The vaccination campaign is stalling – which is why Germany is far from so-called herd immunity to Covid-19. According to the Robert Koch Institute (RKI), this requires a minimum of 85 percent of 12- to 59-year-olds and 90 percent of those over 60 to be vaccinated. That is why there is now a political debate about mandatory vaccination. Katja Bauer and Bernhard Walker summarize the most important aspects.
What is the legal situation in Germany?
The last general compulsory vaccination against disease for all inhabitants of the Federal Republic was vaccination against smallpox. It was withdrawn in 1983. In the 1950s there was also a mandatory vaccination against scarlet fever and diphtheria in the Federal Republic of Germany. In the GDR there was also a legal obligation to vaccinate against tuberculosis, polio, tetanus, whooping cough and measles. Since the amendment of the Infection Protection Act 20 years ago, the introduction of a mandatory vaccination against a certain disease has been possible simply by means of a regulation. In this way, the legislator can limit the fundamental right to physical integrity in the event of a certain health risk due to communicable diseases. Not only the federal government, but also the federal states can issue such a regulation.
Are there current examples of this?
Yes, but a legally controversial one. In Germany, there has been a de facto vaccination against measles since the spring of 2020. Almost a year earlier, the state of Brandenburg was the first state to issue a corresponding regulation. The measles protection law has been in effect nationwide since March 2020. It states that all children who are at least one year old should receive a measles vaccination if they attend daycare, kindergarten or school. This also applies to people born after 1970 who work in community facilities or in the medical field – ie educators, teachers and nurseries. Residents of asylum seekers’ homes must also provide proof of measles protection. Parents who refuse the measles vaccination can be fined up to 2,500 euros for an administrative violation. Unvaccinated children can be excluded from the nursery. There are lawsuits against the law. The Federal Constitutional Court wants to decide in the course of 2021 on the legality of a measles vaccination.
What is the medical purpose of mandatory vaccination?
The goal is to achieve herd immunity – thus eradicating the disease in the area in question. Smallpox is an example of this. Herd immunity occurs when 95 percent of children have received both measles vaccinations – a value that Germany falls short of. According to the RKI, there were 515 reported cases of measles in 2019, far fewer than in 2015 (2442). Whether Spahn’s duty will work is uncertain. Children who are already attending childcare or school will not have to submit proof of vaccination until the end of 2021. It is therefore not possible to estimate whether the measles vaccination is effective, i.e. whether herd immunity has been achieved. According to the RKI, there were 76 cases of measles in the past year. This low number may be related to the lockdown closures of nurseries and schools in 2020.
How realistic is the introduction of a mandatory vaccination against Covid-19?
This is very unlikely at the moment. The federal government has always made it clear that there will be no mandatory vaccination. Chancellor Angela Merkel (CDU) has only recently confirmed this. Federal Minister of Justice Christine Lambrecht (SPD) also rejects a general vaccination obligation and states that this is not legally possible. Lambrecht believes that even certain professional groups such as nurses cannot be required to be vaccinated.
What are the positions in the political debate?
It is not a question of mandatory vaccination, but of whether unvaccinated people should accept greater restrictions on their freedom of rights than vaccinated people. It has long been debated whether such restrictions would apply with a corresponding incidence once all citizens were offered a vaccination offer. Chancellor Minister Helge Braun (CDU) over the weekend highlighted the possibility that unvaccinated people may not be allowed to visit restaurants or concerts in the future. SPD health politician Karl Lauterbach and Greens leader Robert Habeck had made a similar statement. Chancellor-candidate Armin Laschet does not want that. He and Justice Minister Lambrecht continue to believe that the equality of those who have been vaccinated, those who have been tested and those who have recovered is correct.