US Vaccine Mandates During COVID-19 Did Not Raise Vaccination Rates, New Study Finds

New study findings published by investigators in Contemporary Economic Policy found that vaccine mandates, despite their broad implementation across major United States cities during the COVID-19 pandemic, did not consistently lead to higher vaccination rates or improved COVID-19 outcomes. The study authors noted that these findings contrast with evidence from other countries, where national mandates were linked to notable boosts in vaccine uptake.^1,2

Limited Impact of City-Level COVID-19 Vaccine Mandates

Many US cities added indoor vaccine mandates in 2021 to 2022 to increase vaccination and slow the spread of COVID-19, but their impact remains limited.^1,3

During the same time, the FDA had given emergency use authorization to the Pfizer-BioNTech and Moderna COVID-19 vaccines based on evidence showing their safety and effectiveness. In 2021, the FDA authorized the Johnson & Johnson COVID-19 vaccine and fully approved the Pfizer-BioNTech vaccine for individuals aged 16 and older and children 5 to 15 years. In 2022, the FDA approved Moderna’s vaccine for adults and expanded the Pfizer-BioNTech approval to those aged 12 and older and for children as young as 6 months. Following their recommendation, billions of doses were administered worldwide with ongoing safety monitoring.^1,3

City vaccine mandates were among the most restrictive and controversial in the US, limiting millions of unvaccinated individuals from indoor venues. In New York City, most restaurants reported losing customers and facing staff challenges, and more than a thousand workers were fired for not complying. However, national mandates in other countries led to a clearer increase in vaccine uptake, and researchers noted that city-level mandates could have been easier to avoid because individuals could travel to nearby areas without restrictions.⁴

Researchers conducted a study to evaluate how indoor vaccine mandates impacted first-dose uptake, COVID-19 cases, and deaths in 9 US cities.^1,2

“We wanted to take a careful, data-driven look at what these policies actually accomplished in the US context. By the time most cities introduced indoor vaccine mandates, vaccination rates were already high, and many unvaccinated individuals were deeply hesitant or resistant, leaving limited room for further gains,” Elijah Neilson, PhD, of Southern Utah University and corresponding author, said in a news release.²

In the study, researchers used a synthetic difference-in-differences approach, which creates a “synthetic” control city from a weighted mix of similar metropolitan areas to compare outcomes before and after the mandates.^1,2

The results demonstrated no consistent evidence that city vaccine mandates increased first-dose uptake or reduced COVID-19 cases or deaths across the 9 cities studied.^1,2

The findings suggest that local mandates could be less effective when vaccination rates are already high, when individuals can easily avoid restrictions by traveling elsewhere. The study authors noted that this research could help guide future public health strategy and policy decisions.^1,2

“Our findings don’t suggest that mandates can’t work—only that their effectiveness depends on timing, context, and how easily people can sidestep local restrictions,” Neilson concluded.²

REFERENCES

1. Neilson E, Kembio D. Indoor vaccine mandates in U.S. cities, vaccination behavior, and COVID-19 outcomes. Contemporary Economic Policy. November 19, 2025. Accessed November 24, 2025. https://onlinelibrary.wiley.com/doi/full/10.1111/coep.70016

2. Did US cities’ indoor vaccine mandates affect COVID-19 vaccination rates and outcomes? News release. EurekAlert! November 19, 2025. Accessed November 24, 2025. https://www.eurekalert.org/news-releases/1106189

3. COVID-19 and related vaccine development and research. Mayo Clinic. News release. Accessed November 24, 2025. https://www.mayoclinic.org/diseases-conditions/history-disease-outbreaks-vaccine-timeline/covid-19

4. Melo V, Neilson E, Kemboi D. Indoor Vaccine Mandates in US Cities, Vaccination Behavior, and COVID-19 Outcomes. February 22, 2023. Accessed November 24, 2025. https://www.mercatus.org/research/working-papers/indoor-vaccine-mandates-and-covid-19