A new study in JAMA Network Open shows that state COVID-19 vaccine mandates for healthcare workers (HCWs) issued in 17 states in 2021 were associated with increased vaccine uptake.
The authors found that states with vaccines mandates had a nearly 4% increase in vaccination rates compared with non-mandate states, with even bigger gains in states with no test-out options.
The study included 31,142 HCWs sampled across 45 states, including 16 states with vaccine mandates issued in mid-2021. The outcomes measured were increases in the proportions of vaccinated HCWs and those who completed or intended to complete the vaccination series 2 weeks after mandate announcement relative to baseline proportions of 88% and 86% vaccinated HCWs, respectively.
Test-out option tied to higher uptake
The authors found a mandate-associated 3.46 percentage point (pp) (95% confidence interval [CI], 0.29 to 6.63 pp) increase in the proportion of HCWs ever vaccinated against COVID-19 and a 3.64 pp (95% CI, 0.72 to 6.57 pp) increase in the proportion that completed or intended to complete the primary vaccination series 2 weeks after a mandate announcement in states with mandates.
A stratified analysis showed that, in states with a no test-out option and among HCWs aged 25 to 49 years, vaccination increased 3.32% to 7.09% compared to baseline proportions. There were no significant uptake increases in states that offered both vaccine mandates and a test-out option.
In an editorial on the study, John B. Lynch, MD, PhD, of the University of Washington in Seattle, said vaccine mandates are often unpopular and can be politicized, so understanding just how much benefit they yield is important for policy makers.
Researchers are gaining more information on the specific tools that can be used for employer vaccine mandate policies, including not having a test-out option.
"Importantly, researchers are gaining more information on the specific tools that can be used for employer vaccine mandate policies, including not having a test-out option," he said.