Abstract
Background
The Swiss Epidemics Act 2016 foresees no vaccine mandates in routine settings. Only in certain settings can the federal government, after consulting with Swiss cantons, “declare vaccinations mandatory for risk groups, persons at threat of particular exposure, and persons exercising certain activities once a serious danger has been established.” Parliament proposed this Act in March 2012 arguing that recent infectious disease outbreaks required stronger preparedness plans clearly delineating responsibilities of the Confederation, cantons, and third parties. Swiss naturopath Trappitsch gathered >75,000 signatures to launch a referendum contesting the law. Main criticisms dealt with ambiguous language around mandates, infringement upon individual liberty, and fear of an overreaching federal government. Nevertheless, the Swiss populace voted to pass the law (60% in favor) in September 2013.
Methods
Qualitative interviews with key informants (N = 5 public health officials-PHO) and analysis of press coverage of the legislation/referendum allow for an investigation of the ambiguity of the mandate language and the referendum's consequences on this issue in public discourses.
Results
Several PHOs/politicians stated during the referendum that “nobody would be vaccinated against their will” and implied that the law would apply, for example, to non-vaccinated healthcare professionals who could be transferred to different care units to protect patients. Such specificities never appeared in the law. Ambiguous language around mandates served as a point of contention around which vaccination critics united and gained political traction. Such criticisms put State actors in the position of needing to more clearly articulate their perspectives.
Conclusions
With neighboring countries enacting vaccine mandate policies (France, Italy, Germany) in response to resurgence in measles cases, current legislative language leaves the question of mandates open to interpretation