After using computer modeling to predict how many cases could occur, Italian researchers from the Bruno Kessler Foundation and Bocconi University believe that voluntary vaccination programs will not be sufficient to contain outbreaks in the years to come. Concerns were raised about vaccination rates in advanced countries including the USA, Ireland, Australia, and the UK.
According to the World Health Organization, 95% vaccination rates are needed to establish herd immunity and prevent a population from a disease. As rates in England have recently fallen to just over 87%, experts argue that the voluntary system needs to be replaced with a compulsory system, although some questioned the effectiveness of compulsory programs.
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Lead researcher Dr Stefano Merler said that the UK and other countries would “strongly benefit” from compulsory vaccinations as it would help them reach herd immunity.
But Prof Adam Finn, of the University of Bristol, said there was no proof of this.
“Mandatory immunisation is certainly one way to try and increase coverage but it’s far from clear how well it works or whether it would work at all in many places.
“If the reasons that the vaccine is not getting into the children relate to easy access, vaccine supply or clarity of information available to parents, then making it compulsory will do nothing to alleviate such obstacles.
“If there is widespread mistrust of authority or of the motivation behind any such requirements, it could actually make things worse.”
While the guiding biomedical ethical principle of autonomy generally warrants that competent patients be allowed to refuse unwanted medical procedures, the issue becomes more complex when such a refusal can result in increased risks to public health. Many argue that patient autonomy can be overridden in such circumstances. An additional concern arises in terms of the principle of justice, as those refusing vaccination live in first world countries with access to medical care. But increased cases of measles can affect those living in poorer countries with less access to medical care and fewer resources to deal with an outbreak.