Europe Responds to Recent Measles Outbreaks with Tougher Vaccination Laws

A recent 4-fold increase in measles cases in Europe has been linked to declining vaccination rates, prompting several European countries along with other nations to pass legislation making more vaccinations mandatory and penalizing parents who refuse to vaccinate their children.

Vaccine hesitancy is a fear of the risk side effects of vaccination and the safety of vaccine components, which can lead parents, pregnant women, and other groups to delay or entirely refuse vaccination. A 1998 paper linking the measles, mumps, and rubella (MMR) vaccine to autism was debunked and withdrawn, and the author’s medical license revoked, but in the 20 years since its publication, the study has been blamed for declining vaccination rates. Despite the reductions in morbidity and mortality from vaccine-preventable diseases in recent decades, the European Center for Disease Prevention and Control (ECDC) says vaccine hesitancy has led to significant outbreaks of diseases such as measles, rubella, and polio in under-vaccinated communities.

Of the 21,315 measles cases that occurred in Europe’s 2017 measles outbreaks, 5,006 cases were reported in Italy, and the ECDC says outbreaks of the virus are still occurring in a number of countries. Measles vaccination coverage for children in Italy was 85% in 2015, below the target goal of 95% needed to achieve herd immunity. In response, Italy’s Parliament passed a law making vaccinations mandatory for children being registered for school. Under the law, which took effect in September 2017 at the start of the school year, children up to the age of 16 are required to have vaccinations for chickenpox, diphtheria, Haemophilus B (Hib), hepatitis B, meningitis B and C, measles, mumps, polio, rubella, tetanus, and whooping cough. In addition, parents in Italy who don’t have their children vaccinated will face penalties, including being prohibited from enrolling their children in public or private schools and fines of €500 to €7,500 ($559 to $8,380 USD).

“The international scientific community unanimously recognizes that vaccines are one of the safest and most effective public health tools of all time,” a press release from Italy’s Ministry of Health reads. “This practice of primary prevention of infectious diseases entails benefits not only for a direct effect on the vaccinated subjects, but also indirectly, inducing protection for those not vaccinated (so-called herd immunity).”

In Romania, which reported 5,562 measles cases in 2017, health ministry officials said that there are more than 224,200 children between the ages of 9 months and 9 years who have not been vaccinated for measles. On August 9, 2017, Romanian lawmakers adopted a draft bill obligating parents and legal guardians to vaccinate their children, with the state funding and organizing vaccinations. Germany, which saw 927 measles cases last year, has also fought against declining vaccination rates by passing a law calling for kindergartens to report to authorities any parents who fail to provide documentation of vaccination. Parents who fail to follow health ministry requirements on vaccination face penalties of up to €2,500 ($2,800 USD).

In 2015, Australia’s government announced that it was seeking to limit immunization requirement exemptions, and, as such, proposed a “No Jab, No Play” measure aimed at improving vaccination rates. The measure eliminated the conscientious objector exemption while maintaining certain medical and religious exemptions, and extended immunization requirements to children of all ages. The states of New South Wales and Victoria have gone further by passing legislation banning unvaccinated children from enrolling in schools and child care centers and imposing fines on centers that admit unvaccinated children. In 2017, the state of South Australia (SA) proposed a similar bill. “The new ‘No Jab, No Play’ laws will mean children must be appropriately immunized, on an immunization catch-up program, or be exempt for medical reasons, in order to attend early childhood care services,” according to the Government of South Australia.

It is with the hope that these efforts to get more children vaccinated will work to quell the ongoing outbreaks running rampant throughout Europe.