Nature: Mandate vaccination with care
Saad B. Omer, director of the Yale Institute for Global Health and professor at Yale School of Medicine and Yale School of Public Health; Cornelia Betsch, professor at the University of Erfurt, Psychology and Infectious Diseases Lab; and Julie Leask, professor in the Susan Wakil School of Nursing and Midwifery at the University of Sydney, Faculty of Medicine and Health

“…[S]ome governments are now considering making vaccination for measles and other diseases a legal requirement. … However, mandatory vaccination can worsen inequities in access to resources, because penalties for not complying can disproportionately affect disadvantaged groups. What’s more, the evidence suggests that there is no simple linear relationship between the forcefulness of a policy and its impact on the rate of vaccination. It is crucial that policies don’t inadvertently entrench inequity or fuel anti-vaccine activism. … If governments … decide that mandates are appropriate, they should take the following five steps. Use multiple interventions. … Ensure just procedures. … Make penalties proportionate. … Monitor safety and compensate for side effects. … Avoid selective mandates. … [M]aking vaccination a legal requirement can be a powerful and effective tool if implemented with care and with regard to the context. … Overly strict mandates can result in parents finding ways to avoid the vaccine requirements, and selective mandates might damage the broader vaccination program. Most importantly, vaccine policy — like other types of effective public policy — must be based on evidence, and not driven by political and ideological considerations” (7/22).