Vaccination as a duty?

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Vaccinations are among the most successful preventive measures in medicine. Especially against many infectious diseases caused by viruses, which even today can only be treated symptomatically, vaccinations are the most important option to protect against potentially severe health risks. As the example of smallpox shows, some pathogens can even be completely eradicated with vaccination programmes that are carried out consistently and globally.

Despite their considerable and undeniable benefits,  reservations about vaccinations also exist in the population, primarily related to fears of serious side effects. The example of measles shows that these reservations, combined with individual negligence in caring for one's own vaccine protection or that of children, stand in the way of international efforts to curb infectious diseases. In Europe, despite a large-scale WHO campaign to eradicate measles, local outbreaks occur repeatedly. In Germany, the number of reported measles cases has tended to rise slightly in recent years, which is why it is already foreseeable today that the "National Action Plan 2015-2020 for the Elimination of Measles and Rubella in Germany" initiated by the Federal and State Governments will not achieve its goal.

The German Ethics Council takes the case of measles as an opportunity to investigate the general reasons for the failure of national and international vaccination programmes and to ask which regulatory measures for the realisation of vaccination goals are ethically and legally acceptable or reasonable. In fact, every individual decision in favour of or against vaccination has an ethical dimension if it concerns a disease that can be transmitted from person to person. Anyone who acquires immunity against a communicable disease through vaccination thus also protects others, just as does anyone who decides against vaccination thus potentially endangers others. There are also doctors who deliberately do not follow public vaccination recommendations when dealing with the families entrusted to them. The planned Opinion of the German Ethics Council intends to answer in particular the following questions:

  • What are the main reasons for the sceptical attitude towards vaccinations among parts of the population and how are they to be evaluated?
  • Which interventions in the autonomy of fully competent adults can be ethically and legally justified with regard to public welfare, and which of these interventions seem suitable for closing the existing vaccination gaps?
  • Which interventions in parental custody and medical freedom can be ethically and legally justified, and which of them seem appropriate to achieve a higher vaccination rate in children?
  • Would a legal obligation to vaccinate be ethically and legally acceptable, and what range of sanctions would be available to enforce it?