A COMPARATIVE SUBNATIONAL POLICY ANALYSIS OF STATE COVID-19 VACCINE POLICIES AND APPLICATION OF THE POLITICAL DETERMINANTS OF HEALTH MODEL

A COMPARATIVE SUBNATIONAL POLICY ANALYSIS OF STATE COVID-19 VACCINE POLICIES AND APPLICATION OF THE POLITICAL DETERMINANTS OF HEALTH MODEL By Demetrius Cianci Chapman Associate of Science Nursing, Jewish Hospital College of Nursing and Allied Health, 1998 Bachelor of Science of Nursing, Saint Louis University, 2000 Master of Public Health, Saint Louis University, 2004 Master of Science Nursing (Research), Saint Louis University, 2004 Doctor of Philosophy, Nursing, University of New Mexico, 2025 ABSTRACT This study uses the political determinants of health (PDoH) framework to analyze state-level COVID-19 vaccine policies and their impact on population health. The PDoH model examines how structured relationships, resource distribution, and power dynamics shape health equity. The analysis compares policies mandating vaccines for state workers, banning mandates, and regulating vaccine passports. Data were drawn from public sources, excluding human subjects. Findings show that lower voter turnout and Democratic Electoral College votes increased the likelihood of vaccine mandates and decreased the likelihood of passport bans. States with Medicaid expansion were less likely to ban mandates, though policy variables did not reliably predict mandate bans. Democratic control raised the odds of vaccine mandates by 13.57 times, but did not affect passport policy adoption. Higher median income was the only consistent predictor of both vaccine mandates and administration rates. State party control, income, and rural population percentages were key influencing factors.