Will the Dutch deny access to daycare to un-vaccinated children?

No daycare for un-vaccinated children?

A vast majority of the Dutch parliament (Tweede-kamer) wants to approve a law which would allow non-vaccinated children to be denied access to daycare centers. VVD, D66, CDA, SP and PvdA all agree that due to the current vaccination rates in the Netherlands such measures are needed.

At the moment, as there is currently no law on the subject, if a daycare would deny access to non-vaccinated children, the parents could sue on the basis of discrimination for “lifestlyle” or “religious” choices.

Gjalt Jellesma, chairman of the BOINK (belangenorganisatie van ouders in de kinderopvang, organization of parents in daycare ) states that “this discussion should not be taking place at 12 thousand individual daycare centers. It is the government who has to take a stand”.

Vaccination coverage in the Netherlands is at 90,2%

Mürielle Springer from Brancheorganisatie Kinderopvang (organization of daycares) asks as well for mandatory vaccination for all children attending daycare centers: “For outbreaks of innocent infectious conditions such as impetigo or diarrhea we have to follow very strict protocols, however oddly enough, for something deadly like measles, no rules apply”.

The Royal institute for Public health and the environment (RIVM) reported in June that last year only 90.2 % of 2 year-olds in the Netherlands were fully vaccinated against diseases such as measles, polio, tetanus or pertussis. To prevent a measles outbreak the vaccination coverage should be at least 95% (as recommended by the WHO and the European Center of Disease Control and prevention).

Herd immunity and un-vaccinated children

Choosing whether or not to vaccinate is not a parenting, lifestyle or religious choice. There is a beautiful, beautiful, phenomenon called herd immunity. It means that we can prevent an infectious agent from spreading among a population by limiting the amount of susceptible individuals in the pool. An individual is susceptible to an infectious agent when it has not been exposed to it before. It may become immunized -that is, no longer susceptible- by acquiring the disease or through vaccination. When the number of susceptible individuals reaches a certain degree a disease may be completely banned from a population. There will always be individuals who may not be vaccinated because of age (too young, too old) or due to particular health conditions. Herd immunity allows to protect these individuals. The stronger, can protect the weaker. However if the immunization rate is too low (as is the case for measles in the Netherlands now), the susceptible population becomes large enough for an outbreak to occur because the infectious agent can pass from one individual to another.

It is just selfish to actively choose to put others’ lives in danger because of some “pseudo-interesting made up bullshit” (in the bright and clear words of Klaas Dijkhoff, from the VVD). The anti-vaccination movement is based on an article published in the Lancet that has long since being retracted for being fraudulent. Even if the claims  (which have been debunked by scientific evidence several times) were true, namely that the MMR vaccine would be responsible for cases of autism, what kind of person would rather have their own child die?

Looking back at other times with un-vaccinated children

There are always those who argue that back in the day children were not immunized, and look, we survived. I would urge those people to visit 1800 century cemeteries and realize the large amount of children who died before of the age of 3 from diseases that today are easily preventable.

In the words of the brilliant Roald Dahl, in a letter he wrote after losing his 7-year-old daughter to measles:

“Olivia, my eldest daughter, caught measles when she was seven years old. As the illness took its usual course I can remember reading to her often in bed and not feeling particularly alarmed about it. Then one morning, when she was well on the road to recovery, I was sitting on her bed showing her how to fashion little animals out of coloured pipe-cleaners, and when it came to her turn to make one herself, I noticed that her fingers and her mind were not working together and she couldn’t do anything.

“Are you feeling all right?” I asked her.

“I feel all sleepy,” she said.

In an hour, she was unconscious. In twelve hours she was dead.

The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her.

On the other hand, there is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. They can insist that their child is immunised against measles. I was unable to do that for Olivia in 1962 because in those days a reliable measles vaccine had not been discovered. Today a good and safe vaccine is available to every family and all you have to do is to ask your doctor to administer it.“

Body integrity and un-vaccinated children

There is also the argument of body integrity, but as Ernst Hulst, health jurist from Erasmus university puts it, “by not vaccinating you specifically put the body integrity of other children at risk”.

I really do hope such a law will soon come to pass. As my youngest daughter sleeps in her crib, on the day that, at 14 months, she finally was able to receive her MMR shot,I am beyond grateful that she will very soon be no longer at risk.