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Point and Counterpoint |

COUNTERPOINT: Should Childhood Vaccination Against Measles Be a Mandatory Requirement for Attending School? NoMandatory Measles Vaccination. No

Peter Schröder-Bäck, PhD; Kyriakos Martakis, MD
Author and Funding Information

From the Department of International Health (Drs Schröder-Bäck and Martakis), CAPHRI—School of Public Health and Primary Care, Faculty of Health, Medicine, and Life Sciences, Maastricht University; the Faculty for Human and Health Sciences (Dr Schröder-Bäck), University of Bremen, Bremen, Germany; and the Children’s and Adolescents’ Hospital, University Hospital of Cologne (Dr Martakis), Cologne, Germany.

CORRESPONDENCE TO: Peter Schröder-Bäck, PhD, Maastricht University, Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care (CAPHRI), Department of International Health, Postbox 616, 6200 MD Maastricht, The Netherlands; e-mail: Peter.Schroder@maastrichtuniversity.nl


CONFLICT OF INTEREST: None declared.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(4):854-856. doi:10.1378/chest.15-1162
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We have no doubt that childhood measles immunization programs aimed at achieving or maintaining herd immunity are justified from both a public health and an ethical perspective. The minor risks that may be associated with the vaccination far outweigh the burden of disease that measles outbreaks produce.1

Although the effectiveness of a policy imposing a mandatory childhood vaccination prior to enrollment in school (usually including exemptions because of religious or so-called philosophical reasons)2 may look self-evident, we would doubt that this measure is necessary or sufficient for herd immunity. In fact, the vaccination coverage of local populations where measles outbreaks have occurred is as low as 50%3 and is often the result of nonvaccinated adults.4 Thus, it is reasonable to develop or strengthen policies to approach every unvaccinated candidate, including adults.

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