The long-term success of mandatory vaccination laws at implementing the first vaccination campaign in 19^thcentury rural Finland

Abstract

In high income countries, childhood infections are on the rise, a phenomenon in part attributed to persistent hesitancy towards vaccines. To combat vaccine hesitancy, several countries recently made vaccinating children mandatory, but the effect of such vaccination laws on vaccination coverage remains debated and the long-term consequences are unknown. Here we quantified the consequences of vaccination laws on the vaccination coverage monitoring for a period of 63 years rural Finland’s first vaccination campaign against the highly lethal childhood infection smallpox. We found that annual vaccination campaigns were focussed on children up to 1 year old, but that their vaccination coverage was low and declined with time until the start of the vaccination law, which stopped the declining trend and was associated with an abrupt coverage increase of 20 % to cover >80 % of all children. Our results indicate that vaccination laws had a long-term beneficial effect at increasing the vaccination coverage and will help public health practitioners to make informed decisions on how to act against vaccine hesitancy and optimise the impact of vaccination programmes.

The Long-Term Success of Mandatory Vaccination Laws After Implementing the First Vaccination Campaign in 19th Century Rural Finland

“…In brief, smallpox was one of the most lethal diseases in human history, affecting especially European and Native American populations ( 31 – 33 ). For example, in our study population in 18th and 19th century Finland, smallpox was a major cause of death in children, killing up to 15% of Finland’s population around 1800, before the introduction of vaccines ( 34 – 36 ).…”