Control of compulsory vaccination – The benefits of a vaccination register

Vaccination records are not enough, say proponents of a vaccination registry. But building a registry takes careful planning and time. (imago images / Michael Weber)

“If the health system is at risk and the voluntariness really doesn’t work, we definitely have to discuss compulsory vaccinations,” said FDP politician Andrew Ullmann, himself a doctor and a member of the Bundestag’s health committee, on Deutschlandfunk on Saturday. In order to monitor such compulsory vaccinations, many politicians are calling for a vaccination register that records who was given which vaccine, when and where. The opponents reject both the compulsory vaccination and the register in bulk. An important argument: data protection. Large amounts of data that also link sensitive information from a variety of sources – that can indeed pose problems. However, no one has yet specified what a vaccination registry should look like at all. The Federal Data Protection Commissioner Ulrich Kelber said in several interviews that it could be designed in compliance with data protection regulations.

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In Scandinavian countries, vaccination registries have shown their potential

Especially since vaccination registries are most useful in monitoring side effects. That is why experts have been calling for such a database for a long time. In the Scandinavian countries, for example, they showed their usefulness 15 years ago after vaccination against the human papillomavirus, or HPV for short, was introduced. At that time, reports surfaced that this vaccination could have caused damage, says Katharina Paul. “In Denmark, for example, there was a lot of concern on the part of the population because side effects such as chronic fatigue occurred.”

Comparison between data from vaccination register and electronic medical record

Swedish and Danish researchers then checked whether these and other reports of suspicions about neurological diseases were justified. The study was based on particularly good data, says the researcher from the Institute for Sociology at the University of Vienna. Paul has been studying the importance of vaccination registers around the world for years. “Denmark has a very special vaccination registry, which is organized centrally and where – and this is very important – side effects that are experienced individually, so to speak, can be merged with clinical data, that is to say with electronic patient files that basically exist there.”

In Denmark, but also in Sweden and Finland, every resident has an identification number. This enables researchers to synchronize data between the vaccination register and the patient’s electronic medical records.

In Germany, the data comes late and has gaps

The scientists were therefore able to specifically include all girls and young women between the ages of 10 and 17 in their study. Young people this age should be vaccinated against HPV before they have sex for the first time to prevent serious cancers that the virus can cause.

In Germany, the authorities largely rely on vaccinated persons, doctors, pharmacists and manufacturers to report suspected cases to them. To check them, the responsible Paul Ehrlich Institute uses data from the statutory health insurance GKV. But that has disadvantages, says the Ulm virology professor Thomas Mertens, the chairman of the standing vaccination commission. “It always takes six months before the statutory health insurance data is available. You can’t really speed it up. In addition, the statutory health insurance data are of course always incomplete. So, if you will, they are of course suitable and useful as a sample, also as a large sample, but they are incomplete a priori. All of this could of course be done better with a vaccination register. “

Denmark: Vaccination registers largely organized digitally

As in Denmark and Sweden. The studies on HPV there showed that there was no connection with the HPV vaccination, but that there were previous illnesses behind it. Confidence in the vaccination was restored.

The Viennese sociologist Katharina Paul sees great advantages in a vaccination register like in Denmark. “These vaccination registers are organized centrally. To a large extent, they are organized digitally and they allow side effects and effectiveness to be researched. You can easily merge data from different places. Whether it is pediatricians who observe side effects, or patients themselves, and you can just as easily compare these data. “

Findings on how well individual vaccinations protect

The primary purpose of the registers is not to control people, but rather the vaccines. And they provide information about how well individual vaccinations protect. “These data sets are of enormous importance for research, for epidemiological research, even for social science research. Because we can also observe with the vaccination register: who is vaccinated and who is not? Why is that? Where are vaccination gaps that need to be closed, for example? “

“It’s not about transparent patients, but a transparent pharmaceutical industry”

Katharina Paul also sees the opportunities rather than the risks when it comes to data protection. Because it is by no means about creating transparent patients. On the contrary: “It’s actually about a transparent pharmaceutical industry, it’s about being able to illuminate vaccines well and being able to test their effectiveness. At the same time, it is also about a glass vaccination system in general. And finally, of course, is there more transparency on the part of the state? How well does the vaccination system actually work? We can use it to measure vaccination rates well and thus easily evaluate politics well. “

Building such a vaccination registry takes careful planning and time. To enforce the compulsory corona vaccination, it would certainly come too late. But the next new vaccine is sure to come.

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