According to the UN convention of 20 November 1989, children are entitled to optimum healthcare. This also includes protection against diseases that can be avoided by vaccination. It is the duty of the parents to have their children vaccinated.
As in many other European countries, the vaccination of children is not compulsory in Austria. However, some social benefits can only be obtained if children are vaccinated in a timely manner, which significantly increases vaccination coverage. The Federal Ministry of Health has created a so-called vaccination concept in close cooperation with Austrianprovinces and the association of the social-insurance carriers. A vaccination plan is adopted annually. The development of new vaccines is making rapid progress. New combination vaccines are being developed and afford protection against several diseases with one vaccination. The ever-changing epidemiological situation also requires that the vaccination recommendations are always adapted to the most current circumstances. This is done by a board of experts in the Supreme Health Council. The extremely effective instrument of vaccination plans and vaccination calendars makes it possible that all children living in Austria can benefit from important basic immunisations and booster vaccinations up to their 15th year of life. Experts keep emphasising that comprehensive immunisation protection is not only important for the individual child, but especially for the not yet vaccinated nurslings and other children not vaccinated for health reasons. Nevertheless, a certain vaccine fatigue has arisen. This is because people have a false sense of security as well-known children's diseases have been conquered or hardly occur any more. Moreover, in Austria, too, there are societal groups who partially or completely refuse vaccinations for religious or ideological reasons and/or because of misinformation.
Before performing the vaccination, the physician has the duty to inform the person to be vaccinated, and in the case of persons under 14 years of age also a parent or the person who is entrusted with the care and education of the person to be vaccinated, about the illness to be prevented and the vaccination so that they can decide whether to participate in the vaccination.
Impediments to vaccination can be existing allergies against ingredients of the vaccine used. In the case of these persons, vaccination can only be considered after a specialist department was consulted, the patients then being prepared by timely administration of medicines (antihistamine) to alleviate the negative reactions to the vaccination. In the case of persons with congenital or acquired immune deficiencies or dysfunctions of the immune system, the physician treating the immune deficiency must be consulted before every vaccination. Live vaccines may not be used in the case of severe immune deficiencies.
The information given before every vaccination must in any case include:
- information about the illness to be prevented,
- any possibilities to treat the infectious disease,
- advantages of the immunisation for the individual and the general public,
- information about the vaccine (ingredients, indicating the batch number),
- information about the beginning and the duration of the immunisation protection as well as about the vaccination plan,
- necessity of booster vaccinations,
- conduct after the vaccination, contraindications, possible side effects and/or complications.
In the case of underage minors (children who have not completed their 14th year of life) a declaration of consent by a parent or the person who is entrusted with the care and education of the person to be vaccinated must be obtained. Adolescents can consent themselves if they have the necessary understanding and judgement.
When using vaccines, as with all other medicines, the physician has the duty to report unforeseen occurrences due to the medicine, side effects not yet known, the increased occurrence of known side effects, previously unknown intolerances or interactions with other medicines, etc. as laid down in Section 75 of the Medicines Act.
In order to receive childcare benefits, pregnant women must prove that they had five examinations during pregnancy and five examinations during the first 14 months of the child’s life. The Mother-Child Booklet documents important examinations and health data during the course of pregnancy up to the fourth year of the child’s life. Every pregnant woman residing in Austria is entitled to a Mother-Child Booklet. The document is an important aid to keeping an eye on all precautionary and vaccination dates. That is why, as a rule, the vaccination recommendations for babies are followed. Carrying out the HIV tests within the framework of the first examination of the pregnant woman and of the oral glucose tolerance test within the framework of the third examination of the pregnant woman is possible within the framework of the Mother-Child Booklet programme since the beginning of 2010, but will only be a condition for the continued payment of childcare benefits starting on 1 January 2011. The Mother-Child Booklet and the examinations it provides for are free of charge – also for persons who do not have health insurance. The further examinations in the Mother-Child Booklet from the 14th month to the 4th year of life of a child that are not directly associated with monetary benefits are unfortunately not so well accepted in practice.
After the outbreak of an epidemic of measles at an alternative Austrian school in 2008, where more than 170 children fell ill, the department of public prosecution also initiated enquiries. Pursuant to Section 179 of the Penal Code, the “negligent endangerment of persons by transmissible diseases” is liable to prosecution and can be punished by imprisonment up to one year or up to 360 daily rates. It was suspected that healthy children were intentionally brought together with children who had already fallen ill outside the classes, as opponents of vaccination held the view that such “measles parties” would trigger a natural infection, thereby strengthening the immune system, which would bring advantages compared to vaccination against measles. The intentional inducing of an infection – all the more when children are involved – is, however, irresponsible and must be strictly condemned. Especially in facilities that care for children and where epidemics occur, the vaccination cards of all persons must be immediately checked. All pupils and teachers who have not undergone a guaranteed infection and cannot prove that they are vaccinated must be suspended from classes. If there is no vaccination card and uncertainty as to whether vaccination or an illness has already been undergone, vaccination is recommended. If this is refused, a serological examination is carried out to determine the immune status. If parents refuse to subject their children to medical treatment and/or such examinations despite the suspicion of a contagious notifiable infection, fines can be imposed or possibly even custody withdrawn by a court.