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. Author manuscript; available in PMC: 2020 Feb 11.
Published in final edited form as: Pediatrics. 2020 Jan 13;145(2):e20190620. doi: 10.1542/peds.2019-0620

TABLE 2.

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

Mandatory Vaccination No.Countries Pertussisa Incidence Rate Ratio(95% CI) Measles Incidence Rate Ratio (95% CI)

No mandatory vaccination 22 Reference Reference
Mandatory vaccination 7 0.30 (0.07 to 1.30) 0.38 (0.13 to 1.16)
Mandatory vaccination without nonmedical exemptions 5 1.04 (0.18 to 6.32) 0.14 (0.05 to 0.36)
Monetary fine
 No mandatory vaccination 22 Reference Reference
 Mandatory vaccination and monetary penalty for noncompliance 6 0.42 (0.18 to 0.98) 0.14 (0.05 to 0.39)
a

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.