Differential impacts of vaccine mandates: subjective experiences and policy implications

Abstract

Vaccine mandates are diverse policy instruments that impact people differently. This paper explores how different types of mandates may generate distinct subjective experiences of constraint, compulsion, or power across populations. We identify and analyze five key aspects of mandate policies that influence these experiences - (1) the alignment between individual preferences and mandate requirements, (2) the relationship between parents' and children's interests, (3) the experienced severity of sanctions, (4) the availability of reasonable alternatives, and (5) the power that the enforcing authority actually applies to particular persons - which are crucial for assessing mandates' effectiveness, identifying which populations are most affected, anticipating public responses, and informing ethical justifications. We remain neutral about whether these experiences constitute coercion, but we emphasize that these experiences may have ethical significance regardless of how they are categorized. This paper provides a foundation for future normative work by clarifying some of the complex landscape of vaccine mandate policies and their impacts, without explicitly defending a particular theory of coercion or public health justice.

Keywords: Immunization policy; Nonmedical exemptions; Public health ethics; Vaccine mandates.