When health policy becomes criminal policy

Compulsory vaccination in the decision of the Constitutional Court of Serbia

Abstract

Article analyses decision on compulsory vaccination and prohibition for unvaccinated children to attend schools and kindergartens delivered by First Grand Chamber of Constitutional Court of Republic of Serbia. Decision can be reproached on several different grounds. Annual reports made public health authorities in Serbia counts 4 reasons influencing unsatisfied number of vaccinated people in population. Year after year reports put at first place insufficient supply of vaccines. State is not able to obtain enough vaccines for entire population. Report emphasized that age distribution of the most frequent disease, smallpox, is steadfast. If a disease spread evenly through all population compulsory vaccination of children is meaningless. Age distribution of smallpox speaks in favor of compulsory vaccination of all population. Reports indicate that vaccination status of almost all infected is unknown or negative. An proper conclusion from this data would be that vaccinated population is protected, and those who decided not to vaccinate them self bare responsibility. They cannot cause or induce illness to those who are decided to protect with vaccines. That data dissolves court argument that unvaccinated population endanger those who are. Probably the most important data derived from reports is that 'risky population' tend to catch disease more frequently than any other category of population. Reports count in this category roma population, immigrant, refuges etc. Among this population contagion erupt more often and spread easily. Reason for that is fact that this population are not fully integrated in society and that their sanitary, hygienic and health standards are lower than the rest of population. Article concludes that First Grand Chamber joined to executive branch of power in its autistic persistence on only one epidemiologal measure within health policy - vaccination. In this manner court neglect structural factors in Serbian society which enhance risk of eruption and spread of diseases. If Serbian health authority treated these factors seriously this could permanently solve the problem of periodical appearance of diseases and crisis in public health. Abundance of measures from social politics would include and integrate segregated population and rise the level of their living standard which in turn would eliminate the notion of 'risky population'. Compulsory vaccination is counterproductive for it causes suspicions and revolt among those who are unwilling to vaccinate themselves. Moreover it provokes those who are undecided to join the unwilling side because it underminse their readiness. It is practically impossible to administer such a harsh measure. Large number of parents who are prosecuted for this misdemeanor speaks for itself. Moreover it creates new problem with other measures of public health policy. Should the children who are not vaccinated be cast out of schools and kindergartens this would incite flourish of alternative educational institutions which could potentially be nursery of contagion and revolt against vaccination. Its constitutional adequacy remain in question because the court abused its authority by deciding not to organize public hearing and confrontation of arguments. By doing so First Grand Chamber demonstrated fear and fueled more controversy on this subject. It did not solve the problem and yet it enhance suspicions in regularity of not only its decision but decisions made by legislative branch of power. In the same time First Grand Chamber empowered belief of those who oppose the measure in quality of their one postures. This cowardly decision of court is going to afflict irreparable damage to interest of public health because god will of people is going to be spent on such a senseless question. Full dimension of damage done to public health by this cowardice is going to be shown should some dangerous illness in future occur and when extraordinary immunization of whole population appears as a only possible solution. By permanent perturbation of confidence and belief of people in vaccination as a measure of public policy state is not going to be able to carry out this or similar measures in future.