Association of Mandatory Vaccination, the Availability of a Nonmedical Exemption Option, and the Penalty of Noncompliance With the Incidence of Measles (2006–2015) and Pertussis (2006–2016)
| Mandatory Vaccination . | No. Countries . | Pertussisa Incidence Rate Ratio (95% CI) . | Measles Incidence Rate Ratio (95% CI) . |
|---|---|---|---|
| No mandatory vaccination | 22 | Reference | Reference |
| Mandatory vaccination | 7 | 0.30 (0.07 to 1.30) | 0.38 (0.13 to 1.16) |
| Mandatory vaccination without nonmedical exemptions | 5 | 1.04 (0.18 to 6.32) | 0.14 (0.05 to 0.36) |
| Monetary fine | |||
| No mandatory vaccination | 22 | Reference | Reference |
| Mandatory vaccination and monetary penalty for noncompliance | 6 | 0.42 (0.18 to 0.98) | 0.14 (0.05 to 0.39) |
| Mandatory Vaccination . | No. Countries . | Pertussisa Incidence Rate Ratio (95% CI) . | Measles Incidence Rate Ratio (95% CI) . |
|---|---|---|---|
| No mandatory vaccination | 22 | Reference | Reference |
| Mandatory vaccination | 7 | 0.30 (0.07 to 1.30) | 0.38 (0.13 to 1.16) |
| Mandatory vaccination without nonmedical exemptions | 5 | 1.04 (0.18 to 6.32) | 0.14 (0.05 to 0.36) |
| Monetary fine | |||
| No mandatory vaccination | 22 | Reference | Reference |
| Mandatory vaccination and monetary penalty for noncompliance | 6 | 0.42 (0.18 to 0.98) | 0.14 (0.05 to 0.39) |
Models are adjusted for GDP per capita, GINI, urban population, universal health care coverage, median age, percentage of the population <14 years of age, and education level.