Mandatory vaccinations not the best way to encourage participation, study finds

02:00, Aug 30 2019

Making vaccines mandatory could punish those already experiencing hardship and worsen vaccine hesitancy, new research has found. 

A review of 90 recent studies published today in the New Zealand Medical Journal found education – rather than coercion – was the best way to get people to vaccinate their children. 

Paper co-authors Dr Nikki Turner and Dr Mary Nowlan from the University of Auckland found positive experiences of vaccination, such as reducing pain and stress can improve confidence in immunisation, while "coercive" methods can hurt those most in need. 

Associate Health Minister Julie Anne Genter told journalists at Parliament on Wednesday that the national measles number had risen to 849.
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Associate Health Minister Julie Anne Genter told journalists at Parliament on Wednesday that the national measles number had risen to 849.

It comes as New Zealand battles the worst measles outbreak it has seen in two decades, with more than 849 cases nationally this year.

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Making vaccines mandatory "can be effective" but would not solve the "multitudinous" reasons New Zealanders struggle to vaccinate their children on time, Turner told Stuff. 

Instead, advocating for vaccination, education, correcting misconceptions, and ensuring easier access to vaccines would likely be "as successful" in encouraging uptake and positive attitudes, the review found. 

Immunisation coverage is dependent on access to vaccines and engagement with health services, the research said. 

Director of the Immunisation Advisor Centre and paper co-author Dr Nikki Turner said mandatory vaccines can be effective, but don't take into context why New Zealand families struggle to immunise their children.
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Director of the Immunisation Advisor Centre and paper co-author Dr Nikki Turner said mandatory vaccines can be effective, but don't take into context why New Zealand families struggle to immunise their children.

Only a small proportion of New Zealand parents – around 5 per cent – refuse vaccinations, the research said. 

Of those only 1-2 per cent were "anti-vax", others were largely fearful or "hesitant", Turner said. 

Mandating vaccines would likely mean families would be less inclined to express their concerns to those on the frontline, creating more "polarised" views, she said. 

Parents were more likely to trust and accept vaccines when they could discuss their concerns early during pregnancy, the review found. 

Making vaccines compulsory could penalise those experiencing mistrust and hardship, a review of 90 recent studies into immunisation coverage found.
WAYNE DROUGHT/NZPA
Making vaccines compulsory could penalise those experiencing mistrust and hardship, a review of 90 recent studies into immunisation coverage found.

Early and "continued" engagement with healthcare professionals also helped to build trust of immunisations, they found. 

In New Zealand, barriers to accessing health services have a "significant" influence on whether disadvantaged populations were immunised, Turner said. 

People who experience household poverty, are younger when they have children, who move around a lot (household mobility) and Māori and Pacific Island whānau tend to have lower immunisation coverage. 

Enforcing mandatory policies alone would likely be punitive – preventing access to childcare or education or imposing financial penalties – creating "more problems for those in need", she said. 

In New Zealand, early childhood services and primary schools are required to request record of the immunisation status of a child upon enrolment, but a child's right to attend or enrol are not affected if these requests are not met. 

While mandatory vaccination has been "marginally effective" overseas, the researchers said well-informed health professionals and positive education in pregnancy were likely to have as much an effect on coverage as mandates. 

Stuff