Attitudes to mandatory COVID-19 vaccination in early life: findings from the multi-country cross-sectional CANDOUR study

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Abstract
We examined variation in attitude toward mandatory COVID-19 vaccination in early life by sociodemographic characteristics, personal COVID-19 experience, health risk attitude, political ideology, and other COVID-19 vaccine mandate attitudes. For this purpose, we used data from 19 928 participants from 16 countries surveyed in March–November 2022 for the second wave of the COVID-19 vaccine preference and opinion survey (CANDOUR). Analyses were adjusted for poststratification weighting. Participants who disagreed with early life mandatory COVID-19 vaccination were more likely to decline vaccination against COVID-19 (14.5%) compared with those who were neutral (1.8%) and those who agreed (0.5%). Disagreement with early life mandatory vaccination was associated with more unwillingness to take risks with their own health, being centre or left-wing on the left-right political spectrum, believing COVID-19 vaccination should be a personal choice, and being opposed to vaccine mandates for schoolchildren and the public. Neutrality or agreement with early life mandatory vaccination was associated with neutrality or agreement with a vaccine mandate for schoolchildren or a governmental COVID-19 vaccine mandate for everybody. Pandemic preparedness governance needs to focus on attitudes toward vaccine mandates. Further research and commitment by governments at various levels are needed to identify social, cultural, and system-level factors that could inform vaccination strategies to be implemented for the next pandemic.

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