[Science] Should the UK make childhood vaccinations mandatory? – AI

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[Science] Should the UK make childhood vaccinations mandatory? – AI


By Adam Vaughan The measles virus produces an unpleasant rashSouth_agency/Getty Images The UK is looking “very seriously” at making vaccinations compulsory for schoolchildren in England in response to falling vaccination rates there — that’s what health secretary Matt Hancock told the Conservative party conference yesterday. “When the state provides a service to people then it’s a two-way street. You have to take your responsibilities too,” he said. His comments follow figures that emerged last week showing all routine vaccinations in England for under-5s fell last year, a decline which UK chief medical officer Sally Davies said was troubling. Embarrassingly, this year the UK lost its official “measles-free” status, after 231 cases were confirmed from January to March 2019. Hancock’s office didn’t respond to questions about what means would be used to compel people to vaccinate their children. But there are several possible options. Some countries make vaccination a condition for children going to school. Australia uses the “no jab no pay” threat of withholding benefits. Advertisement But is mandating vaccinations the answer? If the UK did pursue this strategy, it would be a return to the past. In the 19th century, the government made vaccination compulsory, only later switching to a voluntary approach when the smallpox epidemic subsided and immunisation levels went up. Read more: MMR vaccine does not cause autism, study once again confirms For a long time, overall routine vaccination rates in the UK held steady at around 98 per cent. But in the case of the Measles, Mumps and Rubella (MMR) vaccine, coverage for the first dose in 2-year-old children has fallen for five years in a row and now stands at 90.3 per cent in England. The World Health Organization (WHO) has a target of 95 per cent coverage. However, the WHO makes no recommendation either for or against mandating vaccinations — it is up to countries to decide the best way of ensuring high rates, it says. Looking to other countries doesn’t give an obvious answer to whether mandating works. Belgium, France and Italy are among the countries that do this. But a 2018 review by the Sabin Vaccine Institute, a non-profit based in Washington, DC, found that examining Europe’s different legislative approaches didn’t point to any one best approach. How medicine is harnessing our natural defences: Daniel Davis at New Scientist Live Some researchers say the UK has reached the point where mandating is necessary because measles protection has got so poor. Stefano Merler at the Bruno Kessler Foundation in Trento, Italy, says the step is needed — otherwise the overall proportion of the UK population at risk of measles infection will rise from 3.7 per cent in 2018 to 5.5 per cent by 2050. His paper found “positive effects” where countries had introduced compulsory vaccination policies. Others think it isn’t such a good idea, regardless of the stick used to compel people to vaccinate. “I do think it is premature and wrong,” says David Elliman at Great Ormond Street Hospital in London. He would like to see more work put into other efforts first, noting it is only a “very small minority” of parents who object to vaccination. Those efforts include offering appointments at convenient times for families and ensuring practice nurses have enough time to answer parents’ questions. Unwelcome consequences Sonia Saxena at Imperial College London says there is “not really great evidence” for mandating vaccinations. And Helen Bedford at University College London says compulsion can have unwelcome consequences, such as excluding children from school. “Children whose parents refuse vaccination could be deprived of a proper education as such parents are unlikely to change their minds because vaccination is required.” Mandating would also have a cost to implement and enforce. In short, it isn’t clear cut that compulsion is the right way to remedy falling vaccination rates. Moreover, existing efforts may yet bear fruit and render the idea unnecessary. It was the 2018-19 figures on falling vaccination that made waves, but subsequent, more recent statistics for April to June this year show vaccine coverage for under-5s either stable or increasing slightly. More on these topics: vaccines health

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