Let’s Not Make Conclusions About Mandatory Vaccination From Imperfect Regression Analysis

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Vaz and colleagues1 used regression analysis to conclude that mandatory vaccination led to increased vaccination coverage and reduced measles incidence in Europe. They compared 21 countries classified without mandatory vaccination and 7 countries classified with: Bulgaria, Czech Republic, Hungary, Latvia, Poland, Slovenia, and Slovakia. The authors found positive association between vaccination coverage and size of monetary fines imposed for not taking children for vaccination. We have several reservations on the methodology and analysis. While the 7 countries have indeed reported high coverage rates for several decades, we do not believe that mandatory vaccination is the primary reason. Instead, strong immunization programs is the major … E-mail: rnandy{at}unicef.org