Compulsory vaccination

From one Compulsory vaccination one speaks when a vaccination is required by law as a preventive measure for humans and / or animals. There is currently no general compulsory vaccination in Germany, Austria and Switzerland.

What is compulsory vaccination?

The first vaccination was compulsory in Germany in 1874. In the Reich vaccination law of that time, all Germans were obliged to have their children vaccinated against smallpox at the age of one and twelve.

The general compulsory vaccination was ended in 1975 and was only mandatory for certain groups of people until the 1980s. Today there are no longer any general compulsory vaccinations in Germany, Austria and Switzerland, only vaccination recommendations. In the Bundeswehr, however, there is still compulsory vaccination against tetanus.

Function, effect & goals

Vaccinations are used to stimulate the immune system to defend itself against specific substances. They were developed for the prevention of infectious diseases such as polio, measles, smallpox or rubella. When it comes to vaccination, a distinction is made between active and passive vaccination.

The aim of the active vaccination is to prepare the body's immune system for an infection with the administered pathogen so that a defense reaction can take place quickly. Live vaccines and dead vaccines are used for active vaccination. The live vaccine consists to a small extent of functional pathogens. These are weakened (attenuated), so that they can still multiply, but under normal circumstances they can no longer cause disease. Inactivated vaccines, on the other hand, consist of inactivated pathogens, i.e. of pathogens or toxins that are no longer able to reproduce. In both cases, the vaccination should induce the body to produce antibodies against the pathogen.

This process can take a week or two. If the pathogen penetrates the body again later, it is quickly recognized by the circulating antibodies and can therefore be fought quickly. With passive vaccination, the recipient is injected with an immune serum. This contains high doses of antibodies against the pathogen. In contrast to active vaccination, the antibodies are available immediately. But the protection only lasts for a few weeks. According to the Robert Koch Institute, vaccinations are one of the most important and effective preventions against infectious diseases. The vaccination against smallpox and the associated compulsory vaccination have led to the global eradication of smallpox.

Other infectious diseases could also be massively reduced through the use of vaccinations. Although compulsory vaccination, especially for children's diseases such as measles and rubella, has been discussed again and again, there are currently only vaccination recommendations in Germany. Vaccination recommendations are issued by the Standing Vaccination Commission (STIKO), an expert committee of the Robert Koch Institute in Berlin. STIKO evaluates scientific and clinical data and uses the results of these evaluations to make recommendations for vaccinations. In contrast to mandatory vaccination, the STIKO vaccination recommendations are not legally binding. However, they are mostly adopted by the state health authorities as a public recommendation.

STIKO currently recommends vaccinations against tetanus, diphtheria, whooping cough, Haemophilus influenzae type b, poliomyelitis (polio), hepatitis B, pneumococci (causative agents of lung and meningitis), rotaviruses, meningococci, measles, mumps, rubella and chickenpox. The STIKO also recommends vaccination against human papillomavirus (HPV) for young girls. Elderly people and people with a suppressed immune system are also advised to be vaccinated against the flu virus. Most vaccinations are given for the first time in infancy and young children and then refreshed between the ages of five and eighteen. Some vaccinations, such as the tetanus vaccination, must be given every ten years to provide adequate protection.

Special features & dangers

Many German paediatricians repeatedly demand that children be vaccinated. Above all, the high number of measles cases is cause for concern and shows that a voluntary vaccination concept based on the vaccination recommendations is not sufficient.

Opponents of vaccination have numerous arguments against compulsory vaccination. Vaccination reactions can be observed with every thirtieth vaccination. This manifests itself in the form of redness and swelling at the injection site, fever, joint pain or febrile cramps. As a rule, the vaccination reactions recede, so that no permanent damage occurs. If a physical reaction goes beyond this normal vaccination reaction, one speaks of vaccination damage. Even if vaccination was carried out with pathogens capable of reproducing and someone other than the vaccinated person suffers damage, this is referred to as vaccination damage. Vaccination damage can manifest itself through many different symptoms and are therefore often not immediately associated with the vaccination.

Due to the difficult evidence, only very few potential vaccine damage are really recognized by the state welfare office. By the end of 1998 there had been fewer than 4,000 recognized vaccine damage since the introduction of the Federal Supply Act. Since 2001, doctors have actually been obliged to report any suspected vaccine damage to the health department. Since this notification is associated with a high level of effort for the doctors and many doctors fear recourse claims in the event of a doctor's mistake, the report is far too seldom in the opinion of the vaccination critics.

Another risk that opponents of vaccination cite against compulsory vaccination is the outbreak of the disease through vaccination. If a live vaccine is given to a person with a weakened immune system, there is a risk that the pathogens contained in the vaccination will break out the disease against which the body was actually protected with the vaccination. The immune system does not have to lie completely idle. Small infections are often enough. Teething children should also not be vaccinated for this reason. Compared to the "normal" disease, the vaccine disease is rather weak. Such vaccine diseases are particularly common in measles.