Germany sees dramatic rise in measles cases

"Measles have come back to Germany," according to the country's top disease control center, the Robert-Koch Institute (RKI). 2024 has seen a staggering rise in the number of cases of the illness, which is especially common in small children and can be fatal. Some 614 cases have been recorded so far, up from 8 just three years earlier.

Measles is an airborne disease that commonly causes rash and high fevers that are extremely dangerous for small children and claimed some 107,000 lives globally in 2023. Since 2019, parents in Germany are legally required to get their children the two jabs necessary for full immunity. If not, they must pay a fine of €2,500 ($2,630).

Other vaccine-preventable illnesses, such as Hepatitis B and whooping cough are also on the rise. The reasons behind the jump are multifaceted and complex, experts have said, ranging from immigration to COVID-19 to increasing vaccine skepticism and anti-vaccine activism online.

Lingering effects of the COVID-19 pandemic

"Nearly all infectious diseases rates declined during the pandemic," said Bonn-based pediatrician Dr. Axel Gerschlauer, due to COVID-19 measures such as social distancing and mask-wearing. The aftereffects can also be seen in a "hesitancy to go to the doctor except in the most necessary cases, for fear of the risk of infection" inside a practice.

Imported cases are also an issue. Dr. Karella Easwaran of Cologne told public broadcaster ARD that "today, there are a lot of people traveling. A lot of people immigrating here. Many children from war zones," where vaccinations are not available, she said, and whose parents may not be aware when they reach Germany about the necessity of the vaccine.

Vaccine skepticism on the rise

Then there is the issue of vaccine hesitancy and the anti-vaccine movement. Dr. Gerschlauer cautioned that the two must be viewed as separate phenomena. "With skeptical parents, concerns and fears can often be allayed with explanations and statistics. Often, a simple information leaflet or a brief conversation is enough," he said. However, "with ˈhardcore vaccine opponents, our hands are tied. They live in their own bubble, which we can no longer penetrate from the outside."

According to a study published earlier in November by research firm Statista, vaccine skepticism has been steadily rising in Germany, from 22% of adults in 2022 to 25% in 2024.

As for the "hardcore" anti-vaccine movement, it has a long history in Germany going all the way back to the 1800s, promoted by people with various agendas – antisemitic precursors to the Nazis, who viewed medical advancements coming from Jewish doctors with skepticism, to groups of doctors worried about the safety of how early vaccines were administered.

According to the Federal Center for Health Education (BzgA), the number of people identifying as completely anti-vaccine has risen only slightly in the past decades, from 4% in 2004 to 6% in 2020. Their numbers can seem larger, however, through their prevalence on social media and the number of anti-vaccine mandate demonstrations that occurred in Germany in response to the COVID-19 pandemic.

In that vein, some doctors see vaccine mandates as counterproductive, adding fuel to the anti-vaccine fire by appearing to curtail personal freedoms.

Esoteric thinking, far-right sympathy prevalent in the anti-vaccine movement

Studies have shown other significant indicators of anti-vaccine sentiment. A recent report by doctors at the University of Freiburg in southern Germany showed a connection between what they called "esoteric thinking" and vaccine hesitancy and refusal. For example, people who may believe in homeopathy or have gone through alternative forms of education like Waldorf Schools, are more likely to view vaccines critically. Another study carried out by the state government of Saxony in 2021 found a correlation between supporters of the far-right Alternative for Germany (AfD) party and vaccine skepticism.

For Dr. Gerschlauer, politicians and doctorsˈ groups could help solve the problem through sustained information campaigns.

"When you see how much effort was put into advertising the vaccination against meningococcus B in recent years, even though this shot was not even recommended by [Germany's vaccine commission] STIKO at the time, and how many people were reached by this advertising campaign, then you would wish that the same effort was made for the measles vaccination!"

Edited by Rina Goldenberg

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