Declining child vaccination rates: mandatory vaccination or targeted education?

Meisje dat gevaccineerd wordt.

Within the Dutch National Vaccination Programme, children receive shots from infancy that protect against mumps, measles, rubella, whooping cough and polio, and against other diseases. But child vaccination coverage has fallen below 90 percent for the first time in decades. If vaccination rates fall for years, infectious diseases can appear. One way to prevent further decline is to institute compulsory vaccination. But is this a good measure? Martin Buijsen, Professor of Health Law at Erasmus School of Law, responds in Metro. 

“There is no support in the Netherlands for mandatory vaccination”, Buijsen says. “That does not mean that it would not be possible to introduce compulsory vaccination: legally speaking, it is not objectionable to introduce compulsory vaccination”, the professor continues. Buijsen explains that the European Convention on Human Rights (ECHR) does not oppose compulsory vaccination, provided certain conditions are met. Dutch law has a similar arrangement: the right to inviolability of the body may be restricted if, for example, public health is at stake. “But even then, it must be regulated by law, be proportionate and necessary”, Buijsen argues. 

Some European countries have instated mandatory vaccination for children and their parents. “If they do not meet this requirement, they are fined, child benefit is cut, or the child is not welcome at a nursery”, Buijsen explains. 

We are autonomous yet submissive 

“That there is no support for compulsory vaccination in the Netherlands has to do with autonomy: individual self-determination is considered very important”, Buijsen begins. “But it is also the case that we are very submissive people. Therefore, we always achieve high vaccination rates purely voluntarily. Today, the vaccination rate does drop slightly for the known childhood diseases, but it is still around 90 percent”, he adds. 

Education 

However, Buijsen does worry about the dropped vaccination rate: “Measles, for example, is a dangerous infectious disease, and that vaccination rate must be a bit above 90 to achieve group immunity. If the vaccination rate drops below 90, there could be measles outbreaks and, consequently, children could die.” 

But what is the best way to increase vaccination coverage? “Targeted education”, Buijsen answers. “That has always helped in the Netherlands. The problem with declining vaccination rates is that people no longer see the effects of dangerous infectious diseases: they no longer experience measles and, therefore, no longer see the need to vaccinate their children. Apart from that, there have always been groups with moral objections to vaccinations. That group seems to be growing slightly”, Buijsen says. 

Professor
Martin Buijsen, hoogleraar Gezondheidsrecht
More information

Read Buijsen’s entire reaction in the article published by Metro (in Dutch).

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