One speaks of compulsory vaccination when a protective vaccination is prescribed by law as a preventive measure for humans and/or animals. Currently, there is no general vaccination obligation in Germany, Austria, and Switzerland.
What is compulsory vaccination?
Nowadays there is no general vaccination obligation in Germany, Austria and Switzerland, but only vaccination recommendations. All vaccinations are noted in the vaccination certificate. The first compulsory vaccination existed in Germany in 1874, when the Reichsimpfgesetz (Imperial Vaccination Law) required all Germans to have their children vaccinated against smallpox at the ages of one and twelve. The general vaccination obligation was ended in 1975 and existed until the 1980s only as a vaccination obligation for certain groups of people. Today, Germany, Austria and Switzerland no longer have a general vaccination requirement, but only vaccination recommendations. In the German armed forces, however, there is still compulsory vaccination against tetanus.
Function, effect, and goals
Vaccinations serve to stimulate the immune system to defend itself against specific substances. They were developed to prevent infectious diseases such as polio, measles, smallpox, or rubella. Vaccination is divided into active and passive vaccination. The aim of active vaccination is to prepare the body’s immune system for infection with the administered pathogen, so that a defense reaction can take place quickly. Live and inactivated vaccines are used in active vaccination. The live vaccine consists to a small extent of functional pathogens. These are attenuated so that they can still multiply, but can no longer cause disease under normal circumstances. In contrast, inactivated vaccines consist of inactivated pathogens, i.e. pathogens or toxins that are no longer able to reproduce. In both cases, the vaccination is intended to induce the body to produce antibodies against the pathogen. This process can take one to two weeks. If the pathogen later re-enters the body, it is quickly recognized by the circulating antibodies and can be combated accordingly. In passive vaccination, the recipient is injected with an immune serum. This contains a high dose of antibodies against the pathogen. In contrast to active vaccination, the antibodies are available immediately. On the other hand, the protection lasts only a few weeks. According to the Robert Koch Institute, vaccinations are among the most important and effective preventive measures against infectious diseases. For example, vaccination against smallpox and the associated mandatory vaccination led to the global eradication of smallpox. Other infectious diseases have also been massively reduced through the use of vaccination. Although compulsory vaccination, especially for childhood diseases such as measles and rubella, is a recurring topic of discussion, only vaccination recommendations currently exist in Germany. Vaccination recommendations are issued by the Standing Commission on Vaccination (STIKO), an expert committee of the Robert Koch Institute in Berlin. The STIKO evaluates scientific and clinical data and makes recommendations for vaccinations based on the results of these evaluations. Unlike compulsory vaccination, the STIKO’s vaccination recommendations are not legally binding. However, they are usually adopted by the state health offices as public recommendations. Currently, the STIKO recommends vaccinations against tetanus, diphtheria, pertussis, Haemophilus influenzae type b, poliomyelitis (polio), hepatitis B, pneumococci (causative agent of pneumonia and meningitis), rotavirus, meningococci, measles, mumps, rubella and chickenpox. For young girls, the STIKO also recommends vaccination against human papilloma viruses (HPV). Older people and people with a suppressed immune system are additionally advised to be vaccinated against the influenza virus. Most vaccinations are given for the first time in infancy and early childhood and then boostered between the ages of five and eighteen. Some vaccinations, such as the tetanus vaccine, must be given every ten years for adequate protection.
Special features and dangers
Many German pediatricians repeatedly call for mandatory vaccination of children. They say that the high number of measles cases in particular is a cause for concern and shows that a voluntary vaccination concept based on vaccination recommendations is not sufficient. Opponents of vaccination have numerous arguments against compulsory vaccination. Vaccination reactions are observed in every thirtieth vaccination.These manifest themselves in the form of redness and swelling at the injection site, fever, joint pain or febrile convulsions. As a rule, the vaccination reactions subside again, so that no permanent damage occurs. If a physical reaction goes beyond this normal vaccination reaction, it is called vaccination damage. Vaccine damage also occurs when a person other than the vaccinated person has been vaccinated with pathogens that are capable of reproducing. Vaccine damage can manifest itself through many different symptoms and is therefore often not immediately associated with the vaccination. Due to the difficulty of providing evidence, only very few potential vaccine injuries are actually recognized by the State Board of Health. By the end of 1998, there were fewer than 4000 recognized vaccine injuries since the introduction of the Federal Vaccine Injury Act. Since 2001, physicians have actually been required to report suspected vaccine damage to the health department. Since this report is connected with a high expenditure for the physicians and besides many physicians fear recourse demands with a physician error, the report takes place however according to opinion of the inoculation critics much too rarely. Another risk that vaccination opponents cite against mandatory vaccination is the outbreak of disease due to vaccination. In the case of a live vaccine administered to a person with a weakened immune system, there is a risk that the disease against which one actually wanted to protect the body with the vaccination will break out due to the pathogens contained in the vaccination. The immune system does not have to be completely dormant. Often even small infections are sufficient. Even teething children should not be vaccinated for this reason. Compared to the “normal” disease, the vaccination disease runs rather weak. Such vaccine diseases are observed particularly often in measles.
