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 US 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, which are proof of vaccination to enter indoor public spaces, in 2021 and 2022 to increase vaccination rates and slow the spread of COVID-19, but their impact remains limited.^1,3

During the same period, the FDA granted emergency use authorization to the Pfizer-BioNTech and Moderna COVID-19 vaccines, based on evidence demonstrating their safety and effectiveness. In 2021, the FDA authorized the Johnson & Johnson COVID-19 vaccine and fully approved the Pfizer-BioNTech vaccine for individuals 16 years and older, as well as an emergency use authorization for children aged 5 to 15 years. In 2022, the FDA approved Moderna’s vaccine for adults and expanded the Pfizer-BioNTech approval to include those 12 years and older, as well as 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, restricting millions of unvaccinated individuals from indoor venues. In New York, New York, most restaurants reported losing customers and facing staff challenges, and more than 1000 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 in the United States without restrictions.¹

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 model 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 by the investigators.^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. Melo V, Neilson E, Kemboi D. Indoor vaccine mandates in U.S. cities, vaccination behavior, and COVID-19 outcomes. Contemp Econ 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. Wiley. 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. Accessed November 24, 2025. https://www.mayoclinic.org/diseases-conditions/history-disease-outbreaks-vaccine-timeline/covid-19