COVID-19 Vaccine Mandate and Vaccination Rates in the US Military, 2020‒2022

Area of Science:

• Public Health
• Epidemiology
• Military Medicine

Background:

• The COVID-19 pandemic necessitated rapid vaccine development and deployment.
• Vaccination mandates have been implemented to increase vaccine uptake.
• Understanding the impact of mandates on specific populations, like military service members, is crucial.

Purpose of the Study:

• To evaluate the effectiveness of the COVID-19 vaccination mandate on vaccination rates within the US military.
• To identify factors associated with incomplete vaccination after the mandate was issued.
• To compare vaccination trends in the military with the general US population.

Main Methods:

• Analysis of COVID-19 vaccination status for active component service members from December 2020 to January 2022.
• Utilized comparative interrupted time series analysis to assess pre- and post-mandate vaccination rates.
• Employed logistic regression to identify independent factors influencing vaccination status.

Main Results:

• Post-mandate vaccination rates significantly increased in the active component compared to pre-mandate periods and the general population (P < .001).
• Factors associated with lower pre-mandate vaccination included prior SARS-CoV-2 infection, lower rank, and non-Hispanic Black race.
• The mandate led to higher vaccination incidence among non-Hispanic Black service members and those of lower rank, reducing disparities.

Conclusions:

• The US military's COVID-19 vaccination mandate effectively boosted overall vaccination rates.
• The mandate successfully reduced existing disparities in vaccination based on race, ethnicity, and rank.
• Vaccine mandates are a valuable tool for enhancing public health, military readiness, and equity.