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Mandatory infant & childhood immunization: Rationales, issues and knowledge gaps.

Noni E MacDonald1, Shawn Harmon2, Eve Dube3

  • 1Department of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.

Vaccine
|August 26, 2018
PubMed
Summary

Mandatory infant and childhood immunization aims to increase vaccine uptake but faces controversy. Successful implementation requires careful consideration of country-specific contexts and ensuring equitable access to vaccines.

Keywords:
EthicsHealth lawMandatoryPublic healthVaccine hesitancyVaccine refusal

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Area of Science:

  • Public Health
  • Immunization Policy
  • Global Health

Background:

  • Vaccine preventable diseases persist globally despite available vaccines.
  • Suboptimal infant and childhood vaccine uptake necessitates strategies to improve coverage.
  • Outbreaks occur even in high-income nations, highlighting persistent challenges.

Purpose of the Study:

  • To provide an overview of mandatory infant and childhood immunization programs.
  • To illustrate variations in mandatory immunization approaches across different countries.
  • To summarize existing outcome data and suggest key considerations for implementing mandatory immunization.

Main Methods:

  • Review of mandatory immunization policies in two high-income and one low-income country.
  • Analysis of program variations including vaccine scope, age groups, opt-out options, penalties, enforcement, and compensation.
  • Synthesis of limited outcome data related to mandatory immunization programs.

Main Results:

  • Mandatory immunization approaches vary widely regarding included vaccines, covered age groups, flexibility, penalties, and compensation.
  • There is no standardized global approach to mandatory infant and childhood immunization.
  • Limited outcome data exists, necessitating careful consideration before implementation.

Conclusions:

  • Mandatory immunization is a controversial strategy to improve vaccine coverage.
  • Key elements for consideration include financial sustainability, supply chain, and equitable access.
  • Alternative, less intrusive interventions may be more effective; if implemented, mandatory programs must be contextually tailored.