Vaccination opposition

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Vaccination opposition denotes general rejection of vaccinations and differs from the attitude of vaccine skeptics, for example. It is one of the most important lay movements critical of medicine. Opponents of vaccinations are called people who are opposed to vaccinations for very different reasons. A rejection, for example, is religiously motivated, can be based on naturopathic assumptions or is based on fear of vaccination damage . For many people, a general attitude of rejection towards vaccinations solidifies even after thorough study of the topic. These people are opposed to those in whom fears and missing or incorrect information provoke a vaccination opposition. Another reason for a general rejection of vaccinations is that the public is paying more attention to the rare side effects and complications of vaccinations and is therefore overrated compared to the significantly greater potentially achievable benefit. Other fundamental opponents of vaccination assert, for example, that vaccinations were based on a conspiracy , or they deny the existence or pathogenicity of viruses or the existence of the vaccination effect . The medical arguments put forward by fundamental opponents of vaccination have been scientifically refuted, insofar as it is a form of science denial , or they are unsubstantiated. The World Health Organization counts the reluctance to vaccinate, which exists for various reasons, as one of the ten most important health risks.

Historical origins, distribution and demographic characteristics

Caricature about anti-vaccination campaigners who feared that the smallpox vaccination would turn them into cows (1802)

The first vaccinations of the general population in many countries were directed against smallpox at the beginning of the 19th century and soon met with rejection for various reasons. In the meantime it can be summarized: Rejection or acceptance of vaccinations are caused by a multifactorial and complex process, which is influenced by numerous structural and organizational factors in the health care system, but also by social, historical, cultural, ideological and other factors.

The reasons given by opponents of vaccination for rejection are similar to those of today: "An alleged lack of effectiveness of the vaccination (illness despite vaccination), the observed side effects, the triggering of further illnesses (' syphilis '), religious motives and the restriction of personal rights through forced vaccinations" .

Immanuel Kant

The philosopher Immanuel Kant has occasionally been cited as an example of an ethically justified rejection of smallpox vaccinations. However, especially in his later years, Kant was not a general opponent of vaccinations, but merely a skeptic and critic of the smallpox vaccinations available at the time. His arguments were very differentiated, contained ideological justifications that are difficult to defend today, and were also based on the low safety of the smallpox vaccines used at the time. In addition, Kant changed his mind about the smallpox vaccination in the course of his life. In his Metaphysics of Morals , published in 1797, he took a rather critical position on the smallpox vaccination: Those who get vaccinated against smallpox "risk their life in the unknown". Since suicide is ethically prohibited, the question arises: “So is smallpox inoculation allowed?” However, Kant avoided answering this question in the same text or in other contexts. Later, in his late work published only posthumously, Kant warned that one should not fall into the arms of “Providence”, which limits excessive population growth also through smallpox epidemics, with vaccinations. Smallpox and wars are "designed" (intended) to limit population growth: "So that states are not overcrowded with people and they are nipped in their bud: two evils are placed in them as antidotes - smallpox and war". Vaccinations are indeed "heroic means of doctors". But one must rely on the fact that “providence” in its wisdom prevents overpopulation through war and smallpox: “Heroic means of doctors are those which are for life and death or, what is just as much, at the risk of the patient for life daring to get sick (even to have to constantly fear infection). - The wise use of such means cannot be made by individual people, but must be expected from Providence, which seems to have wanted war and smallpox (and that on purpose) in order to thereby limit the great increase. ”Later, however, Kant held out both through the authorities Ordered vaccination campaigns against smallpox as well as the acceptance of such vaccinations by the subjects are ethically permitted: “The second remedy, namely that of child smallpox, is allowed by other people: namely that the government orders smallpox inoculation throughout, since it is then inevitable for every individual : is therefore allowed. "

Further resistance to vaccinations

In the second half of the 19th century the vaccination debate gained widespread impact and the number of people vaccinated against smallpox fell. The anti-vaccination scene had attained its first organized character through the Reich Vaccination Act (against smallpox) passed in 1874 . Important representatives critical of vaccinations were the chairman of the "Verein [s] vaccination-opposing doctors" Eugen Bilfinger and the chief clerk of the monthly newspaper "Der Impfgegner", founded in 1881, and co-editor of the magazine "Die Impffrage" Hugo Wegener, an engineer from Frankfurt .

In 1881 the influential combat pamphlet Die Judenfrage (The Jewish Question) appeared as a question of race, morality and culture. With a world-historical answer. by Eugen Dühring , one of the most important thought leaders of the later National Socialism and the racial doctrine associated with it . In it he claimed that vaccination was a superstition, invented by Jewish doctors for reasons of personal gain.

As a rule, it was mainly medical laypersons who criticized the smallpox vaccination. Some opponents of the vaccination questioned the effect of the smallpox vaccination and denied its causal connection with the decline in smallpox cases, although this had only started strongly after the vaccination was introduced. For example, better hygienic conditions were cited. Heinrich Oidtmann, on the other hand, claimed that it was not the protective effect of the vaccination but the declining rag trade in sheep's wool that was responsible for that decline (he took the view that smallpox was transmitted through sheep's wool). Other vaccination opponents did not deny the point of vaccination. Instead, they were critical of the statutory smallpox vaccination requirement, feared long-term consequences or criticized z. B. as a vegetarian, the introduction of animal materials through vaccination (vaccination lymph from cowpox). After all, there were vaccination opponents such as Wegener in the 1910s who consciously wanted to put the population "in fear and terror" through reports of alleged vaccination victims. Wegener published the book Impf-Friedhof . Above all, extremists use emotionally tinged arguments that evoked fears, were largely irrational and anti-science . A recurring motif was the effective media presentation of patients with vaccine damage. Between 1908 and 1914 anti-vaccination campaigners organized several congresses lasting several days.

After the middle of the 20th century, various conspiracy theories were published on the vaccination issue . In one of her books, the American anti-vaccine opponent Eleanor McBean claimed that the Spanish flu from 1918 to 1920 was caused by vaccinations. At that time there was no vaccination against flu and it has been scientifically proven that the influenza A virus (H1N1) caused the Spanish flu.

Conspiracy theorists have falsely claimed that AIDS is not caused by the HI virus , but by vaccinations ( AIDS denial ). The journalist Edward Hooper even claimed in the 1990s that Hilary Koprowski's polio vaccinations between 1957 and 1960 caused AIDS in the Belgian Congo ( controversy over the origin of AIDS ). This is demonstrably wrong and has been refuted; no traces of HIV, SIV or monkey DNA were found in the vaccine used at the time .

Recent denial

Attitude to vaccinations in general from 2012 to 2018, BZgA representative surveys

As of 2004, the number of vaccine opponents in Germany was around 3–5%. According to a study that was representative of the population in Germany in 2016 on behalf of the Federal Center for Health Education , one fifth of 16 to 85 year-olds had reservations about vaccinations of any kind, and five percent had a “(rather) negative” attitude. Compared to 2014, the proportion of those who support vaccinations has increased significantly. Broken down into the various types of vaccination, the proportion of those who rate the vaccination against seasonal flu as "(particularly) important" has fallen significantly compared to 2014 from 56 percent to 47 percent. With regard to the vaccinations of their children, 15 percent of the parents indicated some reservations, two percent indicated a “(rather) negative” attitude. Almost all of the parents surveyed said that their child should definitely be vaccinated against tetanus, polio, measles, rubella and mumps. Most parents should also be vaccinated against whooping cough, diphtheria, meningococci, hepatitis B and chickenpox. Around three quarters of the parents each stated that their child should definitely be vaccinated against HPV and pneumococci. In a survey carried out in the same way as in 2018, the proportion who are (rather) in favor of vaccinations rose further to 77%.

The most frequent motive for rejecting individual vaccinations was given by the parents surveyed as their child's state of health or infections at the time of vaccination. A fifth said a doctor advised them not to have the vaccine. Reasons that indicate certain reservations about vaccination were also given by some parents as a reason for not having a vaccination: They feared excessive physical stress on the child (15%), assessed the vaccination as unnecessary (13%) or were afraid from possible side effects (10%). In 2017, the RKI classified three to five percent of the German population as opposed to vaccination; In 2014 a survey came to two to four percent. About one percent of the parents surveyed strictly refuse to have their children vaccinated. In countries with a lower standard of education , the proportion is sometimes significantly higher. Negative reports about vaccination damage or the denial of the vaccination principle itself are published by vaccination opponents in books, in science - critical Internet forums and especially on websites with conspiracy-theoretical content that reject vaccinations , which are often displayed high up on the search results lists. These websites usually refer to other websites with a similar focus.

A survey of German midwives in May 2007 revealed that two thirds of them were in favor of the measles , mumps and rubella (MMR) vaccination , and a quarter opposed the MMR vaccination. The acceptance also correlates with the midwife's own vaccination status: non-vaccinated midwives are significantly more skeptical about vaccination than vaccinated midwives. The latter unsettles some young parents and can lead them to refuse to protect their children from infectious diseases for fear of vaccination.

Approval of vaccination against various diseases
for children under 2 years of age
depending on the vaccination status of the midwife (number = n )
Advocate
vaccination against 		Midwives with vaccination protection
(against the respective illness) 		Midwives without vaccination protection
(against the respective disease)
tetanus 80% ( n = 314) 54% ( n = 49)
diphtheria 84% ( n = 196) 51% ( n = 69)
whooping cough 87% ( n = 84)0 49% ( n = 89)
Hepatitis B. 11% ( n = 35)0 1% ( n = 1)

Opponents of vaccinations often have alternative medical , anthroposophical or esoteric views. It has been proven that children of followers of alternative medicine receive the recommended vaccinations significantly less often, and there is an above-average number of anti-vaccinations among parents who practice attachment parenting according to Sears . For years , measles diseases in Switzerland have mainly been reported from the cantons of Basel-Landschaft and Lucerne , where anthroposophists and their institutions are very active. Several hundred children had to be admitted to hospitals because of severe measles complications, and one girl died. This development can also be observed in Germany. For example, a toddler in Berlin died during a major measles outbreak with several hundred registered cases in autumn 2014. In Germany, the anthroposophical Waldorf schools were repeatedly the starting point for measles epidemics in the 2010s . Enrollment examinations in Baden-Württemberg have shown that the rate of non-vaccinated among Waldorf students is around 30%, as opposed to around 5% otherwise. Low vaccination rates can also be found among Montessori schools and kindergartens.

There are also vaccine opponents with medical or pharmaceutical training, almost exclusively homeopaths . However, large homeopathic associations recommend vaccination programs and reject vaccination nosodes , even the founder Samuel Hahnemann spoke out in favor of smallpox vaccination at the time. Whether a doctor recommends vaccination is generally strongly associated with his or her own vaccination status.

Some opponents of vaccination come from the right-wing political spectrum; an example of this was Ryke Geerd Hamer (1935–2017), who founded the anti-Semitic Germanic New Medicine (GNM). Anti- vaccination activities can also take place in the sect environment , for example in the "New Impulse Meeting" observed by the Office for the Protection of the Constitution; this was a network of various Scientology followers in the Stuttgart area that was operating in the years after 2000 . Another example is vaccination opponent and dairy specialist Hans Tolzin, a former long-time member of the Moon sect , who also expressly supported Hamer's GNM.

Opponents of vaccinations have experienced further radicalization as a result of the COVID-19 pandemic . For example, the obligation to wear protective masks is not seen as a possible prophylaxis against infection, but rather as a mark imposed by the state on a “ slave ”. Vaccination opponents are not organized centrally, but they can be found at parent meetings, larger demonstrations and mainly through the Internet, for example in closed forums and their newsletters.

Such views are often due to exaggerated fear of vaccine damage, distrust of government institutions, of pharmaceutical companies and of medicine in general, as well as ignorance and misleading media reports . In May 2019, Facebook announced that it would immediately delete false statements published on Instagram .

Vaccination opponents are numerically small minority; However, they have found a potentiator in social media that gives the impression that their position is on par with the vast majority of vaccination advocates. In the US, half of anti-vaccination advertising on Facebook comes from just two large organizations: one is the World Mercury Project (now known as Children's Health Defense) by Robert F. Kennedy Jr. , and the other is the Stop Mandatory project Vaccination ”by US activist Larry Cook. The anti-vaccination campaigns that were run were more extensive than the online advertising of the advocates and reached a larger audience. Vaccination opponents are also supported on Twitter by bots and Russian trolls .

The basic argumentative patterns of today's anti-vaccination groups are similar to those of the late 19th and early 20th centuries.

Response from authorities and organizations

In contrast, the United Nations and UNICEF established in 2002 that every child has the right to be vaccinated against preventable diseases. In the drafting of Paragraph 24 of the UN Convention on the Rights of the Child, which grants children the right to the greatest possible health , the position on vaccinations was adopted that “routine vaccination of children is necessary in order to guarantee children's right to health”.

Global share of those who agree that vaccines are important for children (2018)

In 2019, the World Health Organization added vaccine hesitancy to its list of the top ten global health threats . According to the United Nations, “around three million children still die each year from diseases that could have been easily prevented with one to three units of readily available vaccines, especially in developing countries . Millions of other children are weakened or severely disabled by these diseases ”. In contrast, many serious infectious diseases have become rare in industrialized countries thanks to vaccination programs and good coverage of the population. Those who refuse to be vaccinated will also benefit from the high herd immunity through vaccination. As a result, the consequences of infectious diseases and their complications are forgotten or played down, from developmental defects to permanent physical disabilities and even death. These risks are also underestimated at the so-called measles parties . The recommended measles vaccination offers safe and very well-tolerated protection without the risk of pneumonia or encephalitis. The controversies are discussed in detail in the articles on vaccines ( MMR vaccine , hexavalent vaccine, etc.).

Justifications

In surveys, the reluctance to vaccinate can largely be traced back to five attitudes and views, which are also called "The 5C" :

  • Confidence: lack of confidence in the effectiveness or safety of vaccinations
  • Complacency: perceived as a low risk of becoming seriously ill from the infection
  • Constraints: Restrictions such as stress or time constraints that prevent vaccinations in everyday life
  • Calculation: your own attempts to obtain information, but this led to incorrect information
  • Collective responsibility: low willingness to be vaccinated to protect third parties

Some of the anti-vaccine arguments are known as conspiracy theory. As a rule, they relate to one or more of the points of criticism mentioned in the following four sections, which hereby partially overlap.

effectiveness

Annual cases of infection in the USA before and after introduction of vaccination programs
vaccine before later
diphtheria 175,885
(1922)		 1
(1998)
Haemophilus
influenzae B		 20,000
(1982)		 54
(1998)
whooping cough 147.271
(1925)		 6,279
(1998)
measles 503,282
(1962)		 89
(1998)
mumps 152,209
(1968)		 606
(1998)
smallpox 48,164
(1904)		 0
(1998)
rubella 47,745
(1968)		 345
(1998)

Some fundamental opponents of vaccination are of the opinion that there is no evidence of the effectiveness of vaccinations that withstand "scientific criteria". It is true that no vaccination can protect against the respective disease one hundred percent and that the effectiveness of the protection differs depending on the vaccination. This is an example of the practice of unfulfillable claims made by opponents of vaccinations, as they demand 100% effectiveness or vaccinations must not have any side effects. In principle, however, vaccinations significantly reduce the likelihood of illness. Numerous published studies that meet the requirements of evidence-based medicine confirm this. As a rule, the number of infectious diseases falls shortly after the introduction of vaccinations. For example, before measles vaccination was introduced in the USA (in 1963), several hundred thousand measles cases were recorded annually (with 400 to 500 deaths, 48,000 hospitalizations and 1,000 encephalitis cases). A few years after the introduction of the first one-time vaccination (1963) (and later the two-time vaccination in 1993), a 99% decrease in the number of diseases was registered. The frequency of other infectious diseases such as B. in mumps or polio could be significantly reduced by vaccinations.

Hygiene and living standards

Opponents of vaccination claim that the improvement in hygiene and living standards alone should have led to a decrease in infectious diseases. This may have been the case with some infectious diseases such as typhoid or cholera . However, the occurrence of vaccine-preventable diseases such as B. measles, hepatitis B or polio can only be significantly reduced by vaccinations. In addition, hygienic conditions would not explain why z. For example, India has been considered polio-free since 2014, despite several areas with low hygienic standards, or vice versa, why measles outbreaks occur again and again in Germany or the USA with very high hygienic standards. In addition, vaccination baits were largely responsible for eradicating rabies in foxes, not improved hygiene.

Antibodies and protective effects

The effectiveness measurement by means of antibody titers is also questioned by fundamental opponents of vaccination . Numerous intervention studies and epidemiological analyzes show, however, a good correlation between antibody values ​​and protection against the infectious disease.

Third party protection

Estimated
herd immunity thresholds
illness Threshold
diphtheria 85%
measles 83-94%
mumps 75-86%
whooping cough 92-94%
polio 80-86%
rubella 80-85%
smallpox 83-85%

The herd immunity by vaccination is occupied for many infectious diseases. Above a certain percentage of immunized people in a population (“threshold value”), a pathogen no longer finds enough neighboring people who are not yet protected by vaccination and can therefore be infected. This threshold value is essentially dependent on the basic reproduction number of the respective pathogen. The respective infection then no longer occurs endemically, even after the re-import of pathogens, but only sporadically locally.

unwanted effects

Opponents of vaccination argue that there are diseases and long-term effects that could be seen as side effects of the vaccination or its ingredients. Allergies , autoimmune diseases , asthma , autism , diabetes , hay fever , HIV , homosexuality , cancer , crime , Crohn's disease , multiple sclerosis and sudden infant death syndrome were cited as late effects of vaccinations . These statements are based in part on falsifications - such as the Wakefield case in the alleged link between MMR vaccines and autism - and have been invalidated by many studies.

However, the refutations are often ignored by those who oppose vaccination.

For example, numerous studies have never proven a causal relationship between allergies and vaccinations. In addition, epidemiological comparisons show that allergies in the population of the former GDR , in which vaccinations were compulsory , only increased significantly after the fall of the Wall - at the same time as the number of vaccinations fell. Only after reunification (also in the old federal states) did the frequency of such allergic symptoms increase. The Robert Koch Institute sums up: “One thing is certain: there are more vaccinations these days - and more allergies. However, it has not been proven whether one is related to the other ”. In more recent times, the increase in allergic symptoms from 1990 onwards in the new federal states has been attributed to changes in diet and lifestyle habits (“Western way of life”), mainly due to the investigations by Erika von Mutius . Like infections caused by environmental germs, vaccines stimulate the early childhood immune system. The most important impetus for immune maturation, however, is based on bacterial colonization within the first days of life, i.e. the intestinal microbiome . But live vaccinations can also contribute to this through so-called heterologous effects . Scientific studies also showed no differences in the occurrence of allergic diseases (and infections against which vaccination is not given) between vaccinated and unvaccinated children, while other studies even showed a higher risk of developing allergies in unvaccinated children compared to vaccinated children. In evaluations of vaccination opponents who claim the opposite, "basic standards of scientific data analysis were not adhered to", they are therefore wrong. Unvaccinated children, on the other hand, are significantly more likely to develop vaccinable diseases such as measles or whooping cough than vaccinated children.

Opponents of vaccination also claim that the aluminum adjuvants contained in some vaccines would themselves become allergens and cause intolerance reactions and inflammation. In a randomized, single-blind controlled study, however, it was found that there is no connection between contact dermatitis and an aluminum-containing vaccination. Most subcutaneous allergen-specific immunotherapies against allergies ( desensitization , ie “vaccinations” against allergies) even contain aluminum hydroxide itself as an adjuvant.

Even the claim that vaccinations could cause cancer has not been scientifically proven: the alleged connection between leukemia , especially in children, and vaccinations (MMR, tetanus , diphtheria , whooping cough , polio , hepatitis B, Haemophilus influenzae b infection) has been confirmed by numerous people Studies refuted. Many tumor diseases can be traced back to infections with hepatitis B and C viruses ; vaccines are effective against the former.

Opponents of vaccination also point out that, due to their limited size, approval studies of vaccinations could only record a fraction of the side effects and so side effects that occur less than 1: 500 would not be determined. In addition, the reporting system of the Infection Protection Act is not able to record the actual extent of vaccination complications in Germany; as a result, the relationship between benefit and harm is misjudged. In fact, like all other drugs, vaccines have to go through a complex approval process before they can be introduced . For this approval, the manufacturer must submit extensive studies, which should prove the effectiveness and tolerability to the required extent. After a vaccine has been introduced, a report must periodically be submitted to the responsible regulatory authorities at prescribed intervals, which summarizes the current data on safety - such as independent follow-up studies by university hospitals and other research institutions or reports of side effects to the health authorities. The reporting system is an important instrument for the first, as prompt as possible, determination of possible side effects. As a result of this procedure, for example, the inadequate long-term effect of the hepatitis B component of the six-fold vaccine Hexavac was recognized, so that this vaccine was withdrawn from the market.

With regard to the willingness to establish a connection to vaccination in the event of a disease occurring after vaccination, a scientific study analyzed the basic frequency of certain diseases in large groups of girls and young women when the HPV vaccine was introduced - mind you, before the vaccine was available . With the help of this background morbidity , it was possible to show how many or which diseases would occur in 100,000 female vaccines within six weeks after an (only assumed) HPV vaccination. As a result, there were two or one-digit numbers of various diseases - which would have occurred without vaccination.

It is widely claimed that vaccines contain dangerous chemicals. The mercury-containing thiomersal that was previously used as a preservative - which has a short half-life and is not stored in the body - is no longer used for a vaccine due to the use of single injections. Other substances in dead vaccines are (in extremely low concentrations far below toxicological limit values) aluminum hydroxide as an adjuvant (strengthening of the immune response) or phenol (preservation). The amount of formaldehyde contained (inactivation of toxins and viruses) is so low that the physiological formaldehyde content of the muscle is even diluted by a vaccination.

Number of antigens in vaccinations
vaccine Number of antigens
measles 10
mumps 9
tetanus 1
Whooping cough (today) 2-5
polio 15th
all vaccinations (today) about 150
Smallpox (until 1983) 198
Whooping cough (until 1994) approx. 3,000

Another point of criticism is the idea that “too many” vaccinations or combination vaccinations would “overload” the immune system. However, this does not take into account the fact that, in terms of volume, more foreign antigens are absorbed through a single meal than in total in life through vaccinations, nor the improved tolerance of modern vaccines. Advances in production have increased the specificity, and the number of antigens required for an immune response has decreased. In total, around 150 antigens are presented to an infant by vaccination in the first year, which corresponds to a reduction by a factor of 10 compared to before. In fact, a child is confronted with tens to hundreds of new antigens (viruses, bacteria, chemical compounds) every day. In addition, the immune system of an infant is already ready for all essential defense functions; it is estimated that a toddler could cope with the amount of antigen in 10,000 vaccinations at once. In fact, a study of 24 to 47 month old children in the United States confirmed that vaccination at the guideline frequency did not increase their number of uncontrollable diseases. On the contrary, vaccinations can lower the general risk of infection for a small child if they receive a combination vaccination against diphtheria, whooping cough, tetanus, hib and polio within the first three months.

Data situation

Opponents of vaccination claim that the vaccine manufacturers influence the responsible health authorities (e.g. the STIKO of the Robert Koch Institute in Germany and the CDC in the USA) as well as the scientists in this field, so that there is insufficient education .

For the approval of vaccinations, studies must be submitted to the responsible approval authorities (e.g. the Paul Ehrlich Institute in Germany and the US FDA ) which prove the effectiveness and tolerability and are in fact funded by the applicant. These studies are carried out in one or more clinics. In the context of pharmacovigilance , however, there are also studies that are financed with public funds.

Against the accusation of a lack of neutrality and personal enrichment, the reply is that the health authorities of governments with the most varied of political orientations (e.g. the former Eastern Bloc states ) have essentially reached the same recommendations.

Economic interests

Vaccination studies - like drug studies - are largely financed by the respective pharmaceutical manufacturer . Some opponents of vaccination have speculated that the STIKO is mainly pursuing corporate interests instead of public health. In 2008 the STIKO tightened its rules of procedure in order to dispel doubts about its impartiality. Before 2008, some members of the Standing Vaccination Commission had contact with pharmaceutical companies and there was economic contact with a company that also manufactures vaccines.

Conversely, some vaccination advocates have argued that there are vaccination opponents who are pursuing an economic interest with their criticism. For example, in the late 1990s, a law firm that represented anti-vaccination agents paid several million pounds sterling to scientists for evidence of side effects (see article MMR Vaccine ). Profits are also achieved with books that are against vaccination, seminars and advice against vaccination as well as with alternative medical treatments of the disease or with the " diversion " of alleged vaccine side effects.

The economic interests of pharmaceutical companies are not limited to vaccinations as a precautionary measure. Many of the infections that can be prevented by vaccination lead to diseases with a chronic course. In the case of hepatitis B , the income from the usually three-time vaccination contrasts with the income from drug antiviral therapy, which must be maintained over many years. The hepatitis B therapy costs around 1000 euros per patient per month, other chronic diseases are in no way inferior. The vaccination, however, cost one-time average of 50 to 100 euros and achieve high for hepatitis B immunity rates .

In 2015, the company Sanofi Pasteur MSD presented an invoice at the 4th National Vaccination Conference according to which the statutory health insurance for a woman spends an average of 1,976 euros on lifelong vaccination protection against 15 different infectious diseases, including 1,530 euros for the vaccines and 446 euros for the Doctors' fees. The costs for men are around 400 euros lower because of the shorter life expectancy and the lack of an HPV vaccination, while the costs are higher for people with underlying diseases . The share of vaccine costs in the service expenditure of the statutory health insurance is around 0.6%. This means that pharmaceutical manufacturers earn significantly less money with vaccines than with drugs, such as those that chronically ill people have to take.

In addition, the vaccine business is less attractive to pharmaceutical companies because vaccine production is far more complex and expensive than synthetic drugs. The number of vaccine manufacturers has therefore decreased worldwide.

Some opponents of vaccinations, such as the journalist Torsten Engelbrecht or the doctor Claus Köhnlein, accuse the pharmaceutical companies of having invented diseases such as BSE , AIDS or SARS for profit; apart from that, they withhold current data, cite and translate incorrectly from English or withhold new studies and investigations.

Religious reasons

Various groups reject vaccinations for religious reasons. With the Christians these are z. B. the Amish in the USA or people in the Bible belt in the Netherlands , which has led to regular outbreaks of preventable diseases there, e.g. B. Polio; some of these strictly orthodox Calvinists, trusting God, voluntarily renounce health insurance. Vaccine refusers can also be found among ultra-Orthodox Jews, such as in New York , of whom around 14% are not vaccinated against measles. This regularly leads to measles outbreaks in their communities. In Jerusalem , in the partially isolated quarters of ultra-Orthodox Jews, only half are vaccinated against measles, which also leads to measles epidemics there.

Muslim populations in Nigeria are obstructing the WHO's polio eradication program and boycotting it with false claims.

The Taliban in Pakistan and Afghanistan prevent the polio eradication program, especially after it was used as a cover for military operations by CIA agents disguised as doctors . Regardless of this, religious fanatics and Islamist extremists see vaccinations as "un-Islamic" or even as an alleged plan of the West to make the population sterile. This led to several helpers in the polio vaccination program being attacked or murdered.

See also

literature

German speaking

  • Christiane Meyer, Sabine Reiter: Vaccination opponents and vaccination skeptics. History, background, theses, handling. In: Federal Health Gazette - Health Research - Health Protection 47 (2004), pp. 1182–1188; rki.de (PDF), accessed on May 15, 2019.
  • Sandra Stricker: Vaccination critic and anti-vaccination. An analysis of the criticism of vaccinations using the example of the MMR vaccination . Dissertation, Hannover Medical School 2006.
  • Wolfgang Maurer: Vaccine skeptics - vaccine opponents. From another reality on the internet . In: Pharmacy in our time . tape 37 , no. 1 , January 2008, p. 64-70 , doi : 10.1002 / pauz.200700252 .

English speaking

  • P. Davies, S. Chapman, J. Leask: Antivaccination activists on the world wide web . in: Archives of Disease in Childhood 87, Issue 1 (2002), pp. 22-25, doi: 10.1136 / adc.87.1.22 .
  • Sven Ove Hansson: Science denial as a form of pseudoscience. In: Studies in History and Philosophy of Science 63, (2017), pp. 39–47
  • Matthew J. Hornsey, Emily A. Harris, and Kelly S. Fielding: The Psychological Roots of Anti-Vaccination Attitudes: A 24-Nation Investigation . In: Health Psychology 37, No. 4 (2018), pp. 307-315; apa.org (PDF) accessed on May 15, 2019.
  • Daniel Jolley, Karen M. Douglas: The Effects of Anti-Vaccine Conspiracy Theories on Vaccination Intentions . In: PLOS , February 20, 2014, doi: 10.1371 / journal.pone.0089177
  • Paul A. Offit : Autism's False Prophets. Bad Science, Risky Medicine, and the Search for a Cure . Columbia University Press, New York 2008
  • Paul A. Offit: Deadly Choices. How the Anti-Vaccine Movement Threatens Us All . Basic Books, New York 2011

Web links

Individual evidence

  1. ↑ a b c d Axel Helmstädter: On the history of active immunization. Prevention is better than cure . In: Pharmacy in our time . tape 37 , no. 1 , 2008, p. 12-18 , doi : 10.1002 / pauz.200700247 .
  2. ↑ Wolfgang Kiehl : Infection protection and infection epidemiology. Technical terms - definitions - interpretations. Ed .: Robert Koch Institute, Berlin 2015, ISBN 978-3-89606-258-1 , p. 60, keyword vaccine opponents
  3. ^ Avoxa media group Deutscher Apotheker GmbH: Pharmazeutische Zeitung online: Vaccination opponents: From AIDS deniers and conspiracy theorists. Retrieved July 24, 2017 .
  4. ^ Sven Ove Hansson: Science denial as a form of pseudoscience . In: Studies in History and Philosophy of Science . tape 63 , 2017, p. 39–47 , doi : 10.1016 / j.shpsa.2017.05.002 .
  5. ↑ a b c d e f g h Christiane Meyer and Sabine Reiter: Vaccination opponents and vaccine skeptics - history, background, theses, handling . In: Federal Health Gazette . tape 47 , 2004, doi : 10.1007 / s00103-004-0953-x ( rki.de [PDF; accessed April 30, 2015]).
  6. ↑ Arno Frank: Epidemics and Enlightenment: God's just punishment , taz, online August 20, 2014, accessed August 31, 2019
  7. ↑ Jürgen Stolzenberg: Kant and Medicine , lecture on April 21-23, 2014 as part of the XI International Kant Conference in Kaliningrad, online April 23, 2014, access on August 31, 2019
  8. ↑ Bonner Kant corpus: AA VI, Die Metaphysik der Sitten, (...) Von der Selbstentleibung, 1797
  9. ↑ Lambros Kordelas and Caspar Grond-Ginsbach: Kant on the "moral daring" of the smallpox vaccination. A few fragments of Kant's examination of the ethical implications of the smallpox vaccination. NTM Journal for the History of Science, Technology and Medicine, ISSN  0036-6978 , Volume 8, Issue 1, pp. 22 ff, March 2000
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