Vaccination rates: Vaccine skepticism is spreading. How serious are the consequences?

On Tuesday, the World Health Organization (WHO) addressed the global public: More and more children are going unvaccinated because aid budgets are collapsing and vaccine skepticism is growing in many parts of the world. This poses a significant threat to the health of the global population, said Kate O'Brien, Director of the WHO's Immunization Division, when presenting the annual immunization report, which the WHO produces jointly with the UN Children's Fund UNICEF. What's worrying about this is that the decline in vaccination rates isn't just due to a lack of money; active misinformation and disinformation about vaccinations plays a significant role, said O'Brien. "We are extremely concerned."

According to the data, the number of children who have not received a single vaccination against tetanus, diphtheria, and pertussis in their first year of life has increased by 1.9 million to 14.3 million compared to the pre-pandemic period. Last year, WHO and UNICEF complain that there was already a lack of funds to support poor countries with vaccination campaigns. This year's drastic cuts in development aid – by the US and many other countries – are likely to exacerbate the situation.

Both organizations emphasized the important role of politicians, religious leaders, and other leaders in building confidence in vaccines. "In just over 50 years, 150 million lives have been saved by vaccines," said UNICEF immunization expert Ephrem Lemango. Many of these vaccines have been monitored and tested for decades. He called for a clear message that "killer diseases" like measles can be prevented in this way. Nevertheless, 30 million children worldwide are currently not adequately protected against this dangerous viral disease.

It's not surprising, then, that in 2024, there were major measles outbreaks in 60 countries—more than double the number in 2022. In some of these countries, the outbreaks were due to the active promotion of vaccine hesitancy, said Kate O'Brien. Estimates indicate that there were more than 107,000 deaths from measles worldwide in 2023.

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Europe is no exception. Last year alone, more than 125,000 people in Europe contracted measles, twice as many as the previous year, and nearly 300,000 people contracted whooping cough, a threefold increase. WHO Regional Director Hans Kluge called on countries to strengthen their local health systems, ensure the availability of vaccines everywhere, and combat misinformation.

Despite all this, Germany is still doing quite well. Although vaccination rates have never been among the highest in international comparison, historically-grown vaccine skepticism is probably too strong for that to happen. However, willingness to be vaccinated has not declined since the pandemic, despite all the debates surrounding the COVID-19 vaccination. This is according to an analysis by the Robert Koch Institute (RKI) , which regularly evaluates the uptake of routine vaccinations recommended by the Standing Committee on Vaccination (Stiko) using health insurance claims.

The situation in Germany is still not entirely positive. Adults often ignore the vaccinations recommended for them. And the flu vaccination, which had become more popular during the pandemic, was now administered just as little as it was before the coronavirus years: It is recommended for people 60 and older and those with underlying health conditions, regardless of age, but only about one in three received it.

The vaccination discussions during the pandemic also showed no negative impact on the recommended vaccinations for infants and children. Nevertheless, experts are concerned about vaccination rates. A whopping 96 percent of all infants still receive the first six-in-one vaccination, which protects against diphtheria, tetanus, polio, and whooping cough, among others. However, booster vaccinations are often given too late or not at all – especially since the vaccination schedule for the six-in-one vaccination was changed so that it is to be administered several months later, write the authors of the RKI report. As a result, parents often do not take their children back to the pediatrician or do not do so in a timely manner. Thus, by the age of 15 months, only 64 percent of children are fully vaccinated against diphtheria, tetanus, and whooping cough.

"These data are unsatisfactory," says Berlin pediatrician Martin Terhardt, a member of the Stiko (German Institute for Occupational Health) for many years. "Because diphtheria and tetanus, in particular, have recently become even more urgent." At the beginning of January, a boy in Berlin died of diphtheria after contracting it from his mother. Diphtheria is similar to coronavirus: vaccination does not protect against infection and transmission, but it does protect against severe disease. However, the ten-year-old was unvaccinated, like so many of his classmates: he attended a Waldorf school. Terhardt also reports that unvaccinated children have recently been battling the dangerous tetanus in German hospitals. The tetanus pathogen entered their bodies through simple abrasions or minor injuries caused by a stick.

What's interesting about all this are the significant regional differences. Saxony, for example, ranks last in measles vaccinations, with a measles vaccination rate of only 55 percent among two-year-olds, compared to the leading state, Schleswig-Holstein, where 84 percent of two-year-olds are vaccinated against measles. However, for other vaccinations, such as those against influenza and HPV, the eastern states boast higher vaccination rates than the west. Overall, vaccine skepticism is comparatively high in Baden-Württemberg, where only 69 percent of two-year-olds are fully vaccinated against polio, compared to 82 percent in Lower Saxony.