Over the past four decades but, especially, during the 21st century, the pharmaceutical, medical trade and public health industries in partnerships with Big Tech companies and global communications corporations have stepped up lobbying efforts to eliminate flexible medical, religious and conscientious belief vaccine exemptions in public health laws. The debate about the science and ethics of mandatory vaccination has become more intense in the past decade as citizens of many countries push back against one-size-fits-all vaccine policies that apply increasingly more severe societal sanctions to individuals, who maintain that use of vaccines should be voluntary.