I remember it clearly: Dabbing pink calamine lotion on the itchy chickenpox and listening to my mom tell me not to scratch. That was back in the early 1990s, in the bathroom of our country house, looking out at a big, red barn across County Route 54 in Upstate New York. These days I’m a 32-year-old American mom living in Berlin, Germany. And even though I’m fluent in the German language and culture, I still have moments of culture shock. When the topic is vaccinations, for example.
I have two small children. And you’d better believe I’ve had them inoculated for everything the German vaccination commission (STIKO) recommends. I’ve listened to two kids scream through shots with tears in my own eyes. I’ve woken up every two hours to comfort them when they’ve run a fever as a result. But for me, it was a no-brainer.
Just a few weeks ago, one of the kids in my daughter’s daycare group got chickenpox. Was she vaccinated? Of course not. My kids go to a private international school. The families are highly educated, cosmopolitan, well-off. But despite their background — or perhaps because of it? — many are anti-immunization, at times ideologically and maliciously.
In Germany as in the US and elsewhere, the anti-vax movement thrives on various conspiracy theories.
In Germany as in the US and elsewhere, the anti-vax movement thrives on various conspiracy theories. One is that shots are part of big pharma’s plan to make a killing off our children’s health. The most pernicious is that shots cause autism (which has been unequivocally ruled out by scientific research).
Google the word “impfen” — to vaccinate — in German, and you get the suggestions “nein, danke” — no thanks — or “pro contra,” among others. It’s a phenomenon in certain middle-class enclaves where educated people can recite Adorno and Goethe by heart but are stuck in the dark ages when it comes to medical science. They’re convinced that they know what’s best for their children, and for my children, because of something they heard at a dinner party or found while googling.
If you ask me, that’s child neglect. It’s playing wheel of fortune with a child’s life — and with the lives of other people’s children. My neighbor’s kid got whooping cough despite having been vaccinated. Turns out, some immunizations aren’t 100 percent. The poor little guy is still using an inhaler every night, over a year after the diagnosis. But if the other kids at kindergarten, on the subway and on the playground had been vaccinated, he almost certainly wouldn’t have gotten sick. That’s because of the so-called herd immunity that vaccination provides. If enough members of a group, such as a kindergarten, are immune, then a disease cannot spread within the group at all, and even the few children without immunity are safe.
So vaccines aren’t something that should be left up to parents — myself included. I’m no medical expert. But here in Germany we’re lucky enough to have experts in abundance. Every time I sit in my GP’s waiting room — and with two little kids in daycare, it’s been pretty often this winter — there’s a sign that catches my eye: “You don’t have to have all of your children vaccinated; just the ones you want to keep.”
Germany has had something called the “Preventive Health Care Act” since July 2015: Health insurers invest more than €500 million each year for preventive measures. Costs for immunizations recommended by the STIKO are covered by statutory health insurance providers.
But the only thing compulsory is the provision of information about vaccinations, not the shots themselves. Last June, Germany also passed a law making it mandatory for kindergartens to notify health authorities if parents haven't submitted proof of vaccination counseling for their kids, but not if parents had received counseling but opted out.
In the US, by contrast, all fifty states require that children be vaccinated in order to attend school. Admittedly, this does not mean that all American students must get vaccinated. All states except California, West Virginia, and Mississippi allow religious exemptions, and several others accept personal, conscientious or philosophical objections. In certain rich, coastal enclaves of California, enough parents opt out for whooping cough outbreaks to recur every few years. In the worst, in 2010, 10 infants died, all younger than three months. It’s those babies who normally rely on herd immunity around them.
Germany contributed 926 cases of measles to European statistics last year.
According to the European Centre for Disease Prevention and Control, there were 14,451 cases of measles in Europe last year. That’s more than three times the previous year’s cases. This preventable disease has claimed 50 lives in the EU since 2016. The reason, according to the ECDC? “Suboptimal vaccination coverage.”
Germany came in fourth, contributing 926 cases of measles to the statistic last year. And the part of the ECDC report that makes the mama bear in me want to stand up on her hind legs and maul someone: “The highest incidence of cases was reported in infants below one year of age — those most at risk of severe complications and deaths — and too young to have received the first dose of the vaccine.”
Back in 2016, I was pregnant with my second child, crazy hormonal and cautious, careful not to eat unpasteurized cheese and not to inhale while walking past cars at a stoplight. Or asphalt fumes at a construction site. Or smoke. You name it. The thought that my newborn could end up with a potentially deadly disease because some of the other moms and dads subscribed to conspiracy theories was just unbearable.
So here’s one for you, Jens Spahn. You’ll be the next health minister in Angela Merkel’s cabinet, I hear. Please fix this problem and make sure all children healthy enough to get vaccinated actually get their shots. It would reaffirm something I have appreciated about this country from my first day living in it: its social conscience.
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