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After fighting epidemics, several European countries have increased their legal requirements for child immunization – and vaccination rates have increased.
Childhood immunization rates have risen in Europe after the generalization of a wider range of vaccinations in France and Italy.
Public health experts see this as good news in the fight against the spread of life-threatening diseases, while immunization skeptics worry about security and civil rights issues.
As in the United States, France and Italy have long imposed vaccination of children against polio, diphtheria and tetanus. Italy has also demanded that school-aged children be vaccinated against hepatitis B.
In 2017, after a major measles outbreak, Italy imposed six other vaccines, including vaccines against hemophilus influenzae B, measles, mumps, rubella, whooping cough and chicken pox.
The following year, France began requiring that eight additional vaccines be administered to infants – against whooping cough, hemophilus influenzae type B, hepatitis B, measles, mumps, and the rubella, chicken pox, pneumococcus and meningococcus C – before they can be enrolled in school. .
In a new study published in Eurosurveillance, a review of the European Center for Disease Prevention and Control, French researchers have found that vaccination rates "markedly increased" among children born in 2018 compared to older children who are n & # 39; 39 were not subject to the new requirements.
The vaccination rate against hepatitis B in France has increased from about 92% in 2017 to 98% in 2018, while the vaccination rate against pneumococcus has increased from 98% to 99.4%.
Immunization coverage for the first dose of meningococcal C vaccine increased from 39.3% to 75.7%.
"In addition, immunization coverage for children and for non-legal vaccines also showed an upward trend, reinforcing the positive impact of the current communication strategy on immunization, beyond extension of immunization mandates, "concluded the report.
In Italy, measles immunization rates rose from 87.3% in 2016 to 91.8% in 2017 and to 94.1% in 2018 in children aged 30 months, Italian researchers reported in another study published in the same newspaper.
"Despite the implementation of this law, the hesitation to vaccinate remains a problem in Italy and the political and social debate on compulsory vaccination is ongoing," the researchers noted.
The same is true in the United States, where immunization advocates and vaccine opponents have opposed the issue of mandatory vaccination and whether vaccines are safe and effective.
Centers for Disease Control and Prevention
The 50 states require vaccination as a condition of entry to school, although exceptions vary from state to state.
In addition to mandating vaccination against childhood diseases such as polio, diphtheria and measles, three states – Rhode Island, Virginia and the District of Columbia – have also pbaded laws requiring school-age children to be vaccinated. against the HPV virus, which can cervical cancer and some cancers of the head and neck.
"A national implementation of mandatory vaccination will reduce local epidemics, morbidity and mortality badociated with vaccine-preventable diseases," said Suman Radhakrishna, MD, FACP, infectious disease physician at the CHA Hollywood Presbyterian Medical Center in Los Angeles , California, at Healthline.
According to the National Conference of State Legislatures (NCSL), few states, in contrast, need adult vaccines.
In addition, "all states allow immunization exemptions for medical reasons and almost all (except California, Mississippi and West Virginia) grant religious or philosophical exemptions to those with genuine beliefs that prohibit vaccination", according to a NCSL report. .
"At present, 29 states and the Department of Defense have a religious exemption law and 16 states have a religious and philosophical exemption law. These laws allow parents to claim an exemption based on their personal, moral or other beliefs. "
With rising exemption rates and measles outbreaks in communities with a high percentage of unvaccinated children, California legislators voted in 2015 to eliminate the exemption from personal beliefs. the state.
The lawyers said that the change had resulted in an increase in vaccination rates, but also an increase in the number of health care claims.
"The decrease in immunity due to lack of exposure to vaccine-preventable diseases and the growing number of unvaccinated people is a significant vulnerable population," Radhakrishna said. "Epidemics have been reported in several developed countries, including the United States, New York, for example, [that] recently had a major measles outbreak because of the large number of vaccine exemptions allowed in a Hasidic Jewry community. "
Vaccination experts aim to achieve a 95% vaccination rate to produce "group immunity", which protects the general population against epidemics, even incomplete or not.
For this reason, "the only people allowed to circumvent the mandate are those who suffer from medical illnesses," said Aaron Glatt, MD, chair of the Department of Medicine and Hospital Epidemiologist, South Nbadau Communities. Hospital in Oceanside, New York. Health line.
Currently,
Glatt said that although 95% vaccination is a laudable goal, even a high rate is not a guarantee against the transmission of the disease – especially in environments where a large number of children are close to each other. others, such as schools and daycares.
"The goal should be to vaccinate 100% of the children," he said.
Shira Miller, MD, founder and medical director of the Integrative Center for Health and Wellness at Sherman Oaks, Calif., And president of Physicians for Informed Consent, said the mandatory vaccinations were "unscientific and contrary to" 39; ethics. "
"It has not yet been proven that prescribed vaccines are less risky than the diseases they were designed to prevent," she said. "For example, the risk of dying from measles is 1 in 10,000, according to US data from the pre-vaccine era. However, the risk of death or permanent disability caused by the measles, mumps and rubella (MMR) vaccine has not been found to be less than 1 in 10 000. "
Miller said the law effectively prevented vaccine manufacturers from being sued directly for injuries in the vaccine, these cases then being referred to the program of compensation of the victims of the vaccination.
Compulsory vaccination "promotes medical intimidation and prevents parents from protecting their children from the potential risk of vaccination-related injuries," she said.
Lawyers say that vaccination has been one of the greatest successes of the 20th century in public health. For example, polio – a disease that paralyzed 15,000 Americans every year before mandatory immunization began – was virtually eliminated in the United States. And decades of compulsory vaccination against smallpox helped eliminate a disease that had already killed millions of people.
Glatt, who says he is old enough to know the children who have been wheeled in a lifetime because of polio, added, "I am certainly not in favor of dispossessing the children of their parents and vaccinating them by force. But not doing it should have consequences. "
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