03.07.2019 | Brussels Background The European vaccination dilemma

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When it comes to the ongoing vaccination crisis the daily news look very grim. From Europe being the world’s most vaccine sceptic region to conspiracy theories spread by anti-vaxxers – the hopes are not too high that the situation will improve over night. But what can be done to change people’s minds and win back their trust? Is the introduction of mandatory vaccinations in many Member States the right way or do we need a stronger push at European level from the European Commission?

The news on vaccination and related topics such as measles outbreaks all over the block are gloomy these days. And according to an assessment published by the European Centre for Disease Control (ECDC) they are not going to just disappear: the ECDC foresees that the number of people infected with measles will not cease but rather rise. And it gets worse. According to a survey published by the Wellcome Trust, Europe is the most sceptic region with regards to vaccinations. According to this survey, between 10% and 22% of Europeans do not believe in the safety of vaccinations. One special case is France where a third of the people believe that vaccines are not safe. Compared to South Asia, where 95%believe in the safety of vaccines, the European results are devastating. But what would be the right counter-measures?

Many Member States have opted for or are at least thinking about the introduction of mandatory vaccinations. The means of implementation however, differ widely. France for example, tries to tackle its high levels of scepticism with 11 mandatory vaccinations since 2018. Similar laws exist in ten other Member States. And the trend seems to continue. The German Health Minister Jens Spahn announced that he would like to introduce mandatory vaccination for measles, mumps and rubella with parents having to pay fines up to 2500€ if they couldn’t provide proof of vaccination.

But all these approaches do not seem to really solve the major problem: people don’t trust vaccinations anymore. And the reasons are manifold. For one, vaccines are basically a victim of their own success as most Europeans have never experienced the consequences of those diseases because most of them are vaccinated. In high-income countries it is much easier for rumours to spread because people do not see the benefits of vaccines. Other reasons are a deep-rooted mistrust in politicians and the “ruling classes” in general – a connection between the rise of populism and vaccination scepticism does not seem too farfetched. In Italy, the Minister of Interior is the country´s first anti-vaccine supporter and working towards loosening Italy´s mandatory vaccination regimen. 

As approaches to solve the vaccination conundrum across Member States differ, action at European level may be a suitable option. There are two main possibilities: legislative measures or soft law. As we all know, the legislative approach implies difficulties as health is a Member State competence. One could argue though that the threat of rising measles infections can be seen as a cross-border public health threat which could justify mandatory vaccination policy measures at EU level. This alternative has the advantage that the same rules would apply to all Member States, perhaps with some discretion for Member States to add certain types of vaccinations. However, this is a very sensitive topic. A mandatory vaccination is a serious intrusion into the private lives of citizens. A soft law approach on the other hand, has the advantage that there is no such “force” involved. This way a strong backlash from citizens and vaccine-sceptic Member States could be avoided. In its recommendation which was published in December 2018, the Council of the European Union presents concepts how to strengthen the cooperation against vaccine-preventable diseases. The ideas include establishing a European vaccination information portal, enhancing transparency and sharing scientific evidence and to work towards a European vaccination schedule. The question remains, whether these rather soft measures could do the trick or if they are too “soft” and therefore won’t help solve the problem.

As we have reached incredible medical progress in the battle against many diseases, do we really want to go back in time and deal with diseases which have been extinct thanks to successful and effective vaccinations? A decision has to be taken and we should take it rather quickly as communicable diseases won´t wait for us. Only history will tell whether we took the right decisions at the right time.