In a week a new school year begins in Ukraine. But, as it turned out, not all pupils will be able to go to school. On September 1, schools will open their doors only for the children vaccinated according to the national calendar. This was stated at a joint briefing by the heads of the Ministry of Health and the Ministry of Education.

This ban has once again sparked a public debate between those who support vaccination and its opponents. Why the ministries took this step and what it means – read on Opinion.

Why did the ban occur?

The decision to restrict access to children’s institutions for unvaccinated children arose against the background of the measles outbreak, which has been ongoing in Ukraine for almost two years. Now Ukraine occupies a leading position by the number of patients. Since the summer of 2017, 115 thousand people fell ill in Ukraine, 39 of them died. This is more than in all countries of Europe as a whole.

The Ministry of Health claims that such a number of patients was the result of a failed vaccination company. One of the reasons is the refusal of parents to vaccinate children, the number of which has been growing since 2008.

Every year, the number of new cases of measles classically begins to grow at the beginning of the school year. This is associated with the rapid spread of infection in children’s groups. Banning unvaccinated children should stop the spread of infection among children.

The position of the parents

There are several major reasons for the low vaccination coverage of children. Some parents delay vaccination because of lack of time. Other parents are fundamentally unwilling to vaccinate children because of distrust in the quality of vaccines, or in the vaccination procedure itself, or confidence in the global conspiracy of vaccine manufacturers.

Parents with a principled anti-vaccination position are convinced that the ban is contrary to the law on education. They appeal to the Constitution, which guarantees everyone the right to education. In addition, parents do not understand how their vaccinated children can threaten other children. After all, if all in a class are vaccinated, how can an unvaccinated child be a threat to them?

Several parents sued the educational institutions that banned unvaccinated children. In 2016, a woman from Slavuta town sued a pre-school institution, which refused to accept her unvaccinated child. Slavuta court has banned a kindergarten to not accept her child. The court of appeal of Khmelnytskyi oblast took the side of preschool. As a result, the Supreme Court confirmed the legality of the ban, stating that in this case, the plaintiff opposes the individual right to refuse vaccination to the general interest of society and other parents and their children.

The position of the Ministry of Education

The Ministry of Education supports the position of the Ministry of Health, which refers to Article 15 of the Law of Ukraine “On the protection of the population from infectious diseases”.

In addition, the head of the Ministry of Education assures that attending schools and kindergartens is only one of the possible forms of education. The state guarantees other forms of education to those who choose to refuse vaccination because of their beliefs: external, remote, in absentia. So, a child who does not attend school can study at home and retains its right to education.

The position of the doctors

Doctors say that such a ban is necessary, although a tough, step to protect children and adults from infections. WHO and the Ministry of Health of Ukraine insist that the only reliable prevention of measles, diphtheria and other infectious diseases is vaccination. At the same time, it is the percentage of the vaccinated population that is important. If more than 90% of the people are vaccinated, collective immunity is formed to prevent the spread of infection.

What is collective immunity?

After vaccination, the body creates a weapon against infectious agents – antibodies. To combat infections that are transmitted from person to person, this process is doubly advantageous.

Pathogens like the measles virus use humans as a natural incubator for their own reproduction and distribution to new incubator victims. As a result of vaccination, a person receives individual protection due to antibodies in his blood. After a body becomes resistant to the measles virus, the virus interrupts the chain of infection. Thanks to this mechanism, a number of dangerous infections were overcome. In particular, thanks to the vaccination of the entire population of the world in the middle of the twentieth century, it was possible to completely destroy smallpox.

The maximum coverage of the population is important for the creation of collective immunity. The bigger the number of the immune people, the less the chance of the pathogen to find a victim.

Weaknesses of collective protection

The human immune system has individual characteristics. About 10% of people do not produce protective antibodies. In addition, there are people with absolute contraindications to vaccination. The introduction of vaccines or any other drug might trigger an anaphylactic reaction in them.

People who had organ transplantation or immune system diseases itself also have certain immunity peculiarities. They may be vulnerable to infectious diseases and a severe infection will have very negative consequences for them.

Collective responsibility of the surrounding population should be a protection for these people. It is important for a person from a risk group to have as many vaccinated people in their environment as possible because then the chances of getting infected are minimal. Therefore, an unvaccinated child doesn’t only fall into the risk zone of getting an infection, but can also become a link in the process of infection spreading in its group.

The experience of other countries

In the US, Canada and France, unvaccinated children are not allowed in schools. In some countries, parents are subject to high fines or criminal liability for refusing vaccination. Some countries do not have strict bans but have a high vaccination coverage, such as Finland or Israel.

Expected results for Ukraine

Banning unvaccinated children from attending school is a harsh step. No one has doubts about this. But such a step should stop the measles outbreak in Ukraine and increase the level of vaccination coverage, especially among those who could not find time to vaccinate the child.

The negative side of the ban is the desire of fraudsters to cash in. Even now there are dozens of announcements in the network with the offer to fake any certificate for 300-500 hryvnias. There is even a delivery service. The authenticity of a certificate is rarely checked at school. And even if the forgery can be detected, no one is in a hurry to punish the perpetrators. As a result, parents who bought such a “document” often forget what vaccines their child did get, and which of them were done only on a paper.

Text by Sviatoslav Linnikov

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