information about the vaccine were also less likely to feel relieved post-vaccination.Conclusions: Individuals' attitudes toward COVID-19 vaccines may not necessarily alter post-vaccination. Although mandatory vaccination policies can significantly contribute to achieving herd immunity, public confidence toward vaccines might be eroded, which could in turn impose significant challenges in future pandemics efforts.


2019 ◽  
Vol 214 ◽  
pp. 28-35 ◽  
Author(s):  
Nikolaos Papoutsidakis ◽  
Stephen Heitner ◽  
Jodie Ingles ◽  
Christopher Semsarian ◽  
Meghan Mannello ◽  
...  

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