During the COVID-19 pandemic, some U.S. states mandated COVID-19 vaccinations to increase vaccination numbers, while other states enacted legislation preventing mandates. Research shows vaccine mandates didn’t work and actually caused more people to reject boosters and other vaccinations.
A study in PNAS found that governmental restrictions had unintended negative consequences and no influence on COVID-19 vaccine uptake. State-level COVID-19 vaccine mandates did not impact vaccine adoption during the weeks before or after they went into effect, suggesting vaccine mandates did not directly affect COVID-19 vaccination.
Compared to states that banned vaccine mandates through legislation, states that required COVID-19 vaccination experienced lower levels of subsequent boosters and reduced rates of voluntary flu vaccinations.
Mandates Did Not Affect COVID-19 Vaccination Rates
To determine the impact that state COVID-19 vaccine mandates had on vaccination behavior, researchers examined epidemiological data from the Centers for Disease Control and Prevention (CDC) in 19 states eight weeks before and after mandates were imposed.
They also examined the uptake of subsequent vaccines, such as COVID-19 boosters and seasonal influenza vaccines, to see if restricting the freedom to choose whether or not to be vaccinated in the past affected the adoption of future voluntary vaccinations.
To get a baseline on attitudes toward COVID-19 vaccine mandates, researchers used data from the COVID States Project—a 50-state survey project supported by the National Science Foundation before the COVID-19 vaccine was made available to the public.
A group of scientific researchers launched the COVID States Project in March 2020 to help practitioners and governments make informed decisions, identify links between social behaviors and virus transmission, and measure the impact that regulation and messaging have on individual and community outcomes in a crisis.
As part of their analysis, the researchers examined people who were already vaccinated before the eight-week sampling time frame and found no statistically significant difference in weekly vaccination rates before and after the mandate was imposed, nor were vaccination rates affected by baseline attitudes toward COVID-19 vaccine mandates.
When adjusting the sampling window before and after mandates to four and 16 weeks, researchers observed the same trends, suggesting that COVID-19 vaccination requirements were not associated with changes in vaccine adoption rates.
Mandates Had Unintended Negative Consequences for Other Shots
Using CDC data from November 2021—when boosters became available—through May 2022, researchers examined weekly differences in state-level vaccination rates of COVID-19 boosters in 19 states with vaccine mandates and 22 states that enacted legislation banning vaccination requirements.
Additionally, they looked at those who received a booster and those who were eligible but did not, as well as how state vaccination rates were impacted by legislation banning or mandating vaccinations. The study found COVID-19 booster uptake was lower in states that imposed vaccine requirements—with a greater discrepancy among states with lower vaccination numbers.
“This pattern is consistent with a tendency to respond negatively to COVID-19 vaccine mandates relative to bans, especially among states whose residents initially were less inclined toward getting vaccinated,” the researchers wrote.
The results were the same for flu vaccines. Researchers examined two CDC datasets on state-level flu vaccination rates among children and adults during the 2021–2022 flu season during the same period as the booster analysis.
They found adults in states with COVID-19 vaccine mandates were less likely to report receiving a flu shot than adults in states where mandates were banned. Likewise, children from states with vaccine mandates were less likely to have received a flu vaccine, and the difference was more significant among states with lower COVID-19 vaccination numbers.
The researchers said their findings support concerns expressed by scholars and practitioners that selective vaccine mandates can have harmful or unintended consequences for public health, and other research that found vaccine mandates don’t necessarily reduce the adoption of the required vaccine but do reduce voluntary vaccinations.
