Did the health care vaccine mandate work? An evaluation of the impact of the COVID-19 vaccine mandate on vaccine uptake and infection risk in a large cohort of Canadian health care workers - 15/08/24
, Karen Lockhart, MA a, Stephen Barker, BSc a, Jennifer M. Grant, MDCM, FRCPC b, c, Annalee Yassi, PhD a
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Résumé |
Background |
We aimed to evaluate the impact of health care vaccine mandates on vaccine uptake and infection risk in a cohort of Canadian health care workers (HCWs).
Methods |
We conduct interrupted time series analysis through a regression discontinuity in time approach to estimate the immediate and delayed impact of the mandate. Multilevel mixed effect modeling fitted with restricted maximum likelihood was used to estimate impact on infection risk.
Results |
The immediate and sustained effects of the mandate was a 0.19% (P < .05) and a 0.012% (P < .05) increase in the daily proportion of unvaccinated HCWs getting their first dose, respectively. An additional 623 (95% confidence interval: 613-667) HCWs received first doses compared to the predicted uptake absent the mandate. Adjusted test positivity declined by 0.053% (95% confidence interval: 0.035%, 0.069) for every additional day the mandate was in effect.
Discussion |
Our results indicate that the mandate was associated with significant increases in vaccine uptake and infection risk reduction in the cohort.
Conclusions |
Given the benefit that vaccination could bring to HCWs, understanding strategies to enhance uptake is crucial for bolstering health system resilience, but steps must be taken to avert approaches that sacrifice trust, foster animosity, or exacerbate staffing constraints for short-term results.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The mandate was effective in increasing vaccine uptake healthcare workers (HCWS). |
• | Effectiveness was also shown for lowering infection risk. |
• | Impact was greater in subgroups of HCWs including those who work in long-term care. |
• | Context and epidemiology should be considered when utilizing vaccine mandates. |
Key Words : Health care professionals, Infection control, Occupational health, Health systems, Public health policy, Interrupted time series
Plan
| Previous presentation: This work has not been presented at any meeting. |
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| Funding: Funding was received from the International Development Research Centre (IDRC) under grant M20-00559, and the Canadian Institutes of Health Research (CIHR) under grant VS1-175519 through the rapid research funding opportunity from CIHR under Principal investigator Annalee Yassi and grant, “Protecting healthcare workers from COVID-19: A comparative contextualized analysis.” |
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| Conflicts of interest: None to report. |
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| Ethics approval: This study was approved by the University of British Columbia Behavioural Research Ethics Office, certificate number H21-01380. |
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| Availability of data and materials: The data analyzed in this study is subject to the following licenses/restrictions: Data for this study was compiled from anonymized payroll/workplace systems. It can be made available by the authors if requested. Requests to access these datasets should be directed to stephen.barker@ubc.ca. |
Vol 52 - N° 9
P. 1065-1072 - septembre 2024 Retour au numéro
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