Now that we’ve made it to the summer of 2022, about 2 and a half years after the pandemic started in the U.S., it’s safe to say no one misses the constant media coverage for much of 2021 pitting the vaccinated against the unvaccinated. In a news feature from earlier this month, Nature examines how well COVID vaccine mandates worked to increase vaccination rates.
At a look across the globe, some countries required vaccinations for entry into public venues or as a requirement for school entry or employment, especially in health care and federal government sectors. Others like Greece and Italy fined the elderly for being unvaccinated.
In Italy, anyone over 50 years old was fined the equivalent of $105 U.S. dollars if not vaccinated. Greece passed a law last November to fine anyone over age 60 who remained unvaccinated but then withdrew it in April. Singapore went so far as to make any unvaccinated person pay for their own COVID-19-related health care.
Did vaccine mandates that spread across the world actually work to increase the number of people vaccinated? In a case-control study where physician Dariusz Walkowiak of Poznan University of Medical Sciences in Poland looked at vaccination rates in Poland and its neighboring Lithuania, vaccine mandates seemed to work when the measure of success is an increased vaccination rate. Lithuania, which implemented a vaccine mandate for getting into public spaces, had a 12% increase in vaccination coverage compared to the less-strict Poland.
Researchers in an examination of vaccine policies in Canada estimated that mandates led to an increase of roughly 2.9% more Canadians getting vaccinated. Increases in vaccination rates were starker when there was less time between announcing the policy and implementing it and when pre-policy vaccination rates were lower.
Other studies found no significant increase in vaccination rates in Germany in early mandates until they expanded to the workplace, at which time researchers found a 6.2% jump in vaccinations.
Researchers like Shih En Lu, an economist at Simon Fraser University in Canada, wonder if increased vaccine uptake after mandates comes from mandates overcoming people’s vaccine hesitancy or their complacency about COVID. When people have to choose between getting vaccinated or losing their source of income to pay their bills and put food on the table, is it really much of a surprise that vaccine mandates would increase the number of people getting vaccinated?
Interestingly, vaccine mandates didn’t have this effect in all countries. When the U.K. in June of 2021 announced a vaccine mandate for all care-home workers and National Health Service (NHS) employees and then attempted to enforce it the following November, they lost 5% of their care-home labor force—roughly 26,000 people. The U.K. withdrew its NHS policy after many protests.
“Across the board, there really wasn’t a clear explanation of what the objectives were,” stated Maxwell Smith, a bioethicist and lead author of the WHO’s ethics guidelines for COVID vaccine mandates. A lack of clear vaccine policy objectives fuels public distrust. What were the objectives with these mandates: to increase safety in public spaces, to reduce overall viral transmission, or simply to increase vaccination rates?