We focus a lot of attention on articles that deal with ways to increase vaccination rates in the United States. We do so because our vaccine rates are suboptimal for a variety of reasons, many of which are related to unsubstantiated risk. What can we do to improve vaccination rates? Europe may offer us an answer. Did you know for example that there are 7 countries in Europe that mandate vaccination and only 2 of these allow nonmedical exemptions? In addition, 6 of these 7 countries will inflict financial penalties to families who do not immunize their children. So what are the vaccination rates in these countries and what about the incidence of vaccine-preventable diseases like pertussis and measles?
Vaz et al (10.1542/peds.2019-0620) evaluated these questions in new study being early released in our journal. The authors used data from the European Centers for Disease Control and Prevention and the World Health Organization to look at European countries that do and do not mandate vaccine administration to children in regard to vaccination against measles and pertussis, as well as the annual incidence of these two diseases in these countries. The results are interesting and perhaps not exactly what you might expect. On the good side, mandatory vaccinations did result in statistically significant increases in childhood vaccination against pertussis and measles. The interesting news is that only when a country did not allow nonmedical exemptions did the mandatory vaccine policy result in a significant decrease in measles, but not for pertussis. Why?
We asked Drs. Sean O’Leary (University of Colorado) and Yvonne Maldonado (Stanford) (10.1542/peds.2019-2436) to weigh in with an accompanying commentary. They draw some interesting lessons about vaccination mandates and changes in disease burden and bring to light other important considerations related to financial penalties and vaccination mandates. One important takeaway is that vaccine policies are uniform across each specific European country instead of the patchwork that exists across states. There is a lot of great information injected into the pages of this important study—so take a shot at reading both this study and commentary and then share with parents who will hopefully be even more convinced about why vaccination should be mandatory for their child. If state legislators read this study and commentary, perhaps vaccination policy, including mandates, will be made stronger.
