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How do COVID-19 vaccination mandates affect vaccination?

by Ainsley Ingram

Messenger ribonucleic acid (mRNA) and adenoviral vaccines have been shown to be very effective in reducing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the severity of coronavirus disease 2019 (COVID-19) in the midst of vaccinated people. In fact, people vaccinated against COVID-19 have a ten times lower risk of suffering from severe COVID-19. However, after a rapid vaccination in early 2021, vaccination rates slowed in many countries during the summer months, despite the vaccine’s proven benefits.

In addition, with the emergence of the SARS-CoV-2 Delta variant, increased viral transmission has been observed, even with high vaccination rates. As a result, several non-pharmaceutical interventions had to be reintroduced, including wearing masks and staying indoors.

To study: COVID-19 vaccination mandates and vaccine adoption. Image Credit: Michael Vi / Shutterstock.com

Therefore, a higher vaccination rate would be necessary in some places to minimize the health and economic impacts of the virus. For example, several governments have introduced proof of vaccination warrants to increase vaccination rates and reduce the transmissibility of the virus.

A new study published on the preprint server medRxiv* aimed to assess and quantify the effect of proof of vaccination warrants on the use of the vaccine at the first dose in nine Canadian provinces and three European countries, including France, Italy and Germany between July and September 2021 .

About the study

The current study included data on COVID-19 vaccination numbers, cases and deaths for all Canadian provinces, as well as France, Italy and Germany. Announcement dates and implementation dates for proof of vaccination warrants were collected from major government newspapers and websites.

The study also assessed the extent of the change in the first weekly doses after the announcement of the vaccination mandate. A behavioral model was also used to estimate where the decision to receive the first dose of the vaccine was affected by the announcement of the vaccination mandate, as well as to assess the current epidemiological and public health conditions of COVID-19.

The present study assumed that there was no lag between the announcement of the mandate and a person’s ability to receive a first dose of vaccine, as well as information on current public health conditions being taken into account. account.

Study results

The results of the panel’s data analysis indicated that Canadian provinces that have announced vaccination mandates may have different first dose vaccination trends compared to provinces that have not. The impact of the warrant was relatively rapid, about a week after the announcement, with a significant effect on the timing of the first doses of vaccination. However, this effect gradually diminished over time and wore off seven weeks after the announcement.

Vaccination mandates and absorption of the first dose as of September 30, 2021

First doses after the announcement of the warrant.

Robustness analysis indicated that the results were unaffected by any assumptions, particular province, choice of weekly doses, and asymptotic inference approximations. The current study has also been found to be consistent with the idea of ​​the “ceiling effect” which suggests that provinces with more eligible people at the time of the announcement will have more room for a vaccination boost.

Evaluation of the second doses indicated that there was an increase in absorption from the second dose during the second week following the announcement; however, this trend was short-lived and did not persist over the following weeks. A structural break test following the announcement of a warrant has been associated with a trend break in the use of the first dose of vaccine in most or all locations.

The counterfactual analysis provided insight into location-specific warrant effects and thus potentially gain in precision. The counterfactual analysis for the Canadian provinces suggested that the announcement of the vaccination mandate led to 289,000 first additional doses in Canada.

The largest gains in immunization were seen in Alberta, Ontario and British Columbia. For countries, the first additional doses after the announcement turned out to be significant in France and Italy, while its impact was rather weak in Germany.

Conclusion

Increasing the speed of vaccination is important because it can accelerate progress towards achieving herd immunity against SARS-CoV-2.

The results of the present study indicate that the mandate of proof of vaccination imposed by the Canadian provinces and France, Germany and Italy were quite effective in increasing the first doses of vaccination. However, vaccination warrants are controversial, as some people see them as restrictions on personal freedom. In addition, the costs of imposing and enforcing these warrants are quite high. Therefore, governments must design cost-effective methods to increase vaccination rates in order to reduce cases of COVID-19.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer reviewed and, therefore, should not be considered conclusive, guide clinical practice / health-related behavior, or treated as established information.

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