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In 2021, vaccination against COVID-19 became mandatory for healthcare workers in England. The media coverage of the mandate was extensive and became an issue of public interest. This study aimed to understand the United Kingdom (UK) debate on mandatory COVID-19 vaccination through a framing analysis of UK media coverage. Articles written between November 2021 and April 2022 were identified from UK national newspapers: The Daily (and Sunday) Telegraph, the Times (and Sunday Times), the Guardian (and the Observer), the Independent, the Daily Mail (and Mail on Sunday), the Daily Mirror, the Daily Express, and the Sun. Articles were selected using eligibility criteria before framing analysis was undertaken. The sample included 204 articles. Safe Staffing, Treatment of Staff, Change in Covid Context, and Protect Patient Safety were identified as frames used to stimulate debate on the mandatory vaccination policy. Such frames established three broader concepts in the media: civil liberty theory, duty-based ethics, and social-vulnerability theory. This study analyzed how mandatory COVID-19 vaccination for healthcare workers in England was framed in the UK national media. The broader concepts built in the media heightened debate on the policy, creating a voluminous amount of coverage and criticism that may have played a role in the mandate's reversal. [ABSTRACT FROM AUTHOR]

This article investigates the covariation of belief and science credibility in Kazakhstan in the context of COVID-19 and vaccination. The research methodology is based on a multi-country analysis of COVID-19 indicators from a global database of COVID-19 vaccinations, and the covariance of belief and science credibility was estimated in the case of Kazakhstan. According to the survey, 33.5% of respondents changed their opinions in favor of vaccination and 29.6% of those surveyed affirmed their commitment to vaccination. Furthermore, 58.8% of respondents believe that this is the only and an effective way to protect themselves from COVID-19. Some of the main reasons for refusing to get a vaccine include contraindications (14.1%), fear of possible severe consequences (4.5%), and lack of confidence in vaccines and medicine in general (4.5%). Less than 1% of all respondents cited religious beliefs as the main reason for unwillingness to get vaccinated. [ABSTRACT FROM AUTHOR]

This article explores the factors associated with COVID‐19 vaccine uptake and hesitancy among multinational refugees and migrants residing in various regions of Jordan. Drawing on an analysis of data collected from 636 participants in December 2021, only 58.2 per cent of the refugee community in Jordan received COVID‐19 vaccines, knowing that vaccine hesitancy compromises vaccination campaign efforts to control the spread of the disease. In fact, the International Organization for Migration (IOM) and local Jordanian authorities are well aware that, unless sufficiently vaccinated, the clustered populations of refugees and migrants might witness future infectious outbreaks similar to COVID‐19. This study reveals that COVID‐19 vaccine hesitancy is evident among the refugee and migrant populations, who are mainly sceptical of its efficiency and safety. Migrants and refugees also have a preference for certain types of COVID‐19 vaccines. In light of the findings, future interventions are needed to mitigate their concerns and boost vaccine confidence. A more holistic policy approach should prioritize migrants and refugees who are female, unemployed, less educated, and/or have poor knowledge about COVID‐19 and its vaccines. Unfortunately, imposing the COVID‐19 vaccination as a compulsory measure has been poorly received by some migrants and refugees, making them more hesitant. [ABSTRACT FROM AUTHOR]

Background: Vaccination is efficacious at preventing influenza disease transmission, morbidity and mortality. Benefits of influenza vaccination for healthcare workers (HCW) are emphasized, yet vaccine uptake among HCW remains suboptimal. Mandatory vaccination programs may increase influenza vaccine uptake, however, attitudes and beliefs of HCW towards these mandates are not well known.Aims: This scoping review examined the attitudes and beliefs of HCW to ascertain the barriers and enablers to the implementation and acceptance of mandatory vaccination programs in healthcare settings.Design: Scoping review, guided by the PRISMA Extension for Scoping Reviews.Methods: Literature published between 2019 and 2023 was reviewed from five electronic databases, between June and October 2023.Data sources: Quantitative, qualitative and mixed-methods studies were obtained. Studies were limited to full-text English articles, published within peer-reviewed journals over the last five years. Data were extracted by both authors and documented using a modified version of the JBI’s scoping review data extraction instrument, and analyzed thematically.Results: The original search yielded 319 articles. Forty-two articles were screened, with 10 studies included. Most HCW had negative views towards mandatory influenza vaccination, influenced by geographical location, age and discipline. The protection of patients and affordability/accessibility of vaccination were described as enablers to the acceptance of mandatory measures. The belief that mandatory vaccination was a violation of autonomy and misconceptions concerning influenza transmission, vaccine mechanism of action, side effects and effectiveness, were described as common barriers.Conclusions: Health services must carefully consider the context in which mandatory vaccination programs are implemented and employ strategies that incorporate education and promote vaccine accessibility, affordability and HCW autonomy. The quality of evidence retrieved was moderate to poor, with high heterogeneity between studies. Minimal Australian research was evident, limiting the generalisability of findings. These results should be interpreted with caution and further high-quality research is recommended. [ABSTRACT FROM AUTHOR]

This contribution examines the compatibility of mandatory vaccination with the European Convention on Human Rights (ECHR) through an analysis of the relevant ECHR rights and related case law of the European Court of Human Rights (ECtHR). By focusing on Article 8 (Right to Private Life), Article 2 (Right to Life) and Article 9 (Freedom of Thought, Conscience and Religion) ECHR, we formulate conditions under which mandatory vaccination legislation is justified. With that, this analysis aims to provide national legislators with guidance on responsible legislative policy. Additionally, this article discusses the legal framework underlying the Dutch vaccination policy, including developments therein since COVID-19. Furthermore, the role of the European Union in the context of vaccination is briefly discussed. The importance of an extensive societal and parliamentary debate before implementing a mandatory vaccination policy is stressed, as is the need for proportionality in enforcement. [ABSTRACT FROM AUTHOR]

Decades of research have found African Americans to be unfairly marginalized by healthcare systems. As U.S. colleges released their plans to re-open for in-person classes for the Fall 2021 semester and beyond, research is needed into how African American students view vaccine mandates, such as the one levied in March 2021 by Rutgers University and many other institutions. Subsequently, the purpose of this study is to explore how African American students feel regarding vaccine mandates and a return to in-person learning. In all, this survey study engaged with 180 African American college students currently enrolled in postsecondary education in the United States. Results suggest Black women are more comfortable with COVID-19 vaccinations than Black men, and Black women are more willing to take the COVID-19 vaccine to return to in-person learning on campus. Implications of this work outline how Black women may return to in-person higher education at greater numbers than Black men, perhaps further marginalizing Black men from higher education. Students with disabilities and students attending 4-year institutions also expressed the most discomfort and least likelihood to take a COVID-19 vaccine if it were mandated. Implications for equity and campus safety are addressed. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic reached its second year, and vaccine mandates to return to work or school became a contested debate among leaders in health care organizations and universities, nursing academic and hospital leadership had to consider which health and safety requirements, including COVID-19 vaccines, were needed to return students, nurses, and nurse faculty to more typical clinical and classroom activities. In this context, this mixed-methods study surveyed and analyzed data from a large national sample of students, nurses, and faculty about their vaccine status, and reasons for their decisions to be vaccinated or not. Study findings point clearly to the need for better messaging in all public health campaigns, emphasizing the protection of others as the strongest predictor for vaccine uptake. [ABSTRACT FROM AUTHOR]

Background: Measles is a highly contagious disease with the potential for severe complications. Despite the availability of effective vaccines, there have been recurrent measles outbreaks in Germany over the past decades. In response, a new measles vaccine mandate was introduced on March 1, 2020, aimed at closing vaccination gaps in high-risk populations. This study evaluates the mandate's implementation, identifies operational challenges, assesses the impact of the Coronavirus disease 2019 pandemic, and investigates expert attitudes towards the new policy. Methods: Semi-structured expert interviews were conducted with staff members of 16 different local health departments in Germany. The interviews, carried out in April and May 2021, were electronically recorded, transcribed verbatim, and analyzed using the Framework method. Results: The implementation of the measles vaccine mandate in local health departments varied substantially. Challenges in implementing the mandate primarily arose from uncertainties regarding procedural specifics, such as handling fraudulent medical certificates and imposing sanctions, leading to a call from many interviewees for uniform guidelines to ensure coherent implementation. At the time the measles vaccine mandate came into force, managing the Coronavirus disease 2019 pandemic was a priority in most local health departments, often delaying the implementation of the mandate. Despite the difficulties encountered, most experts considered the mandate to be an effective step towards measles elimination. Conclusions: The measles vaccine mandate has imposed a new responsibility on staff in German local health departments, which is associated with implementation challenges such as procedural uncertainties and vaccine hesitancy, but also the Coronavirus disease 2019 pandemic as a contextual impediment. Significant differences in the implementation approach underscore the need for harmonization to enhance implementation efficiency and public acceptance of the mandate. Despite the mandate's potential to increase vaccination rates, our findings advocate for a comprehensive approach, incorporating public education, accessible vaccination, and measures to address social disparities. [ABSTRACT FROM AUTHOR]

This study investigates the association between parental attitudes towards mandatory and recommended vaccines in the National Immunization Plan (NIP) of Italy and their acceptance of the COVID-19 vaccine in children aged 5–11 years. Using data from approximately 42,000 children in Southern Italy, parental attitudes towards previous vaccinations were examined. Mandatory and recommended vaccinations were considered for the analysis, with the first shot of each schedule being considered relevant, regardless of when it was administered or whether the recommended number of doses was administered. A multivariate logistic regression was performed to analyze associations between the covariates of age, sex, adherence to mandatory vaccinations, number of recommended vaccinations, and COVID-19 vaccination. The COVID-19 vaccine acceptance rate was 50.7% in our sample. We revealed a strong association between parental attitudes towards previous vaccinations and the acceptance of the COVID-19 vaccine. Mandatory vaccinations under the NIP showed the highest acceptance rates, and among non-mandatory vaccines, the pneumococcal conjugate vaccine had the highest acceptance rate, potentially due to its co-administration with the hexavalent vaccine. The study identified a trend of lower COVID-19 vaccine coverage in younger children. The study underscores the importance of co-administration approaches and well-planned vaccination schedules in enhancing vaccine coverage. It suggests that integrating newer vaccines, like the COVID-19 vaccine, into established vaccination schedules could potentially increase acceptance and coverage. The findings highlight the urgency of addressing vaccine hesitancy, particularly in the pediatric population, to ensure high vaccination coverage and effective disease control. Further research is needed to explore the potential strategies to increase vaccine acceptance. [ABSTRACT FROM AUTHOR]

Background: Mandates provide a relatively cost-effective strategy to increase vaccinate rates. Since 2014, five Australian states have implemented No Jab No Play (NJPlay) policies that require children to be fully immunised to attend early childhood education and childcare services. In Western Australia, where this study was conducted, NJNPlay legislation was enacted in 2019. While most Australian families support vaccine mandates, there are a range of complexities and unintended consequences for some families. This research explores the impact on families of the NJNPlay legislation in Western Australia (WA). Methods: This mixed-methods study used an online parent/carer survey (n = 261) representing 427 children and in-depth interviews (n = 18) to investigate: (1) the influence of the NJNPlay legislation on decision to vaccinate; and (2) the financial and emotional impacts of NJNPlay legislation. Descriptive and bivariate tests were used to analyse the survey data and open-ended questions and interviews were analysed using reflexive thematic analysis to capture the experience and the reality of participants. Results: Approximately 60% of parents intended to vaccinate their child. Parents who had decided not to vaccinate their child/ren were significantly more likely to experience financial [p < 0.001] and emotional impacts [p < 0.001], compared to those who chose to vaccinate because of the mandate. Qualitative data were divided with around half of participants supporting childhood immunisation and NJNPlay with others discussing concerns. The themes (a) belief in the importance of vaccination and ease of access, (b) individual and community protection, and (c) vaccine effectiveness, safety and alternatives help understand how parents' beliefs and access may influence vaccination uptake. Unintended impacts of NJNPlay included: (a) lack of choice, pressure and coercion to vaccinate; (b) policy and community level stigma and discrimination; (c) financial and career impacts; and (d) loss of education opportunities. Conclusions: Parents appreciation of funded immunisation programs and mandates which enhance individual and community protection was evident. However for others unintended consequences of the mandate resulted in significant social, emotional, financial and educational impacts. Long-term evidence highlights the positive impact of immunisation programs. Opinions of impacted families should be considered to alleviate mental health stressors. [ABSTRACT FROM AUTHOR]

Using two qualitative data sources: free-text responses to an open-ended question of an online survey and subsequent interviews and focus groups, we explored perceptions and attitudes toward COVID-19 vaccination among health professional students enrolled in Australian universities during the pandemic with data collected from October 2021 to April 2022. Students provided free-text responses to the open-ended question (n = 313) in the online survey and participated in interviews or focus groups (n = 17). Data analysis revealed three themes, including perceptions of COVID-19 seriousness and the risk of contracting the virus, information dissemination, and attitudes toward the vaccine mandate. The study identified evolving perceptions of COVID-19 seriousness among Australian health professional students and their sentiments toward the vaccine mandate. There is a need to ensure the quality of information dissemination related to the vaccine mandate. This may not only support students' uptake of mandatory vaccination but also provide a means for them to address vaccination with healthcare consumers and patients. [ABSTRACT FROM AUTHOR]

This paper analyzes meaning constructions in picket signs containing My Body My Choice (MBMC) within Viewpoint Spaces network theory (Dancygier 2012). It is specifically concerned with multilayered conceptual structures where viewpoints are stacked in the construal of this picket sign slogan, which can be interpreted as: as it is about my body, it should be my choice that matters. To fully understand its use, the viewer requires several pieces of pertinent information, including, for instance, that those who use the phrase to protest vaccine mandates are unlikely to be those who would use it to support abortion rights, even though the phrase ostensibly expresses invariable support for every individual’s right to bodily autonomy. It provides an elaborate account of how multiple pieces of knowledge of different viewpoints, such as invoked frame knowledge of the abortion-rights movement and presupposed knowledge triggered by linguistic constructs, are stacked and (de-)compressed into the overall construal. [ABSTRACT FROM AUTHOR]

• COVID-19 vaccine mandates are controversial but proposed to increase vaccination. • 59% of vaccinated individuals who responded to a survey at a vaccine clinic in South Texas in the U.S. supported a COVID-19 vaccine mandate. • Significant racial, ethnic and age differences were found in mandate endorsement. • Demographic differences must be considered when promoting COVID-19 vaccination. Vaccine mandates are controversial, and people vary widely in their preferences to support or reject vaccine mandates. For some, vaccine mandates represent a commitment to reduce harm and support public health. For others, vaccine mandates are viewed as a threat to individual freedom and a violation of personal choice. This manuscript investigated support for a COVID-19 vaccine mandate among COVID-19-vaccinated individuals and identified differences by demographic characteristics and COVID-19 experience. Cross-sectional surveys were given to COVID-19-vaccinated individuals at a vaccination clinic in South Texas in the U.S. with the goal of identifying attitudes, beliefs, and perceptions about COVID-19 vaccination and willingness to support a COVID-19 vaccination mandate. Associations of interest were analyzed using descriptive statistics. Approximately half of the sample was of Hispanic or Latino origin (48 %); most respondents identified as White (59 %), followed by 12 % who identified as Asian. Overall, 59 % of participants supported the possibility for a COVID-19 vaccine mandate. Preliminary data showed significant racial differences in willingness to support a possible COVID-19 vaccine mandate (χ 2 (1, n = 893) = 26.7, p <.001, phi =.17); 80 % of Asian people reported support for COVID-19 vaccination mandate compared to 50 % to 57 % for other racial groups. Significant differences also emerged by ethnicity (χ 2 (4, n = 1033) = 7.12, p =.008, phi =.08) whereby a higher percentage of Latino participants (66 %) reported willingness to support a COVID-19 vaccine mandate. Similarly, significant differences were found by age (χ 2 (4, n = 1045) = 20.92, p <.001, phi =.21), yet no significant differences were found by sex or previous COVID-19 diagnosis. Support for a COVID-19 vaccination mandate is controversial even among vaccinated people. Identifying and understanding cultural and contextual factors that underlie differences in attitudes and beliefs about COVID-19 vaccination mandates is essential to advance dialogue and inform educational health campaigns to increase COVID-19 vaccination rates. [ABSTRACT FROM AUTHOR]

With heated political and public debate over government vaccine mandates, COVID‐19 offers an opportunity to better understand the role of policy justifications on people's perceptions towards a policy. Through this study, we aim to move beyond the partisan and ideological arguments for and against vaccine mandates to illustrate how individuals' worldviews, based on Cultural Theory, can better explain why people have different perceptions towards vaccine mandates. Using the judiciary and judicial reasoning as the setting, and controlling for individuals' preexisting opinion on COVID‐19 vaccines, we hypothesize that people who prefer vaccine mandates will agree with judicial reasoning that appeals towards individualistic and hierarchical statements. Additionally, we hypothesize that those who have confidence in the judiciary will agree with individualistic and hierarchical statements. To test this hypothesis, we conducted a conjoint survey experiment through Amazon Mechanical Turk. The results confirm the hypotheses. [ABSTRACT FROM AUTHOR]

Public support for and voluntary compliance with protective policy measures are crucial to mitigating the spread of infectious disease. However, it is unclear why and how people with diverse cultural biases support particular protective policies. Relying on the Cultural Theory (CT) of risk, we hypothesize that value congruence with social distancing and a vaccine mandate during the COVID‐19 pandemic influences the level of public support for and compliance with these protective policies. Analyzing a Chinese nationwide sample, we find that the effects of cultural biases on public support and compliance vary not only with cultural biases but by how these are mediated through value congruence with particular protective policies. As hypothesized, hierarchical cultural biases increase public support for and compliance with social distancing and a vaccine mandates both directly and (indirectly) through value congruence. By contrast, as hypothesized, fatalistic cultural biases decrease public support for and compliance with social distancing both directly and (indirectly) through lack of value congruence and individualistic biases decrease public support for and compliance with social distancing and a vaccine mandate both directly and (indirectly) through lack of value congruence. However, the hypothesized effects of fatalistic biases did not hold for the vaccine mandate. We discuss reasons why these latter hypotheses regarding the vaccine mandate were not validated and suggest that risk analysts and communicators do more to discover and explain why particular protective policies are congruent with diverse cultural values. [ABSTRACT FROM AUTHOR]

A vaccination, when understood and applied correctly, is an effective medicinal intervention. The latter is just a part of a multifactorial management protocol for the prevention and control of infectious diseases. The vaccination against Equine Herpesvirus 1 (EHV-1) has, since 1 January 2023, become a prerequisite for the participation of horses in competitions according to the rules of the German Equestrian Federation. This regulation was introduced as a result of the incidents especially those sequelae with symptoms of EHM at and around an international longterm event in Valencia in 2021, which reoccurred in 2023. National racing authorities for thoroughbreds and standardbreds also introduced mandatory vaccination against EHV-1 for starters in their races. This has been introduced partly due to the incidents mentioned or are a reaction to the implementation of compulsory vaccination in other countries due to singular incidents. How the different regulatory bodies within their sphere of responsibility arrived at the decision to proscribe vaccination against EHV-1 remains unclear due to a lack of transparency. Only the Fédération Equestre International (FEI: International Federation for Equestrian Sports) has had the opportunity to review the incidents. To date, the FEI has not yet introduced a compulsory vaccination programme. The (not new) fact that the cases of horses that fell sick, especially those with symptoms of EHM, in Valencia in 2021 and 2023 did not allow a distinction to be made between vaccinated and unvaccinated horses may also contribute to this. It remains unclear “why” and “why now” a cause outside Germany can be enough to react with an inadequate measure: the compulsory vaccination against EHV-1. Another fundamental question could be whether this event is suitable as an example of contemporary history to describe the political struggle to assert one’s own interests (against the “interests” of equine health) with recourse to science that acts arbitrarily. The following explanations are intended to provide a factual, technical presentation [1] of the considerations and the resulting obligations from which no vaccination obligation can arise as a result. In particular, neo-democratic references to the legality of the “majoritarian sovereignty of interpretation” are neglected here. [ABSTRACT FROM AUTHOR]

Laws mandating vaccination against Covid-19 as a condition of employment in health and care sectors were commonplace during the pandemic. Using weekly data at the local authority level, we examine the impact of the vaccine mandate for elderly care homes in England on vaccine take-up, staffing levels, and mortality. Our identification strategy involves (1) comparing take-up and staffing in English elderly care homes relative to other social care settings unaffected by the mandate; (2) comparing take-up and staffing in English elderly care homes relative to those in Wales where the mandate also did not apply; and (3) comparing Covid-19 mortality among English elderly care home residents relative to mortality in domestic homes in England and to care homes in Wales. Our results suggest that the mandate substantially decreased the proportion of care home workers who remained unvaccinated (equivalent to between 28,000 and 41,000 fewer unvaccinated staff), but this came at the cost of a reduction in staffing levels of between 3% and 4% (equivalent to 14,000 to 18,000 staff). We observe this effect most strongly in areas of low unemployment. Our results do not provide evidence that the vaccine mandate was successful in its primary aim of reducing care home deaths. Relatively wide confidence intervals mean inferences regarding mortality are more uncertain than for vaccination uptake and staffing. This paper was accepted by Carri W. Chan, healthcare management. Supplemental Material: The data and e-companion are available at https://doi.org/10.1287/mnsc.2023.4832. [ABSTRACT FROM AUTHOR]

The impact of COVID-19 measures on airport performance is obvious, and there have been numerous studies on this topic. However, most of these studies discuss prevention measures, the effects on airport operations, forecasts of economic impacts, changes in service quality, etc. There is a lack of research on the effects of various prevention measures on airport operations and the interrelationships between these measures. This study focuses on addressing this gap. In this study, an integrated approach is devised that combines the decision-making trial and evaluation laboratory (DEMATEL) method and interpretive structural modeling (ISM). This integrated method is useful for exploring the relationship between pandemic measures and airport performance as well as the complex relationship between them, and the combination of methods improves upon the shortcomings of the original models. This study reveals that mandating vaccination certificates for entry into a country is the most significant measure affecting airport performance. Additionally, aircraft movement at the airport has the greatest overall impact and can be considered the most crucial factor influencing airport performance from an operational standpoint. The findings show that both factors directly influence financial performance, as reflected in the net income. Some management implications are provided to mitigate the consequences of the measures taken to counter the pandemic crisis. This integrated approach should also assist authorities and policy-makers in planning cautious action for future crises. [ABSTRACT FROM AUTHOR]

This article argues that the liberalism of fear provides a useful theoretical framework for public health ethics in two fronts. First, it helps reconcile the tension between public health interventions and liberal politics. Second, it reinforces the existing justifications for public health interventions in liberal political culture. The article discusses this in the context of political emotions in the COVID-19 pandemic. Fear plays a central role in the experiences of pandemic politics, and such fear is extended to the concern that post-pandemic government would normalize emergency politics and threaten the political culture of liberal democracy. The article proposes that the liberalism of fear provides a theoretical solution not only to alleviate such fear, but also to reconcile the long-established tension between liberal politics and public health intervention. This is particularly so if the liberalism of fear's characteristic of political realism is taken into account. The article makes two points about this, and discusses their pragmatic implications in the case of compulsory vaccination. [ABSTRACT FROM AUTHOR]

This article introduces and explores the 3.5-million-word Victorian Anti-Vaccination Discourse Corpus (VicVaDis). The corpus is intended to provide a (freely accessible) historical resource for the investigation of the earliest public concerns and arguments against vaccination in England, which revolved around compulsory vaccination against smallpox in the second half of the 19th century. It consists of 133 anti-vaccination pamphlets and publications gathered from 1854 to 1906, a span of 53 years that loosely coincides with the Victorian era (1837–1901). This timeframe was chosen to capture the period between the 1853 Vaccination Act, which made smallpox vaccination for babies compulsory, and the 1907 Act that effectively ended the mandatory nature of vaccination. After an overview of the historical background, this article describes the rationale, design and construction of the corpus, and then demonstrates how it can be exploited to investigate the main arguments against compulsory vaccination by means of widely accessible corpus linguistic tools. Where appropriate, parallels are drawn between Victorian and 21st-century vaccine-hesitant attitudes and arguments. Overall, this article demonstrates the potential of corpus analysis to add to our understanding of historical concerns about vaccination. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States; yet, despite the availability of safe and effective HPV vaccines, only half of eligible adolescents have completed the vaccine series. School-entry requirements are one proven strategy to increase vaccination rates among children and youth and reduce the burden of HPV-related cancer. This study investigated community perceptions of an HPV vaccine school-entry mandate in Virginia and the consequences of a low threshold exemption option included in the legislation. We conducted 40 interviews with community members including 15 interviews with parents, 19 with healthcare providers, and 6 with community leaders. Interviews asked about knowledge, beliefs, and attitudes concerning the HPV vaccine and mandate. Interviews were recorded, transcribed, and thematically analyzed. Despite healthcare provider support for the mandate, there was widespread confusion over the school-entry policy and concern that the exemption option undermined vaccination efforts. Understanding variations in community-level perceptions and response to school-based vaccination mandates is crucial for designing effective public health strategies. Findings suggest statewide vaccination initiatives should preemptively identify low uptake areas and provide targeted information to communities. Future mandates should avoid the use of ambiguous and contradictory language in vaccine-related legislation. [ABSTRACT FROM AUTHOR]

Vaccination against measles is one of the most effective public health interventions which has saved millions of lives and interrupted circulation of the natural virus in the population. However, it is widely accepted that the immunity after vaccination can wane, especially in those who have had no contact with the virus. This study aimed to classify the particular birth cohorts of adults with regard to their exposure to the wild measles virus in the population with a long history of mandatory vaccination. We introduced two methods. In the first, we estimated the probability of exposure to the wild virus through an analysis of antibody levels from the Immunologic Survey performed in the Slovak Republic in 2018, while the second was based on historical epidemiological data. Both methods resulted in similar estimations. Cohorts born in Slovakia before 1964 can be considered to be cohorts in which most people were exposed to the wild measles virus. Cohorts born after 1977 can be designated as cohorts that most likely did not come into the contact with the wild virus. Cohorts born between 1965 and 1976 are composed of a mixture, with a decreasing proportion of people exposed to the wild virus with increasing year of birth. The proposed methods can help identify potential immunity gaps in the adult population. They can be applied in other countries with high measles vaccination coverage to estimate the probability of exposure to the wild measles virus in particular birth cohorts. [ABSTRACT FROM AUTHOR]

Introduction: Since the beginning of the pandemic, numerous public health measures such as COVID-19 vaccines, vaccine mandates and vaccination certificates have been introduced to mitigate the spread of COVID-19. Public opinion and attitudes towards these measures have fluctuated in response to the dynamic political, social, and cultural landscape of the pandemic. Methods: We conducted a time-series study consisting of national cross-sectional surveys between November 2021 to March 2022 to evaluate the Canadian public's attitudes towards COVID-19 vaccine mandates and vaccine certificates. Results: When examining public sentiment towards COVID-19 vaccine certificates and proof of vaccination measures, there was a shift in responses over time. The proportion of participants "strongly supporting" these measures decreased from 66.0 to 43.1% between W25(Capacity Limits), −W32 (Mask Mandate Removed), whereas "strongly oppose" was the second most common response and rose from 15.9 to 20.6% during this same time period. Concurrently, when examining participants views surrounding mandates, many participants believed that their province was reopening at "about the right pace", which remained relatively stable over time (33.0–35.4%) between W28 (Emergency Act)–W32 (Mask Mandate Removed). Conclusion: Our study's findings on the public's attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada may aid to guide and streamline the implementation of future similar public health interventions. Future research should include extended follow-up and a more comprehensive examination of trust in government institutions and polarized perspectives on vaccine mandates. [ABSTRACT FROM AUTHOR]

Background: The coronavirus (COVID-19) pandemic profoundly impacted patient care across the United States. Objective: To examine nursing staffs' perceptions of the COVID-19 vaccine using the Health Belief Model (HBM) as a theoretical framework. Methods: A cross-sectional, anonymous, web-based survey was completed by practicing nursing staffs throughout the United States. Analyses involved descriptive and comparative statistics. Results: Of the 294 nursing staff who completed surveys, 50% were between 18 and 37 years of age, and 73.1% were registered nurses, with 49.3% employed in a hospital setting. Nursing staff reported their primary reason for vaccination was concern for others (mean: 84.44; SD: 28.26), vaccine prevents spread (mean: 81.85; SD: 28.94), and own health (mean: 79.63; SD: 30.0). Influencing factors that predicted vaccination included age, Wilks' Λ = 0.76, F (32, 919.86) = 2.20, p <.001, η2partial = 0.066, and the vaccine mandate, Wilks' Λ = 0.63, F (8, 249) = 18.61, p <.001, η2partial = 0.374. Conclusion: Nursing staffs' perceptions using the HBM as a theoretical framework provided insight into their decisions to receive the COVID-19 vaccine. Further research is warranted to examine nurses' attitudes and factors that influence their decision-making regarding vaccination. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, some US states mandated vaccination for certain citizens. We used state-level data from the CDC to test whether vaccine mandates predicted changes in COVID-19 vaccine uptake, as well as related voluntary behaviors involving COVID-19 boosters and seasonal influenza vaccines. Results showed that COVID-19 vaccine adoption did not significantly change in the weeks before and after states implemented vaccine mandates, suggesting that mandates did not directly impact COVID-19 vaccination. Compared to states that banned vaccine restrictions, however, states with mandates had lower levels of COVID-19 booster adoption as well as adult and child flu vaccination, especially when residents initially were less likely to vaccinate for COVID-19. This research supports the notion that governmental restrictions in the form of vaccination mandates can have unintended negative consequences, not necessarily by reducing uptake of the mandated vaccine, but by reducing adoption of other voluntary vaccines. [ABSTRACT FROM AUTHOR]

• Healthcare vaccine mandates were broadly effective in increasing vaccination uptake. • The effect of the mandates on healthcare worker (HCW) COVID-19 infection is not well studied. • The mandates did not lead to major service disruptions in most settings. • Uptake and staffing were more impacted in rural areas and among HCWs from minority groups. The rapid development of COVID-19 vaccines is a cornerstone in the global effort to combat the pandemic. Healthcare workers (HCWs), being at the forefront of the pandemic response, have been the focus of vaccine mandate policies. This review aims to evaluate the impacts of COVID-19 vaccine mandates among HCWs, a critical step in understanding the broader implications of such policies in healthcare settings. The review seeks to synthesize available literature to contribute to greater understanding of the outcomes associated with COVID-19 vaccine mandates for HCWs including vaccine uptake, infection rates, and staffing. A systematic search of relevant literature published from March 2020 to September 2023 was conducted. The Newcastle-Ottawa scale was employed for quality assessment of the included articles. A total of 4,779 publications were identified, with 15 studies meeting the inclusion criteria for the review. A narrative synthesis approach was used to analyze these studies. COVID-19 vaccine mandates for HCWs were broadly successful in increasing vaccine uptake in most settings. Although the penalties imposed on unvaccinated HCWs did not lead to major disruption of health services, less well-resourced areas may have been more impacted. Furthermore, there is insufficient literature on the impact of the vaccine mandate on reducing SARS-CoV-2 infection among HCWs. COVID-19 vaccine mandates for HCWs have significant implications for public health policy and healthcare management. The findings underscore the need for tailored approaches in mandate policies, considering the specific contexts of healthcare settings and the diverse populations of HCWs. While mandates have shown potential in increasing vaccine uptake with minimal impacts to staffing, more work is needed to investigate the impacts of mandates across various contexts. In addition to these impacts, future research should focus on long-term effects and implications on broader public health strategies. [ABSTRACT FROM AUTHOR]

To inform the dynamic adjustments of vaccination campaigns, this study examined the transitions among vaccine hesitancy profiles over the COVID‐19 pandemic progression and their predictors and outcomes. The transition patterns among hesitancy profiles over three periods were identified using a latent transition analysis with individuals from a longitudinal cohort study since the emergence of COVID‐19 in Hong Kong. Four profiles (i.e., skeptics, apathetics, fence‐sitters, and believers) emerged consistently over time. From Period 1 (third and fourth pandemic waves) to Period 2 (dormant period, vaccine rollout), 14.17% of believers became fence‐sitters (ambivalization), and 12.11% of fence‐sitters became apathetics (apathetization). From Period 2 to Period 3 (omicron surge and vaccine mandates), 20.21% of believers became fence‐sitters. Lower trust in government predicted a transition to skepticism, whereas higher trust predicted the opposite. Staying as believers was associated with decreased hygienic and social distancing behavior. The stable hesitancy profiles amid the rapid vaccine uptake suggest that structural factors rather than personal agency may drive the surge. Ambivalization and apathetization may signal disengagement in preventive behaviors. Trust in the government is crucial in the pandemic response. Public health interventions may improve compliance with guidelines and prevent skepticism and apathy. [ABSTRACT FROM AUTHOR]

Objective: Governments use vaccination mandates, of different degrees of coerciveness, to encourage or require childhood vaccination. We elicited the views of well‐informed community members on the public acceptability of using childhood vaccination mandates in Australia. Methods: Four community juries were conducted in Canberra, Launceston, Cairns and Melbourne, Australia between 2021 and 2022. We recruited 51 participants from diverse backgrounds, genders and ages through random digit dialling and social media. Two juries were held in metropolitan areas, and two in regional/rural settings. Outcome measures included jury verdicts and reasons in response to structured questions. Results: All juries were concerned about collective protection and individual rights but prioritised the former over the latter. A majority in all juries supported mandates but juries disagreed with respect to the appropriate mandate types. All juries endorsed using the least restrictive or coercive means to encourage vaccination (providing incentives or education, e.g.) before imposing penalties such as financial losses and school exclusions. The overriding view was that it is fairer to place a direct burden on parents rather than children and that mandates should be designed to avoid inequitable impacts on less advantaged groups in society. Many jurors found conscientious objection acceptable as a controlled option for resolute refusers, provided that overall vaccination coverage remains high. Conclusion: This paper gives policymakers access to the reasons that Australians have for supporting or opposing different mandates under conditions of high knowledge, understanding and deliberation regarding policy options. Sustaining high rates of vaccination requires high levels of co‐operation between governments, public health actors and the public. Our findings highlight the importance of considering public values in the design and implementation of vaccination mandates. Patient and Public Involvement: We sought input from individuals who did and did not vaccinate during the study design. The views and perspectives of nonvaccinating parents were presented in the evidence to juries. We deliberately excluded nonvaccinating individuals from participating, as the divisive and often hostile nature of the topic, and their minority status, made it difficult to ensure they would feel safe as members of the jury without overrepresenting their perspective in the sample. Two related projects engaged directly with these parents. [ABSTRACT FROM AUTHOR]

• Austria, Italy and Greece announced a vaccine mandate during the COVID-19 pandemic. • In Italy and Greece, mandates rapidly increased vaccination rates among the elderly. • This effect was apparent after mandate announcement, rather than its implementation. • Mandates did not close the vaccination gap; many people remained unvaccinated. • Vaccine mandates appear to address complacency, but not vaccine hesitancy. During the COVID-19 pandemic, three European countries (Austria, Greece, Italy) announced and/or implemented mandatory COVID-19 vaccination for high-risk groups in the general population. Besides the ethical justification for this policy, it is important to assess and quantify the effectiveness of the mandate in raising vaccination rates. Controlled interrupted time series analysis of first-dose vaccination rates in the targeted age groups (Greece: ≥60 years; Italy: ≥50 years) relative to a control group (Greece: 50–59 years; Italy: 25–49 years) between week 35/2021 and week 50/2022. For Austria an uncontrolled analysis was performed, as the vaccine mandate targeted all adults ≥18 years. Announcement of mandatory vaccination substantially increased vaccination rates in the targeted age groups compared to control in both Greece (RR = 4.36, 95 % CI: 3.57–5.32) and Italy (RR = 2.90, 95 % CI: 2.37–3.56), an effect which persisted throughout the study period. There were 176,428 (95 % CI: 164,097–187,226) mandate-attributable first-dose vaccinations in Greece and 316,192 (95 % CI: 282,467–346,678) in Italy, most of which occurred before the mandate came into effect. In Austria no discernible increase in vaccination rates was observed after the announcement of mandatory vaccination. At the end of the study period, 9.5 % of ≥60 year-olds in Greece, 4.9 % of ≥50 year-olds in Italy and 13.8 % of ≥18 year-olds in Austria remained unvaccinated. In Greece and Italy – though not in Austria – simple announcement of a vaccine mandate rapidly increased COVID-19 vaccination rates in the targeted age groups, without fully closing the vaccination gap. Mandatory vaccination appears to effectively target complacency but not vaccine hesitancy, and its public health benefits need to be weighted against possible detrimental effects on confidence and trust. [ABSTRACT FROM AUTHOR]

Objective This paper highlights the occupational risk of Q fever from exposure to raw animal products in the context of multiple notified Q fever cases from 2020 to 2023 linked to four pet food manufacturing facilities in South-East Queensland, Australia. Methods The Queensland Government Notifiable Conditions System was used to identify Q fever cases linked to pet food manufacturing in the Metro North and Gold Coast Hospital and Health Service areas of Brisbane, Australia. Data on each case from routine public health follow-up were collected and descriptively analysed. Results Between 2020 and 2023, 12 confirmed Q fever infections (17% of total cases) were linked to four pet food manufacturing facilities. Eleven cases reported direct or environmental exposure to raw meat and animal products. None were previously vaccinated for Q fever. Conclusion These cases demonstrate the increased risk of Q fever infection as part of the pet food manufacturing process, highlighting an underappreciated preventable occupational risk, which can be mitigated with the use of pre-screening and vaccination of workers. All occupations should conduct workplace-based risk assessments to identify risks such as Q fever to prevent adverse negative health outcomes. [ABSTRACT FROM AUTHOR]

One of the largest public sector operations in the world is within the United States of America military, with over 2 million service members and approximately 1.4 million full-time equivalent civilian workers, with bases and operations in at least 80 different nations. The US military made COVID-19 vaccinations (COVAX) mandatory among all members but allows for requests to accommodate refusals for reasons of personal beliefs. These can be beliefs of conscience, personal morality or religious expression, whether from organized or individual tenets. Multiple articles have been produced during the COVID-19 pandemic identifying willingness to receive COVAX or reasons for COVAX reluctance and refusal, but almost all data has been obtained from short-response surveys. Taking a departure from that, this study reviews the qualitative data from over 100 extensive interviews conducted with individual military members (from the US Air Force) who requested COVAX exemption. Their reasons given to refuse vaccination are also provided in a letter written by the member, regardless of rank, directly to the general at the top of their particular command. Examination of the reasons given provides unique insights into the thought processes of requestors. Regardless of the request’s outcome, this data demonstrates the administrative and policy importance placed by the US military on at least considering personal beliefs, even in a pandemic, and protecting individual freedoms, even of military members with curtailed rights. By far, disproportionate requests came from lower ranks with some mid-level leadership making formal requests to refuse the COVAX. In this sample, no top leadership requested exemptions. The analysis finds evidence for pressure exerted on members to not submit an exemption request. For those who did, the 111 requests were not a static or set doctrinal view. Arising from at least 29 distinct religious traditions, all requests showed signs of an emerging or developing sense of belief praxis in the face of new situations. Other dominant patterns also emerged. The study found critical objections to the use of fetal stem lines in developing available vaccines and concerns about potential vaccine side effects to the requestor’s body. Trust in the process and a sense of autonomy in participation also were found to be critically import to most requests. [ABSTRACT FROM AUTHOR]

Over decades, vaccination has been proven to be a successful strategy to combat the spread of infectious diseases such as measles, tetanus, and polio amongst children and adults. When the COVID-19 pandemic emerged the biotech industry have put out a historical effort into developing vaccines to contain the pandemic. These vaccines have shown high efficacy in preventing disease transmission and associated risks. However, misinformation and lack of trust have caused a large proportion of the population to be skeptical about these vaccines. Authorities of different nations have established numerous policies to increase vaccination coverage, however in many areas mandates have not been well received. People's views on vaccinations are immensely impacted by their society and cultural beliefs, and enforcing mandates, although beneficial, may have negative consequences. This review discusses the COVID-19 vaccines from cultural and societal aspects; the main reasons withholding the public from receiving vaccination; the human rights angle of enforcing vaccination; and the challenges and prospects of establishing vaccine mandates. [ABSTRACT FROM AUTHOR]

Public protests need to communicate their aims to an audience, and the audience must make sense of the message. Initially this article was planned as a visual analysis of protest signs and placards. But to avoid 'reproduc[ing] the privileged position of sight and vision over other ways of knowing', we attend to the contested relations between signification, power, and all the senses. The sounds, smells, sights, tastes, and textures found at protests by groups such as Extinction Rebellion, Occupy, and the gilets jaunes, and on issues including women's rights, nuclear power, immigration detention, Covid-19 lockdowns and vaccination mandates. Through ethnographic documentation of protests and the 'live' coverage broadcast in social and news media, our investigation of activities, scenes, signs, and participants reveals, firstly, that public dissent communicates through multiple sensory dimensions, and, secondly, that the senses of street-based protests are inextricably intertwined with sensory control tactics used against protesters in the policing of events. [ABSTRACT FROM AUTHOR]

The present study analyzed the structural and the content complexity of 76 preservice science teachers' socioscientific argumentation in the context of a mandatory COVID-19 vaccination. Data were analyzed within the methodological frame of qualitative content analysis. Concerning the structural complexity, the participants' socioscientific argumentation reached a relatively high level (i.e., justifications with elaborated grounds). Concerning the complexity of content, the sample referred to science-, ethics-, society-, and politics-related arguments (i.e., almost the full range of content areas); however, on an individual level, participants referred to merely an average of two content areas. Regarding the relationship between structural and content complexity, a significant positive correlation was found. In sum, the results of this study suggest that preservice science teachers' socioscientific argumentation is on a promisingly high level in terms of structural and on a medium level regarding content complexity. The findings are discussed and implications for science teacher education and assessment in science education are proposed. [ABSTRACT FROM AUTHOR]

While the San Francisco Bay Area counties rank very low in vaccine hesitancy and high in vaccination rates when compared to national numbers, Solano County has the most residents who are hesitant (6.3%) and the least who are fully vaccinated (51.6%) among Bay Area counties, according to the CDC. No studies to date have been able to provide the in-depth, localized information that would inform county-level public health interventions. This study aims to explore reasons and consequences for remaining unvaccinated in Solano County. Using a qualitative in-depth interview approach, we conducted 32 interviews with unvaccinated adults from Solano County. We used a grounded theory approach to our analysis. Using the socio-ecological model as a framework, we found that reasons for not getting vaccinated were primarily structural (mistrust of public information) and individual (bodily autonomy, personal choice) while consequences were primarily interpersonal (discrimination and stigma from friends, family, and employers). An overarching theme was that the vaccine rollout and messaging felt like an encroachment on personal choice and the feeling of being forced created more mistrust. Participants reported feeling like their decisions made them minorities among their colleagues, friends and family and that they were not persuaded by groupthink or by their relationships. Future public health responses to epidemics and pandemics might consider if a vaccine mandate is the best approach for reaching all county residents. [ABSTRACT FROM AUTHOR]

• 76% of parents had at least one school-related concern during the COVID-19 pandemic. • Over half of parents worried their child's learning declined during the pandemic. • Some COVID-19 and school parental concerns made child vaccination more likely. • A hypothetical vaccine mandate may increase parent likelihood of child vaccination. We assessed the impact of a hypothetical school-entry COVID-19 vaccine mandate on parental likelihood to vaccinate their child. We collected demographics, COVID-19-related school concerns, and parental likelihood to vaccinate their child from parents of patients aged 3–16 years seen across nine pediatric Emergency Departments from 06/07/2021 to 08/13/2021. Wilcoxon signed-rank test compared pre- and post-mandate vaccination likelihood. Multivariate linear and logistic regression analyses explored associations between parental concerns with baseline and change in vaccination likelihood, respectively. Vaccination likelihood increased from 43% to 50% with a hypothetical vaccine mandate (Z = -6.69, p < 0.001), although most parents (63%) had no change, while 26% increased and 11% decreased their vaccination likelihood. Parent concerns about their child contracting COVID-19 was associated with greater baseline vaccination likelihood. No single school-related concern explained the increased vaccination likelihood with a mandate. Parental school-related concerns did not drive changes in likelihood to vaccinate with a mandate. [ABSTRACT FROM AUTHOR]

Direct support professionals (DSPs) are at increased risk of contracting COVID-19. A four-wave survey series was conducted, in part, to understand DSPs' COVID-19 vaccination experiences. Fourth wave data were used to compare those vaccinated against COVID-19 when they became eligible (early adopters) and those waiting at least three months before vaccination (in-betweeners). Findings indicated that in-betweeners were more likely to be female, younger, and people of color with lower education levels and annual incomes, with employers requiring COVID-19 vaccination to remain employed. COVID-19 vaccination motivators included protection for self, family, or people supported; an employer who mandated COVID-19 vaccination; and having had COVID-19 or knowing someone who did. [ABSTRACT FROM AUTHOR]

In all Western countries, the vaccination campaign against COVID-19 encountered some resistance. To overcome vaccine inertia and hesitancy, governments have used a variety of strategies and policy instruments. These instruments can be placed on a 'ladder of intrusiveness', starting from voluntary tools based on simple information and persuasion, through material incentives and disincentives of varying nature and magnitude, to highly coercive tools, such as lockdown for the unvaccinated and the introduction of the vaccination mandate. Italy's experience during the vaccination campaign against Covid provides an ideal observational point for starting to investigate this issue: not only was Italy among the top countries with the highest percentage of people vaccinated at the beginning of 2022, but—at least compared to other European countries—it was also one of the countries that had gradually introduced the most intrusive measures to increase vaccination compliance. In the article the different steps of the 'intrusiveness ladder' are presented, providing examples from various countries, and then tested on the Italian Covid-19 vaccination campaign between 2021 and the first months of 2022. For each phase of the campaign, the instrument mixes adopted by the Italian government are described, as well as the contextual conditions that led to their adoption. In the final section, an assessment of the composition and evolution of the Italian vaccination strategy is provided, based on the following criteria: legitimacy, feasibility, effectiveness, internal consistency and strategic coherence. Conclusions highlight the pragmatic approach adopted by the Italian government and underline the effects—both positive and negative—of scaling up the intrusiveness ladder. [ABSTRACT FROM AUTHOR]

In 2017, Carson and Flood outlined a general duty to be vaccinated, arguing from Catholic social teaching on justice, love, solidarity and the common good. This necessarily relied on assumptions about the typical nature of vaccination, assumptions which do not always hold true in concrete situations. I identify twelve criteria that, where they hold, strengthen the particular duty to be vaccinated, and, if not met, weaken or reverse it. These pertain to the biological agent which vaccination aims to protect against, the vaccine and its supply, the costs and benefits of vaccination to the individual and society, and the alternative courses of action. The two-way relationship between the moral duty to be vaccinated and vaccine mandates is discussed. Individuals and policy-makers need to know these criteria – and be provided the necessary information to evaluate vaccination against them – in order to make a truly rational judgement. [ABSTRACT FROM AUTHOR]

COVID-19 vaccinations are critical for mitigating outbreaks and reducing mortality for skilled nursing facility (SNF) residents and staff, yet uptake among SNF staff varies widely and remains suboptimal. Understanding which strategies are successful for promoting staff vaccination, and examining the relationship between vaccination policies and staff retention/turnover is key for identifying best practices. We conducted repeated interviews with SNF administrators at 3-month intervals between July 2020 and December 2021 (n = 156 interviews). We found that COVID-19 vaccines were initially met with both enthusiasm and skepticism by SNF staff. Administrators reported strategies to increase staff vaccine acceptance, including incentives, one-on-one education, and less stringent personal protective equipment requirements. Federal and state vaccination mandates further promoted vaccine uptake. This combination of mandates with prioritization of the vaccine by SNFs and their leadership was successful at increasing staff vaccination acceptance, which may be critical to increase staff booster uptake from its current suboptimal levels. [ABSTRACT FROM AUTHOR]

Growing vaccination hesitancy is well-document among humans. However, we know very little about vaccination hesitancy for pets as well as whether the two phenomena are interconnected. Moreover, support for pet vaccination requirements also remain underassessed. We fielded a large, national survey (N = 3,958) on August 18 and August 19, 2023, to assess U.S. public opinion about the vaccination status of dogs (rabies, canine parvovirus, canine distemper, canine influenza, and Lyme disease) and cats (rabies, feline panleukopenia (parvo), feline herpesvirus-1, feline chlamydia, and feline Bordetella) in the United States. We also queried respondents about their support for vaccination requirements for the 10 diseases. We find that the vast majority of cats and dogs are vaccinated. However, a substantial minority of pets is not, particularly for cats and for non-core vaccines. We find that attitudinal measures of human and pet vaccine hesitancy are closely related to each other. Moreover, they are strong predictors of vaccine behavior. Measures of vaccine hesitancy are also strong predictors of support for vaccination mandates. Common measures used to assess human vaccine hesitancy showed inconsistent effects. However, pet vaccinations appear to be less politically polarizing. The high correlation between pet and human measures raises the stake for public health efforts to improve attitudes about vaccines and vaccination rates across the board. Strong support for vaccination requirements should encourage policymakers to explore policy change. Moreover, veterinarians and their associations should consider expanding the number of core vaccinations. [ABSTRACT FROM AUTHOR]

Vaccination mandates have long been an effective tool in increasing vaccination rates and reducing the potential for disease outbreaks. In the wake of COVID-19, opposition to mandates in the K-12 setting has garnered more attention, and policymakers opposed to them have become more active. This study sought to assess whether these efforts are supported by the U.S. public. We fielded a large, national survey (N = 16,461) from January to April of 2022 to assess U.S. public opinion about seven specific vaccination mandates (diphtheria, tetanus, & pertussis (DTaP); polio; chickenpox; measles, mumps, and rubella (MMR); hepatitis; human papillomavirus (HPV); and COVID-19) in K-12 educational settings. We found that Americans are overwhelmingly supportive of all vaccination mandates with support ranging from a high 90 percent of respondents for DTaP, polio, chickenpox, and MMR to a low of 68 percent for COVID-19. Individuals who deemed vaccines safe and important, those with trust in the National Institutes of Health and the Food and Drug Administration, urban residents, and ethnic and racial minorities tended to be consistently more supportive. Perceptions about vaccine effectiveness were positively associated with mandate support in most cases, as was trust in medical doctors. Respondents who believed that vaccines cause autism, those with better health and more trust in religious leaders tended to be consistently more opposed. Women were generally more supportive of mandates except for HPV and COVID-19. Ideology and partisanship affected opinion for COVID-19 as did trust in the Centers for Disease Control and Prevention. We found no effects for income or education. Vaccination mandates in K-12 have broad support among the American public, even in more controversial cases such as HPV and COVID-19. Vocal opposition and growing interest by policymakers to limit or undo vaccination mandates are not supported by the broader public. [ABSTRACT FROM AUTHOR]

• 43 % of WHO member states have school vaccine mandates, but policy details vary. • Some mandates have begun to include education components for non-vaccinating parents/guardians. • Currently, education components are used only in Canada and the U.S.; most are online modules. • Evidence suggests in-person counseling is associated with decreased non-medical exemptions. • Additional research, especially on online module education components, is required. School vaccine mandates (SVMs) are population health interventions that require monitoring and communicating about vaccination of school-aged children, with an aim of controlling infectious disease outbreaks. While 43 % of World Health Organization member states report having some sort of SVM, their details vary. A newer element of some SVMs is an "education component" requiring compulsory information, education, or counseling of parents/guardians who decline to vaccinate their children for non-medical reasons. This environmental scan sought, mapped, and synthesized evidence on the existence, format, and impacts of education components of SVMs in 18 affluent Organization for Economic Co-operation and Development comparator countries. We found current SVMs in nine of the 18 comparator countries, but education components to those SVMs only in Canada (n = 2) and the U.S. (n = 9), where such policies were made at the provincial/state level. The earliest was implemented in 2011 and most recent has not yet been implemented. Education components were used as requirements for obtaining non-medical exemptions from SVMs, and involved either an informational paper to be read and signed, a counseling or information session from a health professional (public health worker or licensed provider such as family doctor), or an online module to be completed. Peer-reviewed research on in-person sessions suggests association with at least short-term increased vaccine uptake and reduction of non-medical exemptions. Available data on online module education components suggests similar impacts, but research to date is limited. SVMs with educational components are uncommon but have been increasing since 2011. The details of these education components vary, although topics covered in online modules are relatively consistent. Evidence to date suggests at least short-term reduction in non-medical exemptions associated with implementation of SVM education components, but additional research is required to follow-up and confirm, especially as regards online education modules. [ABSTRACT FROM AUTHOR]

The World Economic Forum (WEF) was established in 1971 with the nominal purpose of bringing together leaders to discuss global problems. However, it is well on its way to becoming the most powerful institution in the world, merely by setting forth an agenda for global management that is attractive to many political and business leaders. Two of the central issues on which the WEF has focused are climate change and the pandemic. The first has a depth of scientific support, but the WEF's stance and official pronouncements on the latter were never based on normal scientific review procedures. Since the WEF was a catalyst in the rush to judgment on COVID‐19 lockdowns and vaccine mandates, this suggests that the WEF is primarily guided by political motives, not by science. In fact, the way the WEF approaches the climate issue—as an excuse to restrict freedom without promoting renewable energy sources—makes evident the true motives of the WEF. As a result of the WEF's political use of the climate issue, the validity of climate science has been tarnished in the public mind. If there were true political will to solve the existential problem for future generations, the following could be undertaken immediately: To convert the oil industry to renewable energy, national governments of the world could agree to require that the fossil fuel companies receiving tax dollars convert to renewable energy at a rate of 7%–8% per year. Compounded, within 10 years, these companies would still be dominating the energy game, but with safe sustainable alternatives. [ABSTRACT FROM AUTHOR]