背景:在COVID-19大流行期间,三个欧洲国家(奥地利,希腊,意大利)宣布和/或实施了对普通人群中高危人群的强制性COVID-19疫苗接种。除了这项政策的道德理由之外,重要的是评估和量化任务在提高疫苗接种率方面的有效性。
方法:在第35/2021周和第50/2022周期间,目标年龄组(希腊:≥60岁;意大利:≥50岁)相对于对照组(希腊:50-59岁;意大利:25-49岁)的第一剂疫苗接种率的受控中断时间序列分析。对于奥地利,进行了不受控制的分析,因为疫苗授权针对所有≥18岁的成年人.
结果:在希腊(RR=4.36,95%CI:3.57-5.32)和意大利(RR=2.90,95%CI:2.37-3.56),与对照组相比,目标年龄组的疫苗接种率大大提高。在整个研究期间持续存在的效果。希腊有176,428(95%CI:164,097-187,226)授权归因的第一剂疫苗接种,意大利有316,192(95%CI:282,467-346,678),其中大部分发生在任务生效之前。在奥地利,在宣布强制接种疫苗后,没有观察到疫苗接种率的明显增加。在研究期结束时,9.5%的希腊≥60岁儿童,4.9%的50岁以上的意大利和13.8%的18岁以上的奥地利仍未接种疫苗。
结论:在希腊和意大利-尽管不是在奥地利-简单地宣布疫苗授权迅速增加了目标年龄组的COVID-19疫苗接种率,没有完全缩小疫苗接种差距。强制接种似乎有效地针对自满,但不是疫苗犹豫,它的公共健康利益需要权衡对信心和信任的可能有害影响。
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.