The imperative of vaccination: a public Europe-wide debate around mandatory vaccination
Abstract In a recent editorial the Lancet Infectious Diseases referred to “The imperative of vaccination” to reflect on the principles, practice and impact of mandatory vaccination. As European and global data report decreasing vaccine coverages and large outbreaks of vaccine-preventable diseases (VPDs), international institutions recognize the waning of public confidence in vaccination as a major public health concern and are reinforcing their support to national vaccination strategies. As countries in Europe consider policy responses to this situation, some, including Italy and France, have recently opted to introduce strengthened mandatory law-enforced programmes for infant immunization. Preliminary data show a positive impact of mandatory vaccination both on coverage and attitudes towards vaccine. On the contrary, other countries in Europe have made the deliberate choice to focus on making vaccination the easy and right choice for their citizens, and have managed to maintain high vaccine coverage. The law is indeed a powerful tool States have to stop the spread of preventable infectious diseases and protect collective health, but is compulsory vaccination the right way to go? Is mandating vaccines a mere sign of public health resignation? Or worse, it this an admission of guilt for having failed to promote the individual and social value of immunization trough health education, empowerment and people-centred prevention? The proposed workshop is structured as a pro/con session aimed at engaging with the audience and stimulate a lively debate on the principles, practice and impact of mandatory vaccination, moderated by a firm and charismatic chair (Aura Timen). We plan to have two provocative “pros” and “cons” panels with short and effective presentations by the President and Vice-presidents of the EUPHA Section on Infectious Diseases Control, representing - respectively - the “pros” (the Italian and Polish cases by Anna Odone and Maria Ganczak) and the “cons (The UK and Portuguese cases by Michael Edelstein and Ricardo Mexia). During the presentations the following content will be covered: i) the state of play in Europe with regard to both mandatory immunization and alternative approaches, and their the technical characteristics, ii) the presumptive impact of both approaches on VPDs epidemiology and immunization coverage, by different vaccine and target population. Most importantly, the four European case studies will offer ground to discuss the public health principles behind mandatory vaccination and provide pros and cons arguments to be further expanded and explored in two consecutive workshops moments: i) a structured and challenging “Q&A” session, ii) an open discussion with the audience, both moderated by the chair. The audience will be engaged in an interactive voting session (through the Conference app) to survey opinions on mandatory vaccination both prior to the presentations and after the discussion. Key messages Mandatory vaccination was introduced by EU countries to protect collective health, still the debate is ongoing at the scientific, but also political and community level on its principles and impact. European public health imperative is to promote the individual and social value of immunization trough health education, empowerment and people-centred prevention. Panellists Anna Odone - Italy Maria Ganczak - Poland Michael Edelstein - United Kingdom Ricardo Mexia - Portugal
