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Germany: New Act Makes Measles Vaccinations Mandatory

(Mar. 11, 2020) On March 1, 2020, the Measles Protection Act, which amends several laws, entered into force in Germany. The Act makes measles protection mandatory for children one year or older who attend daycare, school, or other community facilities, and for persons working in those facilities or in medical facilities. Furthermore, measles vaccinations will be mandatory for persons living or working in refugee and asylum-seeker accommodations. Noncompliance will result in fines, and unvaccinated children and persons will be barred from the respective facilities.

Background

In 2018, the number of measles infections in Germany doubled, affecting children, adolescents, and adults. For the first five months of 2019, 420 cases of measles were reported in Germany. The explanatory memorandum (BT-Drs.) to the Measles Protection Act states that current measures to increase the willingness to get vaccinated have not been effective and that risks and complications are often misjudged due to misinformation. It therefore concludes that there is a significant public health risk that needs to be addressed with additional measures. (BT-Drs. 19/13452, at 1 & 16.)

Mandatory Vaccinations

The Act makes measles vaccinations or a medical certificate showing that a person is immune to measles mandatory for the following groups:

  • Children one year or older who attend daycare, school, or similar community facilities
  • Persons working in those facilities
  • Persons working in medical facilities
  • Persons living or working in refugee and asylum-seeker accommodations (Measles Protection Act art. 1, no. 8(e).)

Exceptions exist for persons who have a medical contraindication to the vaccination—for example, due to an allergy or a serious illness—and persons born before 1971. (Measles Protection Act art. 1, no. 8(e).)

Providers Authorized to Administer Vaccinations

The Act authorizes all types of doctors, no matter their specialization, to administer vaccinations. (Measles Protection Act art. 1, no. 8(b).) This new rule implements the goal of “universal vaccination,” as recommended by the German Standing Committee on Vaccination, to use every doctor’s visit to check on a person’s vaccination status and catch up on missing vaccinations as soon as possible. (BT-Drs. 19/13452, at 25.)

Consequences of Noncompliance

Children or adults who are subject to the mandatory vaccination requirement and do not comply with it are not allowed to attend or work in the respective facilities. The facilities must report the noncompliance to the health department for the area in question without undue delay. However, if the child is of mandatory school age, meaning six years of age, or if a person must reside in an asylum-seeker accommodation, they cannot be refused entry to the facilities. (Measles Protection Act art. 1, no. 8(e).) Noncompliance can also be sanctioned with a fine of up to €2,500 (about US$2,712). (Art. 1, no. 13 in conjunction with Infection Protection Act § 73.)

Health Education

The Act tasks the German Federal Center for Health Education (Bundeszentrale für die gesundheitliche Aufklärung, BZgA) with educating the public on a regular and comprehensive basis on preventing illnesses through vaccinations and other specific prophylactic measures. The information is customized for the different target groups. (Measles Protection Act art. 1, no. 8(a).) The goal is to eliminate uncertainties with regard to vaccinations and to achieve preferably universal protection. (BT-Drs. 19/13452, at 25.)

Furthermore, the Act authorizes health insurance companies  to remind people by mail or other forms of communication that they are due for their next vaccination. (Measles Protection Act art. 2, no. 3.)