Context: This research examines the development of vaccination policy in Britain, the United States, and Australia to begin to understand the different forms of coercion that industrialized states utilize to achieve vaccination compliance from the majority of their citizens.

Methods: This research applies a comparative-historical analysis of the three countries listed, using a combination of primary and secondary documents.

Findings: The different degrees of compulsion in the vaccination policies of Britain, the United States, and Australia is explained through an analysis of the path-dependent ways that each nation adapted coercion in response to civil society resistance. Each nation has moved up and down a continuum of coercion searching for a policy that balances overcoming passive noncompliance without engendering active resistance. Arriving at different balancing points between these two objectives, the three nations have now institutionalized policies with different degrees of coercion.

Conclusions: This research shows that vaccination policy is not just created top-down by the state, but through an ongoing interactive process with citizens and civil society. Furthermore, as vaccination is a “wicked problem” that faces ongoing civil society resistance, states will need to perpetually adapt the coerciveness of their policies into the foreseeable future.

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