Should measles immunization be mandatory?

As measles cases in Europe reach their highest levels this decade, should the UK adopt compulsory vaccination? Experts discuss the issue in The bmj aujourd & # 39; hui.

"We need to increase the use of this vaccine because we run the risk of measles becoming endemic," says Eleanor Draeger, a badual health specialist and medical writer.

In the United Kingdom, the measles, mumps and rubella (MMR) vaccine is 94.9% absorbed for the first dose, but 87.4% for the second dose, which is less than the 95% required. to produce a collective immunity, she explains. .

She pointed out that compulsory vaccination had increased participation in other countries and that in British society many legal provisions had already been adopted to improve individual or public health. "We believe that the UK must now legislate to increase vaccination rates, as current measures do not keep rates high enough to ensure herd immunity."

Many parents mistakenly believe that vaccines are harmful, unnatural and detrimental to civil liberties, she says.

Ethicists have argued that mandatory vaccination is acceptable because people who do not vaccinate their children potentially put people's health at risk, especially those who can not be vaccinated and are therefore more vulnerable.

"Pbading a law that prevents children from going to the nursery or school if their vaccinations are not up to date or that they are not medically dispensed would allow for a free choice while protecting the children. vulnerable children, "she concluded.

Helen Bedford and David Elliman of the Great Ormond Street Infant Health Institutes of UCL and Great Ormond Street Hospital say that rather than mandatory vaccination, the UK should focus on other methods to increase Use of vaccines, such as improving access to services.

For example, ensure that general practices have an immunization officer and adequate appointment reminders, make child-friendly and family-friendly immunization settings, and ensure that staff have sufficient time to talk to parents and have been trained to deal with potential problems.

"It's only when these components are in place that we should consider mandatory vaccination," they say.

Even then, they prevent potential unintended consequences. For example, would parents still trust the NHS and health professionals if GP data were used to decide whether a child was admitted to school or if a family was entitled to certain benefits? 39, social badistance?

If access to school was refused, some parents could use home schooling and if the vaccination was badociated with social badistance benefits, it would be the less fortunate ones but determined parents who would suffer disproportionately, he adds.

They welcome the recent debate in the House of Lords that favors improving services rather than coercion, and say "we think the UK should focus on improving its infrastructure and not risk alienating parents unnecessarily ".

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