Vaccination

Failure to Vaccinate May Explain Measles Outbreak in Germany

If articles like this were not taken so seriously I would actually be amused by the content of this article in light of its title. First of all, “less than five” doctors are apparently responsibly for this massive outbreak. What an accomplishment for these five doctors!! The title of this article would lead one to believe that a large number of doctors in Germany are not giving the measles vaccine and this has singlehandedly led to an outbreak. Reading into the article, one finds that the accuser in this case really has little supporting evidence. Math was never my strongest subject, but somehow 5 doctors in a district in Germany spreading an epidemic seems a little far fetched. And, if the large majority of children are indeed vaccinated, shouldn’t they be free of fear and let those who decided not to be immunized suffer? The truth is that a large number of vaccinated children also get the disease.

Doctors opposed to vaccinating children against measles might be at least partly responsible for a measles epidemic in southern Germany, according to a regional division of AOK, one of Germany’s largest public health insurance groups. The measles outbreak has struck the district of Coburg in the German state of Bavaria. The district has a population of less than 100,000, but more than 1000 people, mostly children, have contracted measles since November. Markus Braun, a spokesman for the AOK Bavaria, said today that AOK believes there is a link between the measles epidemic and opposition from “a few doctors” in the area to the combined MMR vaccine (measles, mumps and rubella). A number of people with measles have been admitted to hospitals, which is much more costly than immunising with MMR, which costs around 100 euros in Germany for the two-injection vaccine, he said. Braun declined to say how many doctors in the Coburg area were thought to be opposed to giving children the MMR vaccine, saying only that it was “less than five.” He held out the possibility that AOK would seek monetary damages from doctors opposed to the MMR vaccine. “That is not ruled out, but at the moment it is not under discussion,” he said. AOK has made its concerns known to the KBV, the Bavarian organization that represents physicians accredited with the public health insurance system. Martin Eulitz, spokesman for the KBV, told Reuters Health that leadership of the KBV was strongly in favor of the MMR vaccine, and encouraged all members to use it. However, he said that German law does not require doctors to give the vaccine. Referring to the doctors opposed to using the MMR vaccine, he said: “We can talk to them and try to convince them the vaccine is necessary. But there is nothing else we can do. We can only kick them out [of the KBV] if they do not follow the rules.” Eulitz also declined to say how many doctors in the Coburg area are opposed to the MMR vaccine. But he said that none of these doctors have spoken out publicly against the MMR vaccine. They have spoken only “behind closed doors” to the parents of patients. “The only people who speak out publicly against the vaccine are the parents,” he said. Eulitz said that since November 1, 2001, some 1140 cases of measles have been reported in the Coburn area, with 90% of those cases in children 14 years old or younger. Children with measles have been admitted to the hospital, but he did not know how many. In the Coburg district, 76% of children have been vaccinated, which compares with a rate of 88% in the whole state of Bavaria, he said. When asked if the lower vaccination rate might have been a trigger for the measles epidemic, Eulitz said: “That might be one of the reasons.” Dr. Waltraud Knipping, head of the Bavarian branch of Germany’s Professional Association of Pediatricians (BVKJ), told Reuters Health in late February that as the number of opponents to MMR vaccination has risen, the readiness of parents in Bavaria to have their children vaccinated has declined. She said at least 90% of all children need to be immunized to prevent measles epidemics.