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- Years	Difference in Vaccination Rate, % (95% CI)	P
Measles
Mandatory vaccination, yes or no	287	3.71 (1.68 to 5.74)	.0003
Mandatory vaccination without nonmedical exemption, yes or no	267	3.80 (1.23 to 6.37)	.0037
Financial penalty for noncompliance per €500	59	0.80 (0.5 to 1.15)	<.0001
Pertussis
Mandatory vaccination, yes or no	316	2.14 (0.13 to 4.15)	.04
Mandatory vaccination without nonmedical exemption, yes or no	294	2.07 (−1.74 to 5.89)	.28
Financial penalty for noncompliance per €500	65	1.1 (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.