Shots at shots: Ger­many’s anti-vac­cine move­ment grows.

Health of­fi­cials bat­tle cit­i­zens’ fears that they would be forced to get a coro­n­avirus shot

The Washington Post Sunday - - ‘THE CURSED PLATOON’ - BY LOVEDAY MOR­RIS AND WIL­LIAM GLUCROFT loveday.mor­ris@wash­post.com Glucroft re­ported from Stuttgart. Luisa Beck in Ber­lin con­trib­uted to this re­port.

stuttgart, ger­many — While much of the world is aching for a coro­n­avirus vac­cine, Lilia Löf­fler is adamant that her three chil­dren won’t be get­ting any jabs.

Shrug­ging off light rain to join a two-hour bike protest of shut­down rules, Löf­fler said that pre­vi­ously she vac­ci­nated all her kids. But she changed her mind af­ter what she’s been hear­ing at demon­stra­tions and read­ing on the In­ter­net dur­ing the pan­demic. She noted that her 6-year-old son is sup­posed to get a shot for measles ahead of school in the fall.

“But he won’t get that,” she said. Or any other vac­ci­na­tion.

The pos­si­bil­ity that Ger­many’s anti-vac­ci­na­tion move­ment may gain new ad­her­ents like Löf­fler has been a con­cern for health author­i­ties, as the coro­n­avirus unites a mish­mash of groups re­sis­tant to the prospect of a vac­cine, from far-right con­spir­acy the­o­rists to hip­pie moms.

Ger­many al­ready had a fer­vent anti-vac­cine move­ment, re­flect­ing a his­toric skep­ti­cism of gov­ern­ment con­trol and an affin­ity for al­ter­na­tive medicine. Now, health ex­perts have warned that even if a coro­n­avirus vac­cine is ap­proved, re­fusals could open the way to a resur­gence of the virus while threat­en­ing ef­forts to keep other pre­ventable dis­eases in check.

“With such a bad pan­demic, there were peo­ple that said it would make anti-vaxxers wake up and see that vac­cines are im­por­tant,” said Heidi Lar­son, di­rec­tor of the Lon­don-based Vac­cine Con­fi­dence Project. “But it’s ac­tu­ally done the op­po­site.”

Anti-vac­cine groups have be­come highly “ac­tive and ag­gres­sive,” she said. “I think we are in a vul­ner­a­ble spot right now.”

In Ger­many, con­spir­acy the­o­ries over a vac­cine abound. At­tila Hild­mann, a ve­gan chef, has be­come one of the lead­ing voices of the re­sis­tance, ac­cus­ing the health min­is­ter of pro­mot­ing a sur­veil­lance state and forced­vac­ci­na­tion pro­gram at the be­hest of bil­lion­aire Bill Gates.

Amid the fer­vor, the Ger­man gov­ern­ment has as­sured the public that any coro­n­avirus vac­cine would be vol­un­tary. “The gov­ern­ment is ac­cused of se­cretly plot­ting to in­tro­duce manda­tory vac­ci­na­tion,” said spokesper­son Ul­rike Dem­mer. “There will be no oblig­a­tory vac­ci­na­tion against the coro­n­avirus.”

That’s dif­fer­ent from the ap­proach Ger­many has taken with measles. To ad­dress what health of­fi­cials warned was one of the worst ef­forts to com­bat measles in Europe, Ger­many last year made the measles vac­cine manda­tory for chil­dren en­ter­ing preschool or kin­der­garten. Par­ents who do not fol­low the rules face fines of 2,500 eu­ros, about $2,800.

Isolde Piechotows­ki is an in­fec­tious-dis­ease ex­pert with the health depart­ment in BadenWürt­tem­berg, a south­west Ger­man state known for a par­tic­u­larly strong anti-vac­cine com­mu­nity. She said her of­fice was in­un­dated with calls and emails af­ter the measles an­nounce­ment. Since the coro­n­avirus pan­demic be­gan, there has been an­other del­uge.

“The mes­sages from these peo­ple — they sup­pose that there will be a manda­tory vac­ci­na­tion. That’s the con­tents of a lot of emails and let­ters right now,” she said. “They are try­ing to in­flu­ence those de­ci­sions, even though there is no such de­ci­sion to be made right now.”

Sur­veys in Ger­many con­ducted by the Univer­sity of Er­furt found that in late June, 64 per­cent of re­spon­dents said they would be will­ing to get a hy­po­thet­i­cal coro­n­avirus vac­cine — down from 79 per­cent in mid-April. The no­tion of manda­tory vac­ci­na­tion was re­jected by 38 per­cent of re­spon­dents.

“Even with a per­fectly func­tion­ing vac­cine, this might not be enough for herd im­mu­nity,” said lead re­searcher Cor­nelia Betsch.

That echoes a warn­ing for the United States by An­thony S. Fauci,

the gov­ern­ment’s top in­fec­tious-dis­ease spe­cial­ist. Last Sun­day, Fauci told CNN that while he’d “set­tle” for a vac­cine that is 70 to 75 per­cent ef­fec­tive, if a third of Amer­i­cans are re­luc­tant to get vac­ci­nated, as some opin­ion polls sug­gest, achiev­ing herd im­mu­nity would be “un­likely.”

Ger­many’s vac­ci­na­tion rates for child­hood dis­eases ap­pear to be some­what higher than those in the United States, ac­cord­ing to com­par­a­tive data com­piled by the Or­ga­ni­za­tion for Eco­nomic Co­op­er­a­tion and Devel­op­ment. But Ger­many’s re­ported fig­ures may over­state vac­ci­na­tion rates — and un­der­es­ti­mate an­ti­vac­cine sen­ti­ment.

Ger­man health in­surer Barmer cal­cu­lated that, based on its pa­tient data­bases, 89 per­cent of 6year-olds were ad­e­quately im­mu­nized against measles in 2017, be­fore the measles man­date. That’s far lower than Ger­many’s re­ported measles vac­ci­na­tion rate of 97 per­cent for that year and falls short of the 95 per­cent tar­get for pop­u­la­tion herd im­mu­nity.

The Robert Koch In­sti­tute (RKI), Ger­many’s fed­eral agency for dis­ease con­trol, ac­knowl­edges that its of­fi­cial data re­flects only what fam­i­lies in­di­cate on vac­ci­na­tion cards at school en­try and ex­cludes those who don’t present a card. As­sum­ing all those with­out cards are not fully vac­ci­nated would mean a “worst case” rate of 81 per­cent, health of­fi­cials said.

RKI says its data from a wider range of health in­sur­ance com­pa­nies es­ti­mates full measles cover­age at 93 per­cent at school age — still be­low the 95 per­cent tar­get. Health author­i­ties sin­gle out late vaccinatio­ns as a par­tic­u­lar prob­lem, with only 74 per­cent of chil­dren re­ceiv­ing their sec­ond measles dose in the rec­om­mended time pe­riod.

One of the hubs of Ger­many’s anti-vac­cine move­ment is BadenWürt­tem­berg, a wealthy re­gion bor­der­ing France and Switzer­land and home to auto gi­ants Daim­ler and Porsche. Dur­ing the peak of Ger­many’s shut­down protests in May, the largest crowds con­gre­gated in the re­gional cap­i­tal of Stuttgart. More than 5,000 peo­ple marched through the streets, bol­stered by a con­tin­gent of anti-vaxxers.

Those track­ing grow­ing re­sis­tance to a hy­po­thet­i­cal vac­cine say peo­ple may feel a vac­cine has be­come less ur­gent since Ger­many man­aged to flat­ten its coro­n­avirus curve.

But vac­cine at­ti­tudes in Ger­many are com­pli­cated by the coun­try’s po­lit­i­cal his­tory, with the Third Re­ich leav­ing be­hind a legacy of un­ease over gov­ern­ment man­dates.

Re­sis­tance is also tied up with the coun­try’s al­ter­na­tive and holis­tic medicine tra­di­tions. Sa­muel Hah­ne­mann, the fa­ther of home­opa­thy — whose statue sits on Wash­ing­ton’s Scott Cir­cle — was a Ger­man from the east­ern state of Sax­ony. And it was in Stuttgart that Ru­dolf Steiner, an Aus­trian who de­vised an­thro­po­soph­i­cal medicine, opened his first Wal­dorf School 100 years ago.

While the Wal­dorf in­sti­tu­tion has dis­tanced it­self from an­ti­vaxxers, the Steiner phi­los­o­phy is rooted in free will and in­de­pen­dence of thought, and some of his fol­low­ers are vac­cine skep­tics. In Baden-Würt­tem­berg, in­fec­tious­dis­ease spe­cial­ist Piechotows­ki said, low vac­ci­na­tion rates can be at­trib­uted, in part, to “quite a high num­ber of peo­ple who are fol­low­ing the an­thro­po­sophic phi­los­o­phy.”

“It’s be­come very com­mon, in the past 20 years, to think that typ­i­cal child ill­nesses are good for healthy devel­op­ment,” said Natalie Grams, for­merly a prac­tic­ing home­o­pathic doc­tor who now speaks out against what she sees as pseu­do­science. “Peo­ple are try­ing to avoid early vaccinatio­ns, and this comes from home­o­pathic and an­thro­po­sophic think­ing, very much. There’s a com­mon thought that early vaccinatio­ns harm lit­tle ba­bies.”

Grams said she is con­cerned at how the move­ment ap­pears to have ex­panded in just the past few months.

“The move­ment is get­ting far more po­lit­i­cal in­flu­ence,” she said. It’s no longer just 2 to 4 per­cent of the pop­u­la­tion against vac­cines, she added. “It’s far more peo­ple. The sit­u­a­tion is much more in­tense than if it was just the anti-vax move­ment spread­ing dis­in­for­ma­tion about a coro­n­avirus vac­cine.”

The gov­ern­ment needs to build sup­port for a coro­n­avirus vac­cine even be­fore one ex­ists, she added, so peo­ple wary of a hastily de­vel­oped med­i­cal in­ter­ven­tion don’t turn to con­spir­acy the­o­rists or hardcore anti-vaxxers to fill the knowl­edge gap.

Christoph Hueck, a Wal­dorf ed­u­ca­tor who has spo­ken at shut­down protests, said he sees a chance to get his mes­sage out and doesn’t mind who is in the au­di­ence as long as he speaks his “truth.”

“The only thing is to make my point of view as clear as pos­si­ble,” he said. “As spread out as pos­si­ble. I don’t feel like I’m a con­spir­acy the­o­rist.”

But his talk­ing points touch on con­spir­acy the­o­ries in­volv­ing Bill Gates, the World Health Or­ga­ni­za­tion and vac­cine tat­toos. The risk of the coro­n­avirus is overblown, he said. He said he hopes peo­ple will start to demon­strate and take off their masks.

He said he’s not anti-vac­cine but against com­pul­sory vac­ci­na­tion.

“You can­not send your kid to school any­more un­less they are vac­ci­nated,” he said. “The state wants to con­trol its cit­i­zens. This is the dic­ta­tor­ship of health, which sets it­self above the value of free­dom.”

Na­dine Sch­mid, 37, who runs a “nat­u­ral medicine” prac­tice just out­side Stuttgart, said she thought care­fully about vac­cines for her 3-year-old and 7-year-old. The el­der child has had a measles shot, the younger only tetanus.

She said there has been tense dis­cus­sion in her com­mu­nity since the measles vac­cine be­came manda­tory. “Corona has ac­cel­er­ated that de­bate,” she said. For a vac­cine, ev­ery­one should be able to choose, she said, but it’s “not for me or my chil­dren.”

THOMAS KIENZLE/AGENCE FRANCE-PRESSE/GETTY IM­AGES

A shut­down pro­tester’s sign refers to a con­spir­acy the­ory in­volv­ing Bill Gates. Ger­mans’ his­toric skep­ti­cism of gov­ern­ment con­trol and affin­ity for al­ter­na­tive medicine have helped drive op­po­si­tion to vac­cines, es­pe­cially now that a measles shot is re­quired for school­child­ren. The gov­ern­ment has as­sured peo­ple that any coro­n­avirus vac­cine would be vol­un­tary.

MATTHIAS HANGST/GETTY IM­AGES

Christoph Hueck, an an­thro­po­sophic ed­u­ca­tor, sees vac­cine re­quire­ments as “the dic­ta­tor­ship of health.”

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