VIENNA, Va. — Austria has become the first country in Europe to set a legal requirement for vaccines to prevent chickenpox. The move suggests that a tipping point has been reached in how vaccines are viewed in Europe, with the continent heading towards a considered approach to vaccination policy on a spectrum from “overwhelmingly supportive” to “strictly incremental,” according to Pfizer, which makes the chickenpox vaccine.
The decision is a triumph for Dutch journalist Marieke Kucinich, who in 2010 spearheaded a campaign in the Netherlands to have its chickenpox vaccination mandate canceled, also resulting in a binding Supreme Court ruling against the ministry. She told me that many countries in Europe have since come under political pressure to lift or widen their chickenpox vaccination mandate or at least provide stronger protection against the disease.
Many Western countries have lacked measles and whooping cough vaccines because of resistance from European countries to a voluntary public health program, believed to have been carried out at no cost to health care providers. (Quarantines for those with measles were enforced starting in 1998, and were used against a large scale measles outbreak beginning in 2006.)
Today, only Central and Eastern Europe and the Middle East have eliminated the diseases, according to the World Health Organization. However, WHO immunization estimates suggest that health care coverage rates globally are more than 90 percent, which is significantly higher than 90 percent in Western Europe.
At the same time, WHO officials are pushing a gradual approach to immunization mandates, something that could take years to impact the number of vaccines needed. In Europe, WHO finds that countries are generally embracing partial measures, with exemptions on medical grounds.
What Will It Take?
I recently had the chance to speak with European campaign director for the Coalition for Vaccine Choice, Hans Peter Sobdahl. I started by asking Sobdahl what it would take to accomplish universal vaccination in Europe. According to him, it would take more time than appears to be currently in the cards. He pointed to the resistance the European Union had faced from neighboring countries to requiring all visitors, Europeans or foreign tourists, as a central source of resistance.
“I don’t think everyone will agree that it’s a good idea that people do not have access to vaccines,” he said.
Danish major Peperami said the nation may be nearing an endpoint for its children’s vaccines, which until recently was good news for its residents.
“It’s well known that the Danish school systems do not allow injections, so in 2014 the Danish government introduced a 10-year ‘road map’, which is slowly getting pretty hard as we go down the middle of the road,” Peperami told me via email. “In three to four years’ time, it will be ‘investing in skills and immunization’ as the administration’s slogan.”
He noted that the agency plans to phase out most of the five-month-old vaccine schedule, and he expects, but does not know, that Danish doctors will have to write prescriptions and get those written up by the mid-2020s.
“All of the countries in the EU and in the world are improving their vaccination coverage, including the Scandinavian states, but we also have to keep in mind that some countries’ vaccination protocols are really old and already a burden for the doctors,” he said.
The U.S. did set national law requiring children get vaccinations, which typically applied to a broad range of vaccines, starting with the measles, mumps and rubella (MMR) shot for children, for instance. In 2010, President Obama’s health secretary Kathleen Sebelius encouraged states to strengthen mandates, such as requiring kids be vaccinated for measles, mumps and rubella if the immunization records showed that their parents took the day care or daycare children out for an otherwise potentially preventable infectious disease. (Parents on the other hand may not be aware that their child had unprotected exposure to the disease in a swimming pool or for any other reason.)
Sebelius rescinded her position as a vocal proponent of mandatory vaccinations in 2013, but as of now, there are no mandatory vaccines in the United States. But just three years after that conversation, the U.S. Supreme Court declared that the Vaccine Court could hear cases in which personal, financial, or philosophical beliefs outweighed the seriousness of a disease, particularly when patients lacked medical conditions to qualify for a