Indoor Vaccine Mandates in US Cities, Vaccination Behavior, and COVID-19 Outcomes

During the pandemic, many of the largest cities in the United States introduced vaccine mandates. Their goal? To increase the number of people being vaccinated, thereby limiting the spread of COVID-19.

In “Indoor Vaccine Mandates in US Cities, Vaccination Behavior, and COVID-19 Outcomes,” Vitor Melo, Elijah Neilson, and Dorothy Kemboi question the efficacy of these efforts in nine cities that implemented the mandates: Boston, Chicago, Los Angeles, New Orleans, New York, Philadelphia, San Francisco, Seattle, and Washington DC.

Intended and Unintended Effects of Indoor Vaccine Mandates

City vaccine mandates were arguably among the most restrictive and polarizing regulations ever enacted in the United States. Millions of people were prevented from entering restaurants, bars, gyms, theaters, sports arenas, and other public indoor areas without proof of COVID-19 vaccination. The mandates negatively affected unvaccinated individuals and businesses that were not allowed to serve unvaccinated customers.

In New York City, for example:

  • More than 90 percent of restaurants reported having customer-related challenges, such as losing customers who objected to the mandate.
  • Three-quarters of restaurants reported staff-related challenges because of the city’s vaccine mandate.
  • 1,430 city workers were fired for failing to comply with the mandate.

Previous research has shown that similar country-level mandates increased vaccine uptake substantially. However, city-level mandates are easier to evade than country-level mandates because it is generally easier to travel to a neighboring city that does not have a mandate than to cross national borders.

Cost-Benefit Analysis

Most supporters of the regulations claim that the benefits associated with the increase in vaccination rates as a result of the mandate—and its implied reduction in the spread of COVID-19—outweigh the costs of its disruptions. However, the authors find that indoor vaccine mandates had no significant impact on COVID-19 vaccine uptake, cases, or deaths across all nine cities that implemented the policy.

Key Takeaway

Public health restrictions and regulations were widespread during the COVID-19 pandemic, and so understanding their consequences is essential. The authors find that city-level mandates had smaller effect on vaccine uptake (and consequently on COVID-19 cases and deaths) than nationwide mandates— and thus failed to achieve their intended objectives.