Germany and Samoa Mandate Measles Vaccine

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A vial containing one dose of the MMR vaccine.
Source: NBC News, “What’s in a Measles Vaccine?,” nbcnews.com, Feb. 9, 2015

In the midst of a global resurgence of the measles virus, Germany and Samoa have mandated the measles vaccine for several groups of people.

The German Parliament voted in favor of the Measles Protection Act on Nov. 14, 2019 to require that all children receive two measles vaccinations before entering kindergarten (the equivalent of preschool in the US) or school. Older children must provide proof of prior vaccination. Adults who work in community or medical facilities who were born after 1970, and asylum-seekers and refugees must also receive the measles vaccine under the new law. The law will take effect in Mar. 2020.

A fine of up to € 2,500 ($2,750) and an administrative offense charge can be imposed on parents who do not vaccinate their children, unvaccinated adults working in community or medical centers, and unvaccinated refugees or asylum-seekers. The fine can also be levied against daycare centers that allow unvaccinated children to attend, medical and community centers that allow unvaccinated workers, and housing that allows unvaccinated refugees and asylum-seekers. Germany has reported 501 cases of measles in 2019.

The Samoan government closed schools on Nov. 18, 2019 in the face of a measles outbreak that has killed at least 24 children and one adult as of Nov. 25, with an additional 20 children hospitalized in critical condition. Of the children who have died, the median age is 13 months.

The country has seen about 2,200 cases of the measles since the beginning of the outbreak in October. According to the World Health Organization (WHO) and UNICEF (United Nations Children’s Fund), the vaccination rates of Samoan babies has fallen from over 70% in 2013 to under 30% in 2018.

The Prime Minister of Samoa (who is also the Minister of Health) Faimalotoa Kika Stowers-Ah Kau declared a state of emergency on Nov. 15, which requires that every citizen receive a measles vaccination and bans minors from public gatherings.

Mandating vaccines remains contentious around the world. AnneMarie Schieber, a Research Fellow at The Heartland Institute, stated, “This isn’t about being ‘anti-vax.’ Vaccines have had an incredibly positive impact on stopping the spread of disease. This issue is primarily about personal freedom and protecting the long-established and protected medical practice of informed consent.”

The Editors of Scientific American stated, “Many of the people who choose not to vaccinate believe that the government should not be able to force them to put medicine into their or their children’s body. They frame the choice as a personal right, but they are not taking into account the right of their children or others to be free from disease. When it comes to balancing the two, we need to consider the needs of the herd over the individual.”

In the United States, as of Nov. 7, 2019, there have been 1,261 individual cases of measles confirmed by the Centers for Disease Control (CDC) in 31 states, the greatest number of cases in the country since 1992. Only 10 cases were reported in Oct. 2019, down from 342 in Apr.

The CDC recommends that children receive the first MMR (measles, mumps, and rubella) vaccine between 12 and 15 months old, and the second dose between four and six years old. However, the second dose can be given as few as four weeks after the first dose. All 50 states and DC require some vaccines for children to enter public school. While all 50 states and DC allow for medical vaccine exemptions, 45 states and DC offer religious exemptions and 15 and DC offer philosophical or personal exemptions.

Discussion Questions – Things to Think About
1. Should the US government mandate any vaccines? Why or why not?

2. Are vaccines important to public health? Why or why not?

3. Besides vaccine mandates, what else might governments do to stop or slow the spread of contagious diseases? Explain your answer.

Sources:

AP, “Samoa Measles Epidemic Worsens with 24 Children Now Dead,” latimes.com, Nov. 25, 2019

Bundesministerium für Gesundheit, “Impfpflicht soll Kinder vor Masern schützen,” bundesgesundheitsministerium.de, Nov. 14, 2019

CDC, “Measles Cases and Outbreaks,” cdc.gov, Nov. 12, 2019

Melissa Eddy, “Germany Mandates the Measles Vaccine,” nytimes.com, Nov. 14, 2019

AnneMarie Schieber, “Government Should Get out of Exam Rooms when Ordering Vaccines,” heartland.org, Nov. 11, 2019

Scientific American Editors, “The U.S. Needs to Tighten Vaccination Mandates,” scientificamerican.com, June 24, 2019

Amy Woodyatt, “Germany Makes Measles Vaccination Compulsory for Children,” cnn.com, Nov. 15, 2019

Paolo Zialcita, “Samoa Closes Schools and Mandates Vaccinations amid Deadly Measles Epidemic,” npr.org, Nov. 18, 2019