As countries around the world grapple with rise of “anti-vax” sentiment, non-vaccinating parents in Italy face fines or their children being turned away from school

Health 13 March 2019

Italy made vaccinations compulsory for children attending state schools this week. Children under the age of six will be turned away from nurseries and kindergartens unless their parents have given proof of their vaccination status.

Children aged six and over won’t be stopped from coming to school, but their parents will have to pay fines of €500 (£430). The required vaccines include measles, mumps and rubella, known as the MMR jab, as well as chickenpox and polio.


Children’s immunisation rates have been falling in many western countries for the past couple of decades, stemming from mistaken fears that vaccines carry health risks. But only a minority of places have made vaccinations mandatory for attending school. These include France, Germany, and some states in the US and Australia.

In Italy the law was introduced in 2017 but there have been tussles over whether and when it would come into force. Parents had until this week to provide immunisation certificates to schools, so parents in some regions are now being sent letters of suspension.

Health officials seek to get vaccination rates up to 95 per cent, the level that gives herd immunity. This means there are so few unvaccinated people that if one person brings in the disease from elsewhere they are unlikely to come into contact with anyone they can pass it on to.

This stops outbreaks from spreading, and so shields infants who are too young to have had their jabs yet or people who cannot be vaccinated because of an impaired immune system. “These children need to be protected,” says Siddhartha Datta of the World Health Organization.

Measles is a particular concern as it is highly contagious and can cause pneumonia and brain damage. Before the 1960s, when vaccination was introduced, it used to cause epidemics every two or three years, with 95 per cent of children having had it by their 15th birthday.

But countries have to balance the protection of those who cannot be vaccinated against parents’ wishes to determine their children’s medical care. Different countries need to set their own policies, says Datta. “What works in in one country won’t necessarily work in another.”

In the US this year there have been six outbreaks of measles, in places such as New York and California, linked to travellers returning from areas where there are currently large outbreaks, such as Israel and Ukraine. Lawmakers in New York are proposing a bill that would allow children 14 years and over to get vaccinated against their parents’ wishes.

In the UK vaccine fears were mainly driven by a single researcher, Andrew Wakefield, who pushed the false claim the MMR vaccine was causing a rise in autism. But countless studies – including a massive one from Denmark released earlier this month – show children who got the jab are no more likely to be diagnosed with autism than those who didn’t get it. Other studies have shown autism isn’t really on the rise, doctors are just becoming better at identifying it.

Wakefield has since been struck off for dishonesty by the UK’s regulatory body for doctors, the General Medical Council, and his original paper making the link was retracted by The Lancet, the medical journal that published it.

In the US, anti-vax sentiment centres more on the mistaken belief that the ingredients in vaccines are harmful or that too many could somehow overload a child’s immune system, which isn’t possible.

Recently the World Health Organization said that “vaccine hesitancy” was one of the ten biggest threats to global health in 2019, along with other risks such as antibiotic resistance and the possibility of a new flu pandemic.

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