Why Did Germany Make the MMR Vaccine Mandatory?

Have you seen the news about the new law that called for mandatory measles vaccination in Germany?

A new law that calls for mandatory measles vaccination in Germany.
Maybe we just need laws against this kind of misinformation about vaccines and vaccine-preventable diseases…

It’s true, although it certainly won’t cause “death and injury rates” to sky rocket.

Why Did Germany Make the MMR Vaccine Mandatory?

So why did it happen?

“Often, there is a lack of information or targeted disinformation that prevents people from getting themselves or their children vaccinated and exposure to avoidable health hazards.”

Opinion of the Scientific Advisory Board of the Paul Ehrlich Institute, Federal Institute for Vaccines and Biomedical Drugs, On the Quality and Safety of Vaccines

Germany has been one of the countries most affected by measles outbreaks in Europe over the past few years, with over 5,000 cases since 2015.

And at least three measles deaths, including an unvaccinated toddler. Plus additional deaths from SSPE.

This toddler in Germany who died in 2015 was not vaccinated for measles.
This toddler in Germany who died in 2015 was not vaccinated for measles.

And almost all of the cases are among those who are unvaccinated.

This led to the reestablishment of endemic measles virus transmission in Germany in 2017, even as we are supposed to be working towards eliminating measles.

So what does mandatory measles vaccination in Germany mean?

“The bill stipulates that all children from the age of one on entering the school or kindergarten must have the measles vaccine recommended by the Standing Vaccination Commission. In the case of care by a childminder, proof of measles vaccination usually has to be provided.

The same applies to persons who work in community facilities or medical facilities such as educators, teachers, day care workers and medical staff (if these were born after 1970). Asylum seekers and refugees must also have the vaccine protection four weeks after admission to a shared accommodation.”

Vaccination is designed to protect children from measles

Passage of the Measles Protection Act (Masernschutzgesetz), which goes into effect on March 1, 2020, also means that parents can be fined up to €2,500 if they don’t vaccinate their children, daycare centers can be fined for admitting unvaccinated children, and certain unvaccinated workers, including healthcare workers, can be fined.

“Since measles vaccination is highly effective and very well tolerated, the German Ethics Council is of the opinion that every person is morally obliged to have him- or herself vaccinated against measles and, if applicable, to provide appropriate immunisation for his or her own children.”

Ethics Council: Increasing measles vaccination rate by a package of measures rather than by mandatory vaccination

While some oppose the law, including the German Ethics Council, it is important to note that few people see mandatory vaccination as the first step in getting folks vaccinated and protected. It is typically one of the last measures taken after everything else has failed and outbreaks are once again getting out of control, with people dying needlessly of an easily preventable disease.

Don’t want vaccine mandates to come to your community?

Then stop scaring people away from getting vaccinated and protected with misinformation and propaganda!

Vaccines are safe, with few risks, and are obviously necessary.

More on Mandatory Measles Vaccination in Germany

Standing Orders for Vaccination

Have you heard about standing orders for vaccination?

Anti-vax folks have become overt in how they are now all about conspiracy theories.
Anti-vax folks have become overt in how they are now all about conspiracy theories.

Guess what?

Standing orders does not mean “covert vaccination without consent.”

Standing Orders for Vaccination

For one thing, there is nothing covert about them.

In addition to the Take a Stand! website, the Immunization Action Coalition has hosted workshops all over the United States on using standing orders to increase vaccination rates.

And they aren’t about vaccinating people without their consent.

So what are standing orders for vaccination?

“Standing orders are written protocols approved by a physician or other authorized practitioner that allow qualified health care professionals (who are eligible to do so under state law, such as registered nurses or pharmacists) to assess the need for and administer vaccine to patients meeting certain criteria, such as age or underlying medical condition.”

10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting

Again, that doesn’t mean you can skip getting informed consent before giving vaccines.

“Having standing orders in place streamlines your practice workflow by eliminating the need to obtain an individual physician’s order to vaccinate each patient.”

10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting

All standing orders do is eliminate the need for doctors and other health care providers to assess and write orders for vaccines on each and every patient they see.

Instead, standing orders help delegate that part of the vaccination process to other qualified health care professionals to help make sure that “immunizations are available at all visits, sick or well, regular hours, or weekend clinics.”

Everything else is essentially the same.

Even with standing orders, you still have to get informed consent before giving a vaccine.
Even with standing orders, you still have to get informed consent before giving a vaccine.

The health care provider giving the vaccine still has to:

So what’s the benefit of standing orders?

It removes some of the barriers to getting vaccines, such as needing a well child checkup or physical exam, allowing for vaccination-only appointments.

“The Community Preventive Services Task Force (CPSTF) recommends standing orders for vaccinations—when used alone or when combined with additional interventions—to increase vaccination rates among adults and children from different populations or settings.”

Vaccination Programs: Standing Orders

Standing orders also help make sure that you keep kids on schedule or get them caught up as health care providers automatically check their vaccination status at each and every visit to the office, even during sick visits.

For example, if you child comes in for an appointment in October with a mild ear infection or because they have a wart, a standing order for a flu vaccine can help make sure you child is vaccinated and protected before flu season starts.

Standing orders do not override laws requiring informed consent.
Standing orders do not override laws requiring informed consent and there is no single form that would give consent to all medical procedures.

It should be obvious that standing orders simply lead to fewer missed opportunities to be vaccinated and protected.

Not surprisingly, their source and evidence for forced vaccination is simply another anti-vaccine website...
Not surprisingly, their source and evidence for forced vaccination is simply another anti-vaccine website…

There is nothing covert about them.

“Consent is a communications process, not a form. The process provides an opportunity for the patient to understand the benefits, risks and alternatives to the treatment he or she is about to undergo, and for the physician to explain these in detail. Forms are used to document the process.”

Consents Policy

Not even in the way anti-vax are using them to try and scare you away from vaccinating and protecting your kids.

More on Standing Orders for Vaccination

Anti-Vax Groups Are Targeting Minority Communities

It’s a big deal that anti-vax groups are targeting minority communities.

Anti-Vax Groups Are Targeting Minority Communities

Some of these communities already have low vaccination rates and have been hit with outbreaks of vaccine-preventable diseases.

Anti-Vax Groups Are Targeting Minority Communities

Unfortunately, Bobby Kennedy and the latest Harlem Vaccine Forum isn’t the first time this has happened.

Remember when Andy Wakefield, JB Handley, and others targeted Somali immigrants in Minnesota?

How about when opponents of new vaccine laws in California targeted Latinos in the community?

Why is this a problem?

“Q: I do have a question, on behalf of the Hispanic media, and also the African-American media. Rates for vaccinations have been historically low. Could you tell us what those communities can do to try and raise those rates, please? And also, the issues that they’re facing?

WILLIAM SCHAFFNER, MD: I think it’s very important that, number one, we reach out in ways to communicate with the minority communities in our country, and that we work with the leadership of those communities to actually educate those communities, bring them in, and to provide access, so that we can actually extend the benefit of vaccination to them. Colleagues?

PATRICIA WHITLEY-WILLIAMS, MD: I would certainly agree with that. I also would say, I am a member of the National Medical Association, which is an association predominantly of African-American physicians. We know about the disparities, with regards to vaccination coverage rates, both in adults and in children. But we also know about the deaths and severity of disease related to flu and pneumococcal infections; there is a disparity there, in terms of hospitalizations and deaths among underrepresented minorities in this country.

It is through education. It also depends on that relationship between adult patients and their providers. Again, there should be no opt-out. Patients need to understand that they’re tremendously at risk, and there is a disparity. As I think we all know, there is a historical context and a belief that exists in the African-American community, in terms of maybe mistrust of the medical system, because of experimentation that had gone on earlier. And again, it’s trying to provide that information and education through providers.”

National Foundation For Infectious Diseases (NFID) September 26, 2019

It is well known that many minority communities have low immunization rates.

“Since 1995, annual estimates of MMR vaccination coverage and poliovirus vaccination coverage increased among all children aged 19–35 months, and since 2007, disparities between racial/ethnic minorities and non-Hispanic white children for these vaccines has been nonexistent.”

Reduction of Racial/Ethnic Disparities in Vaccination Coverage, 1995–2011

Tragically, we are losing many of the gains that we had recently seen in reducing the gaps in vaccination among some racial/ethnic groups.

“HPV vaccine follow-through is lower in racial and ethnic minorities than Whites.”

Spencer et al on Disparities and reverse disparities in HPV vaccination: A systematic review and meta-analysis

In addition to children and teens, we are seeing growing disparities among adults too.

“On further examination, it is evident that some populations receive vaccinations at a level below other populations. For instance, 31% of Hispanic individuals received influenza vaccine in 2014 compared to 34.4% of African American and 46% of White Americans. This difference is also apparent in populations that receive pneumococcal and herpes zoster vaccines. These differences represent disparities in the use of nationally recommended vaccines.”

Anthony Pattin on Disparities in the Use of Immunization Services Among Underserved Minority Patient Populations and the Role of Pharmacy Technicians: A Review

We must continue to work to remove barriers to access to vaccination and encourage providers in these communities to get the message out that vaccines are safe, with few risks, and are obviously necessary.

“There are many Latino and African-American physicians who have a practice that predominantly serves a population of the same ethnicity. We really rely on those providers to help us get the word out, as the press will. These patients trust their providers. We also need to involve community-based organizations to help us in getting the message out as well.”

Patricia Whitley-Williams, MD

Providers, especially in those communities that are being targeted, can improve vaccination rates by:

  • using standing orders, especially during flu season
  • using reminder and recall systems so that everyone knows when they are due for their vaccines
  • providing consumer-oriented information about vaccines to help overcome any negative perceptions, misinformation, and fears parents might have

Don’t allow anti-vaccine propaganda and misinformation to infect your community and make your job harder or put your kids at risk to get a vaccine-preventable disease.

More on Vaccines and Minority Communities

Did the National Childhood Vaccine Injury Act of 1986 Cause the Immunization Schedule to Triple?

Why do some parents think that the National Childhood Vaccine Injury Act of 1986 caused the immunization schedule to triple?

The National Childhood Vaccine Injury Act did not cause the immunization schedule to triple.

The usual suspects…

Did the National Childhood Vaccine Injury Act of 1986 Cause the Immunization Schedule to Triple?

It is not just folks holding anti-vax propaganda signs though.

“In 1986, Congress—awash in Pharma money (the pharmaceutical industry is No. 1 for both political contributions and lobbying spending over the past 20 years)—enacted a law granting vaccine makers blanket immunity from liability for injuries caused by vaccines. If vaccines were as safe as many claim, would we need to give pharmaceutical companies immunity for the injuries they cause? The subsequent gold rush by pharmaceutical companies boosted the number of recommended inoculations from 12 shots of five vaccines in 1986 to 54 shots of 13 vaccines today. A billion-dollar sideline grew into the $50 billion vaccine industry behemoth.”

Robert F Kennedy, Jr on The Harlem vaccine forum

It is a common anti-vax talking point that the immunization schedule ballooned in 1986, with passage of the National Childhood Vaccine Injury Act.

It didn’t.

The National Childhood Vaccine Injury Act did not cause the immunization schedule to triple.

In fact, it is very easy to see that most new vaccines weren’t added to the immunization schedule until the late 1990s and after.

  • hepatitis B – 1981
  • Hib – 1985
  • hepatitis B vaccine (improved) – 1986
  • Hib (improved) – 1988
  • Varivax – 1995
  • DTaP – 1996 (replaces DTP)
  • hepatitis A vaccine – 1996
  • RotaShield – 1998 (quickly withdrawn)
  • LYMErix – 1998 (later withdrawn)
  • Prevnar – 2000
  • FluMist – 2004
  • Menactra – 2005 (replaces the Menomune vaccine approved in 1981)
  • Tdap – 2006
  • RotaTeq – 2006
  • Gardasil – 2006
  • Trumenba – 2014

And the immunization schedule did not change very much at all after passage of the National Childhood Vaccine Injury Act.

What about Bobby Kennedy‘s other point? Why did we need the National Childhood Vaccine Injury Act if vaccines are safe?

Protection from frivolous lawsuits.

What we need now is protection from this kind of misinformation that continues to scare parents away from vaccinating and protecting their kids!

More on the Immunization Schedule