Good news for those of us who want to stop vaccine-preventable diseases – the German government has backed a bill for a mandatory measles vaccine for all children entering school or kindergarten. I’m sure the science-denying anti-vaccine crowd in Germany are angry.
If the German parliament approves the bill, which is almost certain, parents will have to provide evidence that their child has received the measles vaccine before they are enrolled in school. If the parents have failed to do so, they will be subject to fines up to €2,500 ($2,800).
If this bill is passed, Germany will join France and Italy as the other European countries with a mandatory vaccines law. Many other European countries have such high vaccination rates that they have little need for mandatory measles vaccine, but I’m sure they are watching carefully considering the rather large measles epidemic that has hit Europe over the past year.
The USA does not have a Federal mandatory measles vaccine law, but all 50 states and the District of Columbia require children to be fully vaccinated (according to the CDC immunization schedule, which includes the MMR vaccine for measles, mumps, and rubella) before entering school. However, many states allow so-called “personal belief exemptions,” which allow parents to easily skip some or all vaccines based on whatever they want.
As a result, some states have either implemented or are considering strict laws to make certain that children entering school are fully vaccinated. California, Maine, New York, Washington, Mississippi, and West Virginia have mostly eliminated personal belief exemptions, only allowing medical exemptions, where the child has some contraindications to some vaccines. The German law also does the same – it only allows medical exemptions.
The German state of Brandenburg recently passed its own law instituting a mandatory measles vaccine for children entering kindergarten. The state government was concerned about Brandenburg’s relatively low measles vaccination rate, 72.5%, far below the 92.9% rate for the whole country.
A quick measles primer
Measles (also called rubeola, not to be confused with rubella, or German measles, which despite its name, isn’t the issue in Germany) is a respiratory disease caused by the measles virus. Measles virus normally grows in the cells that line the back of the throat and lungs.
The virus is spread through respiration (contact with fluids from an infected person’s nose and mouth, either directly or through aerosol transmission), and is highly contagious — 90% of people without immunity sharing living space with an infected person will catch it.
There are no specific treatments for the disease. There are no miracle preventions.
The oft-repeated, and highly inaccurate, claim that vitamin A supplements can cure or prevent measles completely misses the mark. It’s important to supplement with vitamin A to prevent blindness as a result of measles, but it doesn’t reduce mortality or prevent some neurological issues. Moreover, it is most useful in children with vitamin A deficiency, not exactly a major issue in well-fed children in developed countries.
Why do we need mandatory measles vaccine?
- About 30% of measles cases develop one or more complications.
- Pneumonia, which is the complication that is most often the cause of death in young children.
- Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
- Diarrhea is reported in about 8% of cases.
- As many as 1 out of every 20 children with measles gets pneumonia.
- About 1 child in every 1,000 who get measles will develop encephalitis, an inflammation of the brain that can lead to convulsions, deafness, and other long-term neurological deficits.
- A measles infection can result in short- and long-term immune system dysfunction which can leave the child susceptible to other diseases early in life (which is in direct opposition of claims by anti-vaccine activists that it helps “boost” the immune system.
- About 1-2 children, out of 1000 who contract measles, may develop subacute sclerosing panencephalitis (SSPE), a rare chronic, progressive encephalitis that affects primarily children and young adults– it is caused by a persistent infection of the measles virus. The disease starts with measles infection, usually before the age of 2 years, followed by approximately 6-15 asymptomatic years. Some researchers think the asymptomatic period is around 5-8 years after the initial disease. Gradually, the disease progresses with psychological and neurological deterioration, which can include personality changes, seizures, and coma. It is always ultimately fatal.
- And sadly, for every 1,000 children who get measles, 1 or 2 will die from it.
These measles complications are more common among children under 5 years of age and adults over 20 years old (usually those with lapsed immunity).
Even in previously healthy children, measles can be a serious illness requiring hospitalization. Measles also can make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby.
There is only one good way to prevent measles unless you want your child to live in a hermetically-sealed bubble forever – get the MMR vaccine.
Serious complications to measles can be as high as 3 out of every 10 children who get the disease. Serious complications from the MMR vaccine is approximately 1 out of every 1 million vaccine doses. The benefit to risk calculation is way over on the side of vaccines.
Measles is a dangerous, highly contagious disease that can permanently harm or even kill healthy children. It is not a disease that should be ignored.
The German mandatory measles vaccine law is what needs to be done to protect the children of the country. It is great that Germany is taking this step – I’m sure other countries will do the same.
Vaccines save lives. And the German government knows this and is moving to make sure every child is protected.
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