Target missed again

High skepticism towards measles vaccination in Bonn

Eine Arzthelferin bereitet eine Masernimpfung vor.

A medical aid preparing a measles vaccination.

BONN. Bonn is below the national average when it comes to measles vaccinations and skepticism of vaccines has only grown over the years.  So far, the government has refused to make it compulsory for children entering school.

North Rhine-Westphalia has achieved a rather sad record, with more measles cases recorded in NRW in 2017 than in any other German state.  With 520 cases reported in NRW, this is more than half of all cases in the country.  The virus could be eliminated through a higher vaccination rate, as has already been achieved when it comes to other viruses.  But some persist in their reservations against vaccinations, and not only in NRW. 

Professor Max Baur, longtime professor and Dean of the Medical Faculty of the University of Bonn, is infamous for his lectures. At the same time, he has shaped the Bonn science scene of medicine and epidemiology over the past 32 years. At his jubilee speech for the 200th anniversary of the University of Bonn, he broached a serious topic: "Max, please talk about vaccinations", pleaded Michael Lentze, who was head of the Bonn Children's Hospital for 22 years.

Baur heard the plea.  As a medical biometrician, he wanted to demonstrate that although humans have an intuitive understanding when it comes to probability, they can also be fooled.  Because the side effect of “vaccination measles” occurs in only five to 15 percent of those vaccines given.  And the cases are mild, non-contagious and limited forms of the infectious disease. By contrast, the late complications of fully developed measles can be fatal even after seven years, as was the case for a 37-year-old woman from Essen in 2017.

Baur has approached the vaccination question from a psychological standpoint:  "We underestimate the risks we impose on ourselves, such as poor nutrition or smoking," he explains. On the other hand, externally induced risks, such as nuclear power plants or vaccines, are generally overestimated. "A doctor who heals diseases is a hero. But someone who stops them through prevention is a spoilsport," says Baur. Or even more dramatically: "There is no fame in prevention."

Extremely risk-averse society

At the urging of the CDU and FDP parties, the state government decided on a local advertising campaign for NRW to counter the weak reputation of vaccines.   The Robert Koch Institute recommends a vaccine target rate of 95 percent and this was missed again, according to data from the Institute. However, the data is not complete, because parents did not provide immunization records for one in ten children entering school. Whether these parents are opposed to vaccines or feel they are being patronized by the authorities is not known.

What is certain is that the Bonn vaccination rate is always just below the national average and nearly ten percent points below the NRW average.  "Parents no longer know the danger of measles because they have become so rare here," says Michael Lentze, who ran the Bonn Children's Hospital until 2012. "We have been blowing the same horn for 30 years, but in vain." Lentze would immediately endorse compulsory vaccination and even recommend that vaccination be paired with entry into kindergarten and school as a condition. So far, the government has refused to encroach on the rights of parents to decide.

But it’s not only about small children, 20-year-olds also need refresher vaccines.  Especially adults who are not protected by a vaccination, pose a risk to themselves and others who are not vaccinated.  Baur says the mentality in Bonn has changed over the 30 years of his career.  People used to have lots of faith but have become much more skeptical.  “We have become a society that is extremely risk-averse," says Baur. In light of that, it is important to weigh the risks of vaccination and non-vaccination objectively.

Author Victor Sattler is one of nine scholarship holders of the Konrad-Adenauer-Stiftung, who is pursuing current topics in a seminar in cooperation with the General-Anzeiger. Her texts appear from time to time in the GA.

(Translation: ck)