Proposals for Mandated Vaccinations Draw Strong Opposition in U.S.

If any pharmacist or other healthcare professional has ever wondered why, if widespread vaccination is so important to stop the COVID-19 pandemic, the government doesn’t just mandate immunization, a recent opinion poll gives a clear answer to that question. Researchers determined that widespread opposition likely would mean that mandates are ineffective, or, in a worst-case scenario, would ignite a backlash. Here is more information.

PHILADELPHIA – Despite the need for widespread vaccination of Americans to stem the spread of COVID-19, mandating vaccines does not seem viable, especially for adults, according to a recent survey.

The article in JAMA Network Open points out that, currently, certain vaccines are required for children to attend school and that some adults, such as healthcare workers, are required in some instances to be vaccinated to remain employed.

“Vaccine mandates have drawn attention because of growing concerns that voluntary COVID-19 vaccination rates will be insufficient to stem transmission,” write University of Pennsylvania Perelman School of Medicine-led researchers. “Consistent with prior research, we found that demographic characteristics and partisanship were associated with self-reported likelihood of COVID-19 vaccination. Demographic characteristics and partisanship were also associated with acceptance of COVID-19 vaccine mandates. This suggests that in some states or localities, COVID-19 vaccine mandates—particularly for adults—may be ineffective or, worse, prompt backlash.”

To find out if a broader mandate might be acceptable, the study team surveyed 2,730 adults in the United States. S public to assess acceptability of COVID-19 vaccine mandates. The Gallup Panel web study was completed between Sept. 14 and 27, 2020; participants consented through a website for the survey, which had a 39% response rate.

Respondents were queried about the acceptability of states requiring adults and children and employers requiring employees to “get the COVID-19 vaccine (unless they have a medical reason not to be vaccinated).” The sample was weighted to be demographically representative of the U.S. population.

According to the results, overall, 61.4% (95% CI, 60.0%-63.0%) of respondents indicated they would likely get a COVID-19 vaccine. Researchers note, however, that Republicans and Independents were significantly less likely to get vaccinated than Democrats (Republicans, 44.3% [95% CI, 41.7%-46.8%]; Independents, 58.4% [95% CI, 55.5%-61.1%]; Democrats, 76.6% [95% CI, 74.7%-78.5%]). In addition, the survey determined, Black respondents were significantly less likely than non-Black respondents to get vaccinated (43.6% [95% CI, 39.2%-48.2%] vs 63.7% [95% CI, 62.3%-65.2%]).

Asked about requiring COVID-19 vaccination for children attending school, nearly one-half (48.6%; 95% CI, 44.8%-53.0%) of respondents regarded requiring COVID-19 vaccination for children attending school as acceptable or very acceptable and 38.4% (95% CI, 34.6%-42.0%) regarded it as unacceptable or very unacceptable.

The authors point out that, while 40.9% (95% CI, 37.2%-45.0%) of respondents viewed state mandates for adults as acceptable at some level, 44.9% (95% CI, 41.0%-49.0%) found them unacceptable at some level. They add that, compared with state mandates for adults, slightly more respondents (47.7%; 95% CI, 43.8%-52.0%) found employer-enforced employee mandates acceptable, but 38.1% (95% CI, 34.4%-42.0%) found them unacceptable.

Respondents reporting that they were likely to get a COVID-19 vaccine also were more likely to accept mandates than those unlikely to be immunized:

  • mandates for children, 73.6% [95% CI, 68.5%-78.1%] vs 23.7% [95% CI, 19.4%-28.7%
  • mandates for adults, 65.0% [95% CI, 59.7%-69.9%] vs 17.3% [95% CI, 13.6%-21.7%]; and
  • mandates for employees, 72.5% [95% CI, 67.3%-77.1%] vs 22.9% [95% CI, 18.6%-27.8%]).

Mandates for both children and adults were more acceptable to respondents identifying as Democrats -- 70.2% [95% CI, 64.3%-75.7% and 60.8% [95% CI, 54.6%-66.6%, respectively. As for vaccine mandates for children, 27.4% [95% CI, 21.5%-34.2%] of Republicans and 44.0% (95% CI, 36.5%-51.7%) of Independents agreed. Rates were considerably lower for mandates for adults -- Republicans, 22.6% [95% CI, 17.1%-29.3%]; and Independents, 34.0% [95% CI, 27.1%-41.5%].

Political identification also affected views on employer-enforced employee mandates (Republicans, 31.0% [95% CI, 24.8%-37.9%]; Independents, 41.0% [95% CI, 33.7%-48.8%]; Democrats, 66.0% [95% CI, 59.9%-71.7%]).

In terms of race, compared with non-Black respondents, fewer Black respondents said they could accept state mandates for adults (42.7% [95% CI, 38.7%-46.8%] vs 27.0% [95% CI, 17.5%-39.2%]), and a greater percentage found them unacceptable (43.1% [95% CI, 39.1%-47.2%] vs 58.4% [95% CI, 45.7%-70.1%]).

Education also affected acceptance of mandated vaccine: Respondents with a bachelor’s degree or higher were likelier to find mandates acceptable than those without (mandates for children, 66.0% [95% CI, 60.1%-71.4%] vs 39.7% [95% CI, 34.9%-44.6%]; mandates for adults, 56.4% [95% CI, 50.4%-62.2%] vs 32.9% [95% CI, 28.3%-37.7%]; mandates for employees, 62.4% [95% CI, 56.5%-68.0%] vs 39.9% [95% CI, 35.2%-44.9%]).

Overall, however, no gender differences were observed, according to the authors.

The only area where vaccine might be a possibility, according to the researchers, is among businesses, explaining, “Employer-enforced employee mandates did not garner majority acceptance; however, acceptability exceeded unacceptability, suggesting a potential role for employers to increase COVID-19 vaccine uptake, particularly among key groups such as frontline workers.”

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