A closeup of a teenage child receiving a vaccine from a pediatrician with a syringe fullfilled with some substance. The concept of required preventive vaccination.

The Federal Constitutional Court confirmed on Thursday that measles vaccination has been compulsory for around two and a half years, including for daycare children. Several lawsuits from affected families were withdrawn, as the judges in Karlsruhe announced. The encroachments on fundamental rights are not insignificant, but are currently reasonable.

The four pairs of parents with unvaccinated small children had sued because they saw this as a disproportionate encroachment on the fundamental right to physical integrity and their right to bring up children. “Without violating constitutional law, the legislature gave priority to the protection of people at risk of measles infection over the interests of the complaining children and parents.” (Az. 1 BvR 469/20 et al.)

However, experts warn against the fallacy that measles is just a harmless childhood disease. With compulsory vaccination one would like to eradicate the measles completely.

Symptoms are fever, conjunctivitis, runny nose, cough, headache and the typical skin rash. Complications include diarrhoea, middle ear and pneumonia. In very rare cases, measles can lead to encephalitis, which in a special variant that only occurs years later is almost always fatal. Experts also warn that an infection weakens the immune system for a long time. Once you have measles, you are immune for the rest of your life.

In the Corona years, only 76 (2020) and 10 (2021) cases were reported to the Robert Koch Institute (RKI). Before that it was usually several hundred a year, in 2015 even 2465. Critics of compulsory vaccination also refer to these relatively low numbers. On the other hand, there are people who are particularly at risk and cannot be vaccinated themselves, such as infants, the sick with an immune deficiency or pregnant women. If enough others get vaccinated, they are also protected.

Many people have been vaccinated against measles. However, the quota is not high enough to prevent the circulation of the highly contagious virus and outbreaks. At least 95 percent of the population would have to be immune for this. Germany has also made a commitment to the World Health Organization to eliminate measles.

Especially after the first vaccination, reactions such as fever and headaches can occur. Some vaccinated people also get a skin rash, the so-called vaccine measles. “Severe undesirable effects of vaccination are rare,” says the federal information portal.

It starts with those “who regularly come into contact with other people in community and health facilities”, as the draft law states. These are mainly day care centers and schools. The obligation to vaccinate also applies, for example, in refugee accommodation and for employees in hospitals and medical practices. An exception applies to people who cannot be vaccinated for medical reasons. Nobody is forced to be vaccinated anyway.

Since March 1, 2020, children over the age of one may only be admitted to a day care center or childminder if they have been vaccinated or have already had the measles. The parents have to prove that. The same rules apply to school – however, in case of doubt, compulsory schooling takes precedence. For children who were already in their day care center or school at the time, there was a transitional period for proof that was extended several times. It expired on July 31, 2022.

If the proof is not available in time or if there are doubts about its authenticity, the facility must inform the health department. The office can then – with the exception of schools – after a reasonable period of time in individual cases, depending on the risk, issue a ban on entry. Alternatively, a fine of up to 2500 euros can be imposed. However, it is not possible to “buy your freedom”: If you continue to refuse vaccination, you may face additional fines.

For children, the Standing Vaccination Commission (Stiko) recommends one vaccination from eleven months and a second from 15 months. A so-called live vaccine made from weakened measles viruses is injected. In Germany there are only combination vaccines that are also used to vaccinate against mumps, rubella and, in some cases, chickenpox. The plaintiffs also criticize this.

According to an RKI report from 2020, one problem is that some children are vaccinated much later than recommended. At that time, only 68 percent of the 24-month-old children had been vaccinated twice against measles, when they started school it was 93 percent. According to these figures, around 35,000 children up to the age of six had no measles vaccination at all. However, there are even larger gaps among adults. In 2019, the German Ethics Council therefore did not consider it justified to introduce compulsory vaccination for all children.

Anyone born before 1971 is exempt. The older ones are thought to have most likely had the measles anyway. Vaccination has only been recommended in Germany since 1974. In the GDR it had been compulsory for children since 1970.

In 2021, the European Court of Human Rights approved compulsory vaccination in the Czech Republic against measles, among other things, which is also enforced with fines and denied daycare access.

In spring, the Federal Constitutional Court dismissed a lawsuit against the corona vaccination requirement for nursing and health staff: the legislator’s consideration of “giving the protection of vulnerable people priority over a free vaccination decision in every respect” was unobjectionable. However, it was about a special professional group and a pandemic with many unknowns.