Image
© European Commission DG ECHO/Flickr
Europeans are turning away from vaccines, amid rising distrust of immunisation for infectious diseases. France's Constitutional Council has upheld legislation obliging parents to have their children innoculated.

Given the choice, not everybody would vaccinate their children. Marc and Samia Larère asked the French Constitutional Council for a "priority preliminary ruling on the issue of constitutionality" (QPC) on whether they could legally be forced to vaccinate their children.

The response came on 20 March: compulsory vaccination is legal under the French constitution. Like many parents, the Larères feel that the obligatory DTP vaccine (against diphtheria, tetanus and pertussis) poses too high a risk and protects against illnesses that are virtually non-existent in France.

The only DTP vaccine to not contain aluminium was withdrawn from the market in June 2008, and the others have been out of stock for months. The only remaining option is the hexavalent vaccine that also immunises against hepatitis B, although this is not on the obligatory vaccination list, and the vaccine has suspected links to multiple sclerosis.

Michèle Rivasi, a Green MEP, called this "a forced sale". "Vaccination is not benign. I am not against vaccination but I believe in moderation," she said at a press conference on 24 March. Together with pharmacist Serge Rader, she has launched an operation to blow the whistle on conflicts of interest and corruption in the public health sector.

For recommendation, against obligation

If there is one domain within the sector that tends to keep its nose clean, says Selon Serge Rader, it is vaccination. In Europe, France is the only country to maintain the policy of compulsory vaccination against diphtheria, tetanus and pertussis.

Portugal has kept compulsory vaccination for diphtheria and polio, and Belgium just for polio. Elsewhere in Europe, Germany, the United Kingdon, the Netherlands, Switzerland, Spain and others have all abolished compulsory vaccination.

The Commission's objective in this domain is to maintain or increase rates of vaccination against preventable diseases. The Executive has committed to assisting with the introduction of vaccines against cervical cancer and promoting the vaccination of "people at risk" of seasonal flu. The Council recommendation of 22 December 2009 advised member states to aim to vaccinate 75% of their "at risk" citizens against flu by the winter of 2014-2015. Only the United Kingdom and the Netherlands achieved this target, but experts say that if it was reached across the EU, between 9,000 and 14,000 lives would be saved every year.

"We are in favour of recommendation, not obligation," said Michèle Rivasi. Serge Rader said it is important not to forget that vaccines can be dangerous. Thousands of cases of multiple sclerosis have been detected following hepatitis B vaccinations and the measles, mumps and rubella vaccine (MMR) has been linked to cases of autism. In Canada, a 15 year-old girl died immediately after her second injection of Gardasil, the vaccine against the papillomavirus, which causes cervical cancer.

"I would like to give people two pieces of advice. Firstly, there should be no rush to vaccinate babies, as their immune systems are too fragile to receive vaccines in the first year. Secondly, be vigilant for side effects and declare them to the pharmacovigilance organisation," Serge Rader said. "This is in the interest of public health, which today is dominated by financial interests," he added.

Distrust of vaccination

According to the French National Institute for Prevention and Health Education, distrust of vaccination has risen from 10% in 2005 to 40% in 2010.

"There has been a startling drop in vaccination in France, particularly against potentially serious diseases," said Professor Roger Salamon. "Some whistle-blowers are very dangerous [...] because they cause people to lose their trust," he added.

In November 2014, a panel of experts advised the EU to launch its own information campaign to counterbalance the work of the anti-vaccination lobby.

The Italian Health Minister said that it was "only thanks to a new alliance between the institutions and stakeholders, including the scientific community, and thanks to a new public communication strategy that we can ensure that everybody has access to vaccines. This service is essential for public health".

In September 2014, the French High Council for Public Health called for a public debate on whether vaccination against certain diseases should remain compulsory in France or not, and suggested setting up free public vaccination centres.

Translated from French by Samuel White