Compulsory Vaccinations in Europe – Current State of Play

In total, 15 European countries do not have compulsory vaccinations, while the remaining 14 countries have at least one compulsory vaccination included in their vaccination programme. The United States and Canada – in a way like Germany – have chosen a middle way. People who do not have vaccinations are not sanctioned there, but a medical certificate is required for admission to school. Let’s find out more about the situation with vaccinations in Europe.

The First Compulsory Vaccinations

In Europe, compulsory vaccinations were born in the early nineteenth century, with the spread of vaccination against smallpox. The doctors had in fact noticed that by protecting the individual it was possible to avoid the spread of the epidemic to the whole community. However, to achieve this, it was necessary to have a massive adherence. England first made smallpox vaccination universal and free, and then mandatory with the Vaccitation Act of 1840, 1841 and 1853.

In Italy, the obligation to vaccinate all newborns against smallpox was suspended in 1977 and abolished in 1981. In the meantime, vaccinations against diphtheria (1939), polio (1966), tetanus (1968) and hepatitis B (1991) had become mandatory. Nowadays, however, the number of compulsory vaccinations has risen to 12.

Vaccinations in Europe

But how does it work in other countries? All 29 countries of the European Union include the vaccine against diphtheria, hepatitis B, Hib, influenza, MMR, whooping cough, polio and tetanus in their vaccination programs. In total, 28 countries include vaccination against invasive pneumococcal disease among those recommended. In some countries it applies only to children, while in others this is also for adults or risk groups. Most other vaccinations (against hepatitis A, HPV, invasive diseases caused by meningococcus C, tuberculosis and chickenpox) are also covered by at least 20 countries. An exception is rotavirus vaccination, which is included in the national immunization program in 9 of the 29 countries considered.

In total, 15 European countries do not have compulsory vaccinations. On the other hand, the remaining 14 countries have at least one compulsory vaccination included in their vaccination programme. In particular, polio vaccination is mandatory for all children in 12 European countries. The vaccination against diphtheria and tetanus is mandatory in 11 countries while the vaccination against hepatitis B in 10 countries. Moreover, some countries have adopted a mixed strategy between recommended and mandatory. This usually means that vaccination is recommended for the whole population, but is in fact only mandatory for certain risk groups. Finally, there are countries that have chosen not to sanction those who do not vaccinate, but to make it necessary to present a special medical certificate for admission to school.