ArticleJAMA network open2025
Socioeconomic Differences in Vaccination Coverage After a Mandatory Vaccination Law, 1855-1900.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
Importance: Mandatory vaccination is a major tool to combat increasing vaccine hesitancy. In principle, a vaccination law, ie, a mandatory vaccination law without exemptions, applies equally to everyone, but its effects across different socioeconomic groups (SEGs) remain unknown. Objective: To examine the association of a vaccination law with vaccination coverage in different SEGs during 1855 to 1900. Design, Setting, and Participants: This population-based cohort study monitored 45 years (1855-1900) of Finland's first vaccination campaign against smallpox to estimate the association of the 1883 vaccination law with vaccination coverage in infants (age <1 year) across different SEGs. Data were analyzed from October 2023 to January 2024. Exposure: A mandatory smallpox vaccination law for all children. Main Outcomes and Measures: Vaccination status was determined from vaccination records and defined as receiving 1 dose of the smallpox vaccine. The primary outcome was the annual vaccination coverage in different SEGs and its change before vs after the vaccination law. Results: A total of 40 008 children aged less than 1 year were included. The high SEG had high vaccination coverage, at a mean (SD) of 90% (49 percentage points), and the law was associated with halting its declining trend. For the middle SEG, the law was associated with a 26-percentage point increase in coverage, to a mean (SD) of 83% (50 percentage points). For the low SEG, the law had no association with vaccination coverage, which always remained below 35% (mean [SD]: prelaw, 26% [22 percentage points]; postlaw, 32% [23 percentage points]). Conclusions and Relevance: In this cohort study, a historic vaccination law was not associated with increased vaccination in the SEG with the lowest vaccination coverage, emphasizing the need for additional interventions to increase vaccine uptake in low-coverage communities.
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