Croatia's Constitutional Court has upheld compulsory vaccination laws against nine infectious diseases. The court's statement has been translated as reading, “The child’s right to health is more than the rights of parents to the (wrong) choice.” 

 

Croatia and its neighbor Slovenia have been at the forefront of universal vaccination. While most governments advocate in favor of vaccination, and in some cases provide financial incentives, only a few make childhood vaccination compulsory. 

 

According to a study of 29 European countries, “15 countries do not have any mandatory vaccinations; the remaining 14 countries have at least one mandatory vaccination included in their program”. Moreover, most of these do not enforce the laws, provide extensive opt-out clauses, or make vaccination universal only against a small number of diseases.

 

Since Croatia  made vaccinations universal in 1999 diphtheria, whooping cough and measles have disappeared entirely and tuberculosis has decreased by 93%, tetanus by 97% and hepatitis B by 65%.

 

Possibly because of this success, however, Croatia has experienced substantial resistance to what was once an uncontroversial policy. Having achieved universal vaccination for a decade (presumably excluding cases where there was a valid medical reason) 28 children went unvaccinated in 2012, according to official records, and in 2013 this climbed to 143. While these numbers are not enough to generate the sorts of outbreaks seen in the US and UK as a result of campaigns by anti-vax lobbyists, the direction is clear.

 

The potential scale of the revolt is indicated by 10,000 people signing a petition claiming, "the vaccination of healthy children poses a threat to their health." Inevitably the law was challenged in court, but the highest court in the land has now endorsed it. The decision has been hailed by the Croatian Medical Association and the Croatian Institute for Public Health.

 

The implications of a let up in vaccination regimes can be seen in Syria where the war has interrupted the childhood immunization program. As a result polio, recently confined to just three countries, is now spiraling out of control in Syria. Children, including those who make it to refugee camps in surrounding countries, are being sentenced to lifelong paralysis.

 

Failing to vaccinate a child against a transmissible disease is analogous to strapping a bomb to their chest and sending them out in public – if something triggers an explosion they are the most likely one to die, but there is a substantial risk everyone close to them will get hurt as well.