11 vaccinations become mandatory and the reasons are clear
Published the 30.12.2017 to 16h31
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Worn by the minister of Health, Agnes Buzyn, and adopted in late October by the national Assembly, the passage of three to eleven vaccines required for children born on or after January 1, 2018.
In addition to the 3 vaccines already compulsory (diphtheria, tetanus, and poliomyelitis or DT-Polio), 8 recommended vaccines become mandatory : whooping cough, measles, mumps, rubella (MMR), Haemophilus influenzae b, pneumococcal, meningococcal C, and hepatitis B.
These eleven vaccines will be required for the child to be admitted in the community (nursery, school…). To allow a compliance time, the first audits will take place from 1 June.
Why make it mandatory that the 11 vaccines
With the improvement of the hygiene and water quality, the immunization was the intervention of the most effective public health against infectious diseases.
The vaccination is quite satisfactory on the diseases for which it is compulsory (polio, tetanus, diphtheria) or for which vaccines are routinely (whooping cough) or almost always (Haemophilus influenzae b) combined with the vaccines mandatory.
By contrast, for other diseases, and especially measles, the vaccination coverage in France is notoriously too low to protect the entire population against the disease : children die or have sequelae of measles in France in 2017 so that they are preventable.
The threshold vaccination is not reached for all infections
There is a minimum threshold of vaccine coverage for a “group protection” works in those who cannot be vaccinated (newborns, immunocompromised, etc.). This threshold depends on the contagiousness of the disease.
In France, with a vaccine coverage of about 97% for diphtheria, one exceeds the threshold for herd immunity and so it is the whole nation is protected, including in the case of infection made by a migrant. In the same way, the Haemophilus influenzae b of the child, rubella, or mumps have been nearly eliminated in the country because the coverage rate of vaccines exceeds the threshold of herd immunity to these 3 diseases.
On the other hand, the current level of measles vaccination coverage (79 %) remains insufficient to enable a immunity group (the threshold of herd immunity = 94 %), and so we see resurgences of epidemic disease large-scale : more than 23 000 reported cases in France between 2008 and 2012, more than 1,500 pneumonia severe, and over 30 types of encephalitis with 10 deaths). It is unbearable.
In the same manner, the insufficient coverage with the vaccine against meningitis C (70 % at the age of 2 years, but low in adolescents and young adults) is responsible for the majority of the nearly 800 cases and 100 deaths have occurred since 2011.
A controversy paradoxical
In the framework of the extension of mandatory vaccination, the vaccination becomes a debate of opinion and controversy, fuelled to full, both by the arguments scientifically unfounded and demagogic lobby anti-vaccines, the lack of training of the medical profession and the public on the subject. France, however, the home of a Pastor, became one of the countries in the world where the distrust of vaccine is the strongest with over 40% of French who think that vaccination is not safe.
This controversy took place even as the vaccination requirement is the immunization schedule (current vaccinations are required and recommended) and that it adds no vaccine additional. It simply aims to ensure that all children receive the vaccines they would have received if the schedule was respected for all children.
However, the experience of some european countries, like the netherlands, shows that we can succeed to make almost disappear diseases such as meningococcal C disease through vaccination coverage is very high among children aged 1 to 18 years.
Efficacy and safety of 11 vaccines mandatory
The 11 vaccines that will be mandatory in France are very effective. They protect children in over 90 % of diseases and adverse effects, when they exist, are typically minor and short-lived.
Some side effects are minor and common to all injectable vaccines : reaction at injection site (pain, redness, swelling) in about 10 cases on 100 children vaccinated), some general effects, also of short duration (fever, muscle or joint pain) in 1 to 10 in 100 vaccinees.
Severe allergic reactions are extremely rare (less than one case out of 450 000 vaccinated), but they are mentioned in the majority of certificates of convenience. But other adverse effects, sometimes attributed to some vaccines, are scientifically unfounded and all of the scientific data has been independently reviewed by the INSERM to establish the facts about immunization.
No link between autism and measles vaccination
The scientific evidence of the absence of a link between vaccination against measles (or vaccines measles-mumps-rubella and type MMR) vaccine and inflammatory bowel disease or autism are numerous and of a very high scientific level.
Moreover, it is proved that the only study that had suggested a link between MMR vaccination and autism carried out on 14 patients and was a scientific fraud of one of its authors. The co-authors retracted the article has been removed from the Lancet, and the physician defraud struck off from the college of physicians british.
No link between multiple sclerosis and vaccination against hepatitis B
Many studies conducted between 1996 and 2004 had rejected any risk, and eliminated the link suspected between vaccination against the hepatitis B virus and serious adverse effects in the adult, whether in respect of neurological injury-type multiple sclerosis or other autoimmune diseases. These disorders can occur coincident when vaccination of the young adult age group where these diseases occur most often.
It should also be noted that the suspicion of a link with multiple sclerosis has never been observed when the immunization of infants.
No toxicity of adjuvants
Among the 11 vaccines that will be mandatory in France, with the exception of the MMR vaccine (which vaccine is a live vaccine), all of which contain salts of aluminium, an adjuvant is indispensable to the strengthening of their effectiveness.
In the light of the data available to this day on a global scale, with a decline of use of 90 years and hundreds of millions of doses injected, the safety of aluminum salts contained in vaccines cannot be questioned. A team of French researchers had suggested a link between the lesion at the site of injection referred to as a ” myofasciite to macrophages “, which contains traces of aluminum (like a tattoo contains the ink) and the existence of symptoms of chronic non-specific such as fatigue, muscle or joint pain or cognitive disorders. The independent analysis by other teams of their results did not permit to date to demonstrate the existence of this link. Moreover, this disease has practically not been observed outside France, even though the vaccines containing aluminum are used throughout.
No dangers with the vaccines combined
Combination vaccines have as main interest to facilitate the vaccination of infants (less injections, less medical appointments for parents).
The immune response obtained for each of the infections is not lower than that observed when the different vaccines are administered separately. Adverse effects are not more frequent with the combination than when administered separately (and concomitant) of different vaccines.
Finally, the arguments developed by the lobbies anti-vaccine, and who claim that the vaccines combined to cause a depletion of the immune system of the infant, is not based on any scientific basis.
The stimulation of the immune system induced by a vaccine, be it vi, is indeed negligible compared to its response capabilities and compared to the very many stimuli and environmental day-to-day that receives an infant from birth (less than 0.01% use of the capacity of the immune theoretical according to some experts.
That can happen in case of refusal of the vaccination ?
Children born on or after January 1, 2018, and which will not be in compliance with their required vaccinations will not be able to return to daycare and school, so as not to expose other children to potential disease risks.
Up here, the parents who refused compulsory vaccination risked six months ‘ imprisonment and 3 750 € fine. A penalty which was never enforced, and this rule of the code of Public Health (article L 31116-4) has been abolished. A decision trompe-l’oeil as any health professional will always be able to prevent the public prosecutor if it finds that the parent poses a risk to their child and then passes it on to the criminal (article 227-17 of the penal code) : punishment of two years imprisonment and a 30 000 euro fine ” the fact, by the father or the mother, of escape, without legitimate reason, to its legal obligations to the point of compromising the health, safety, the morality or education of his minor child “.
In the case of doctors, the Council of the Order will be ruthless and a doctor has just been struck off for false certificate of cons-indication to vaccination.
For the protection of the French society as a whole, and particularly the the most fragile people, it is essential to increase vaccination coverage levels of children in France : it is to prevent severe disease, sequelae and deaths are preventable.
In order to protect people who, for medical reasons, may not benefit from the direct protection of vaccination, and whose only protection is the immunity group, all children who do not present medical contra-indications proven (extremely rare) should be vaccinated.