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A child gets a vaccination in the upper arm (symbolic picture)
Photo: KatarzynaBialasiewicz / iStockphoto / Getty Images
Around two and a half years ago, compulsory measles vaccination was introduced for daycare children, among other things.
The Federal Constitutional Court has now dismissed several lawsuits from affected families, so the law remains in force.
What does this mean for children and their parents?
How does vaccination work and how dangerous is measles anyway?
The most important questions and answers:
Why is measles vaccination compulsory?
Many people have been vaccinated against measles.
However, the quota is not high enough to prevent the circulation of the highly contagious virus and outbreaks.
At least 95 percent of the population would have to be immune for this.
Germany has also made a commitment to the World Health Organization (WHO) to eliminate measles.
What is the obligation to vaccinate?
The obligation to vaccinate applies to those who regularly come into contact with other people in community and health facilities.
These are mainly day care centers and schools.
The obligation to vaccinate also applies, for example, in refugee accommodation and for employees in hospitals and medical practices.
There is an exception for people who cannot be vaccinated for medical reasons.
Nobody is forced to be vaccinated anyway.
What does this mean specifically for children and parents?
Since March 1, 2020, children over the age of one may only be admitted to a day care center or childminder if they have been vaccinated or have already had the measles.
The parents have to prove that.
The same rules apply to school – however, in case of doubt, compulsory schooling takes precedence.
For children who were already in their day care center or school at the time, there was a transitional period for proof that was extended several times.
It expired on July 31, 2022.
What happens in case of violations?
If the proof is not available in time or if there are doubts about its authenticity, the facility must inform the health department.
The office can then - with the exception of schools - after a reasonable period of time in individual cases, depending on the risk, issue a ban on entry.
Alternatively, a fine of up to 2500 euros can be imposed.
How dangerous are measles?
more on the subject
WHO:More than 200,000 people died from measles in 2019
Measles, mumps and rubella: why childhood diseases are dangerous for adults
Measles is a viral disease that is transmitted more quickly than, for example, the flu.
Even a sneeze or cough is enough for the pathogens – packed in droplets – to get from one person to another.
Infected people can be contagious before the typical rash appears.
Measles is not just a childhood disease, young people and adults who have not gone through the measles and are not vaccinated can also become ill.
Symptoms are fever, conjunctivitis, runny nose, cough, headache and the typical skin rash.
Complications include diarrhoea, middle ear and pneumonia.
In very rare cases, it can also lead to inflammation of the brain, the measles encephalitis.
As a rare complication, the so-called subacute sclerosing panencephalitis (SSPE) can occur years after the disease, which is always fatal.
Experts also warn that an infection weakens the immune system for a long time.
Once you have measles, you are immune for the rest of your life.
How widespread are measles in Germany?
During the corona years, only 76 (2020) and 10 (2021) cases were reported to the Robert Koch Institute (RKI).
Before that, it was usually several hundred a year, and even 2,465 in 2015. Critics of compulsory vaccination also point to these relatively low numbers.
On the other hand, there are people who are particularly at risk and cannot be vaccinated themselves, such as infants, the sick with an immune deficiency or pregnant women.
If enough others get vaccinated, they are also protected ("herd immunity").
Is the measles vaccination dangerous?
Especially after the first vaccination, reactions such as fever and headaches can occur.
Some vaccinated people also get a skin rash, the so-called vaccine measles.
"Severe undesirable effects of vaccination are rare," says the federal information portal.
How does the vaccination work?
For children, the Standing Vaccination Commission (Stiko) recommends one vaccination from eleven months and a second from 15 months.
Adults born after 1970 who have received only one vaccination or have not yet received one should be vaccinated once.
A so-called live vaccine made from weakened measles viruses is injected.
In Germany there are only combination vaccines that are also used to vaccinate against mumps, rubella and, in some cases, chickenpox.
The plaintiffs also criticize this.
Where are there vaccination gaps?
more on the subject
WHO warns: Number of measles cases up by 80 percent at the beginning of the year
Consequences of the pandemic: Because of Corona, millions of children have missed the measles vaccination
According to new data from the Robert Koch Institute (RKI), 75.6 percent of children aged 24 months nationwide have been vaccinated twice against measles.
The vaccinations are often made up for by the time children start school – for the decisive second vaccination, the vaccination rate for school beginners is 92.7 percent.
The necessary 95 percent has so far only been achieved in Brandenburg and Mecklenburg-Western Pomerania.
However, there are even larger gaps among adults.
In 2019, the German Ethics Council therefore did not consider it justified to introduce compulsory vaccination for children.
How do the complaining families argue?
They did not want to let the decision about vaccination be taken out of their hands.
"Parents who make an informed and well-considered decision against the measles vaccination or who want to vaccinate later will be deprived of every possibility of external care for their children," says a statement from the associations Doctors for Individual Vaccination Decisions and Initiative Free Vaccination Decisions, which the constitutional complaints supported.
"This represents an unjustifiable interference with the parents' freedom of choice for their own social life and upbringing concept." The children's basic right to physical integrity is also violated.
What do the courts say?
The Federal Constitutional Court has now confirmed the measles vaccination requirement.
The judges in Karlsruhe said that the encroachments on fundamental rights are not insignificant, but are currently reasonable.
"Without violating constitutional law, the legislature has given the protection of people at risk of measles infection priority over the interests of the complaining children and parents."
In 2021, the European Court of Human Rights approved compulsory vaccination in the Czech Republic, including against measles, which is also enforced there with fines and denied daycare access.
mar/dpa/AFP