In Germany, vaccinations have always been political | Germany | News and in-depth reporting from Berlin and beyond | DW | 14.01.2021

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Germany

In Germany, vaccinations have always been political

Germans have a long track record of vaccine skepticism. From mandatory smallpox inoculations 150 years ago to voluntary COVID-19 jabs today: Immunization is political.

a certificate of vaccination and a child receiving injection into its arm

A number of vaccines are mandatory in Germany today

Anti-vaxxers have come up with plenty of unfounded conspiracy theories to oppose getting a jab against COVID-19. They have succeeded in mobilizing people against it even though in Germany there is no legal requirement to get the shot.

Malte Thiessen, a medical historian, says opinions about vaccines have always been "highly political."

"Inoculation has always been about more than just the prick. It's also always about a worldview," he tells DW.

That is because the issue is at the intersection of society, the state, and one's own body, and it is not new. "Even 200 years ago, vaccines were controversial and intensely debated," Thiessen says.

Watch video 05:20

Medical ethicist: 'Vaccinations for healthcare workers absolutely must be mandatory'

Vaccine requirement for smallpox

Germans' relatively critical stance goes back to the 19th century. Many of the arguments and misconceptions from then remain today.

The imperial vaccination law came into force in 1874 as a result of widespread smallpox infections across Europe, which killed tens of thousands of people in Prussia. Getting vaccinated for it became mandatory. The "Lebensreform" (life reform) movement picked up pace at the same time. Adherents believed in natural paths to strengthening the body, such as sunshine or special diets.

The first vaccine opposition groups were founded in 1869 in Leipzig and Stuttgart — five years before the imperial vaccination law. The Imperial Association Opposing Compulsory Vaccination soon had 300,000 members.

For them, vaccines were the "devil's tool," Thiessen says. "Something artificial, chemical getting injected into the body. That helps explain the huge opposition to vaccines in Germany's alternative circles, until today."

Watch video 03:04

Polio almost eradiceted by vaccine

Anti-vax and antisemitism

Antisemitic conspiracy theories played a role in the early anti-vax movement. Opponents spread the lie that vaccines were part of a global Jewish conspiracy to intentionally damage the German people. These anti-Semitic views have found their way into anti-vax tweets and other social media posts today.

The belief that an omnipotent state is forcing vaccinations on citizens is not new and may contribute to Germans' vaccine hesitancy when it comes to COVID-19. An international poll in December by the World Economic Forum ranked Germany in the bottom half of countries ready to accept a vaccine.

Similar figures hold true for influenza among over 65-year-olds. Many German seniors worry more about the vaccine than the virus it protects against. Figures from 2019 show just 35% of them get the flu shot, in comparison to 85% of Koreans and 72% of the British.

Vaccine acceptance is higher in the former East Germany, according to Germany's Robert Koch Institute for public health.

Vaccine Cold War

The former East Germany required vaccinations for diphtheria, tuberculosis, and smallpox; those who refused faced a fine. Meanwhile, the former West Germany largely avoided compulsory vaccination. In the 1960s, for example, the East was much quicker than the West to implement a systematic vaccination program against polio, which causes childhood paralysis. As a result, polio cases decreased rapidly in the East, but spread in West Germany.

In 1961, Thiessen says East German officials offered the West 3 million doses of the polio vaccine, given the dissipation of the epidemic in the East. 

"This would have, of course, been a propaganda win for the East," Thiessen says. Then West German Chancellor Konrad Adenauer politely declined.

Woman in a crowd, holding a handwritten sign in front of her face, which reads mandatory vaccination is a crime (in German)

Anti-vaxxers claim mandatory vaccination is a criminal infringement of their personal freedom

Mandatory vaccination a 'last resort'

Bavarian Premier Markus Söder made headlines this week by suggesting that medical staff should be required to get vaccinated because many of them are refusing to do so voluntarily. Thiessen advises against the idea, saying a requirement for particular groups should only be a "last resort."

A better option, he says, is to appeal to their sense of medical ethics. "Penalties don't do anything in the face of someone who absolutely refuses to get vaccinated," says Thiessen.

History shows a secondary problem in this regard: fake immunity certificates. "That would make medical staff potentially contagious, but not identifiable as such."

This article was translated from German.

While you're here: Every Tuesday, DW editors round-up what is happening in German politics and society. You can sign up here for the weekly email newsletter Berlin Briefing, to stay on top of developments as Germany enters the post-Merkel era.

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