TABLE 1

Association of Mandatory Vaccination, the Availability of a Nonmedical Exemption Option, and the Penalty of Noncompliance With Rates of Vaccination Against Measles (2006–2015) and Pertussis (2006–2016)

No. Country-YearsDifference in Vaccination Rate, % (95% CI)P
Measles
 Mandatory vaccination, yes or no2873.71 (1.68 to 5.74).0003
 Mandatory vaccination without nonmedical exemption, yes or no2673.80 (1.23 to 6.37).0037
 Financial penalty for noncompliance per €500590.80 (0.5 to 1.15)<.0001
Pertussis
 Mandatory vaccination, yes or no3162.14 (0.13 to 4.15).04
 Mandatory vaccination without nonmedical exemption, yes or no2942.07 (−1.74 to 5.89).28
 Financial penalty for noncompliance per €500651.1 (0.95 to 1.30)<.0001
  • All 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.