A parenting debate has captured the attention of the world. A new movement of "anti-vaxxers" are proclaiming that vaccinations are unnatural, unneeded or even dangerous. However, as the most important inoculations are administered during childhood, it is the offspring of anti-vaxxers who are most affected. As innocent children potentially fall victim to their parents' unusual views, the Italian government has taken drastic steps to ensure that contagious diseases aren't spread in schools.
Parents have been told not to bring their children to school if they aren't vaccinated. Pupils under the age of six will be turned away if the school isn't provided with sufficient evidence that their vaccinations are up to date. Parents risk being fined up to €500 ($565) if they flout these rules.
Intended to stem the spread of measles following a recent outbreak, the deadline was extended to 10 March. However, as this fell on a weekend, it was then extended to Monday. Officials believe that parents now have no excuses for not having had their children vaccinated. "Now everyone has had time to catch up," Health Minister Giulia Grillo told La Repubblica newspaper. Following delays, extensions and bureaucratic hold-ups, the rule is now simple. "No vaccine, no school," stated Ms Grillo who, in a single announcement last year, explained that she was pregnant and would vaccinate the baby.
Nicknamed Lorenzin law after the former health minister who introduced it, the legislature dictates that pupils must be inoculated against a range of diseases including chickenpox, polio, measles, mumps, and rubella.
In Italy, however, there is a stark north-south divide, with less infrastructure in the south. The issue is therefore as much about educating the public and access to healthcare as it is about the anti-vaxx movement. But it seems that the issue is also as much about documentation as it is about vaccination.
On Monday, Italian authorities stated that the vaccination rate was now at around 95 per cent for children born in 2015. Of course, this hinges on which vaccinations one counts. Nonetheless, this figure is significant as it represents the point at which "herd immunity" kicks in. This is where enough of the at-risk population is vaccinated for the entire population to be safe from outbreaks.
"When you get below a certain level of vaccination in the community, that's how you get outbreaks," explained Dr Anthony Fauci, director of America's National Institute of Allergy and Infectious Disease to CBSN AM. "That's been scientifically proven year after year."
Yet the figure of 95 per cent makes clear that thousands of children have missed school this week, assuming that the new rules were upheld. Authorities have confirmed that around 5,000 children do not have their vaccine documentation up to date. In Bologna alone, approximately 300 pupils were suspended.
Children aged six to sixteen cannot be banned from schools but their parents will face fines if they haven't received the necessary inoculations. The Italian government has come in for harsh criticism due to the new rules.
On Monday, Ms Grillo stated that Lorenzin law "is a law that, at the time of approval, we criticised for several reasons" before admitting that it would be changed to only included vaccinations deemed necessary based on scientific data. It is expected that measles will be included.
"Measles is not a trivial disease," Fauci warns, in relation to an outbreak in the US. "When measles was rampant before the vaccines were available, it was one of the most devastating diseases globally and in the United States. Prior to the 1960s when the vaccine was introduced there were a couple [of] million cases of measles and 400 to 500 deaths a year, thousands and thousands of hospitalizations and a thousand cases of encephalitis [inflammation of the brain]."
"There's a category called philosophical reasons not to get vaccinated and that particular category has been abused," he adds, in relation to laws around inoculations. "So I'm in favour of states or cities making regulations that require a more strict interpretation of the exemptions that one has to not get vaccinated."
In the US, of course, the anti-vaxx movement is the trigger issue relating to immunisations. Many anti-vaxxers believe that inoculations may lead to autism - a notion derived from a long-discredited paper by Andrew Wakefield.
Whether for reasons of indifference, disagreement or lack of access, those who do not have their children vaccinated would be right to feel that they are under fire. Yet, in dealing with these issues, governments tread a very fine line between being protective and aggressive.
