{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T09:50:51Z","timestamp":1769766651160,"version":"3.49.0"},"reference-count":57,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Mandatory vaccination is a major tool to combat increasing vaccine hesitancy. In principle, a vaccination law, ie, a mandatory vaccination law without exemptions, applies equally to everyone, but its effects across different socioeconomic groups (SEGs) remain unknown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the association of a vaccination law with vaccination coverage in different SEGs during 1855 to 1900.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This population-based cohort study monitored 45 years (1855-1900) of Finland\u2019s first vaccination campaign against smallpox to estimate the association of the 1883 vaccination law with vaccination coverage in infants (age &amp;lt;1 year) across different SEGs. Data were analyzed from October 2023 to January 2024.<\/jats:p><\/jats:sec>Exposure<\/jats:title>A mandatory smallpox vaccination law for all children.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Vaccination status was determined from vaccination records and defined as receiving 1 dose of the smallpox vaccine. The primary outcome was the annual vaccination coverage in different SEGs and its change before vs after the vaccination law.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 40\u202f008 children aged less than 1 year were included. The high SEG had high vaccination coverage, at a mean (SD) of 90% (49 percentage points), and the law was associated with halting its declining trend. For the middle SEG, the law was associated with a 26-percentage point increase in coverage, to a mean (SD) of 83% (50 percentage points). For the low SEG, the law had no association with vaccination coverage, which always remained below 35% (mean [SD]: prelaw, 26% [22 percentage points]; postlaw, 32% [23 percentage points]).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, a historic vaccination law was not associated with increased vaccination in the SEG with the lowest vaccination coverage, emphasizing the need for additional interventions to increase vaccine uptake in low-coverage communities.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.60558","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T16:00:57Z","timestamp":1739980857000},"page":"e2460558","source":"Crossref","is-referenced-by-count":2,"title":["Socioeconomic Differences in Vaccination Coverage After a Mandatory Vaccination Law, 1855-1900"],"prefix":"10.1001","volume":"8","author":[{"given":"Susanna","family":"Ukonaho","sequence":"first","affiliation":[{"name":"Department of 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