What can the UK learn from European vaccination policies?

Problem

Vaccines are one the pinnacles of primary prevention, preventing and estimated two to three million deaths each year. However, the growing anti-vaccination movements and increasing vaccination scepticism in the general population has led to a fall in vaccination uptake in the recent past. This has had fatal consequences in the form of a measles outbreak spreading across Europe. In the UK, coverage for the vast majority of vaccines does not reach the 95% target recommended by the WHO. For many vaccines, coverage rose until the early to mid-2010’s and has declined in the last 2-3 years. This highlights the importance of tackling this issue by implementing policies and strategies to counter the increasingly vocal anti-vaccination movements.

Approach

A literature review was conducted, using Pubmed and Google Scholar, to determine different approaches of European countries to vaccination policies. Namely, newly implemented policies and their implications in Italy and France were analysed. Their evidence-base was reviewed, as well as arguments in favour and against such policies. They were then analysed in an ethico-legal framework, according to constitutional law, utilitarian ethics and individual autonomy.

Findings

There is evidence that vaccine mandates have contributed to increase the vaccination coverage in given populations, especially in the USA. In addition, it was found that removing vaccine mandate may cause coverage to decline. From a legal point of view, it has been extensively argued that mandatory vaccination is in accordance with the constitution in many countries where it has been implemented. In the UK, such legislation has proven to be possible with smallpox vaccination being made compulsory in the Vaccination Act (1853). From an ethical standpoint, however there is little to justify mandating vaccines. The utilitarian argument is opposed by the morality of sanctions taken against parents who refuse to vaccinate their children, and the repercussions on these children.

Consequences

Although policies rendering vaccines mandatory have worked to increase vaccine uptake in the past, many arguments can oppose such policies. Firstly, the growing role of social media in spreading misinformation makes the social context of these policies drastically different to what it was 10 years ago. In addition, there are many ethical arguments opposing the sanctions that inevitably come with vaccine mandates. Their repercussion on the education and development of the child in question are not negligible. Finally, there are alternatives to vaccine mandates as seen in Germany or Australia, which many be better suited and less polarising than making vaccines mandatory.