Measles outbreak plagues the Bible Belt

Measles is spreading in the Dutch Bible Belt since the end of May due to deeply rooted religious resistance to vaccination. The advancing disease is a danger to unvaccinated children. It has sparked a fresh debate about compulsory immunisation.

Measles is spreading like wildfire in the stretch of land running all the way from the South-western coastal province of Zeeland, right through the Veluwe nature reserve and upwards to the top of Overijssel in the North-East of The Netherlands. Many orthodox Protestants with religious objections to vaccinating their children live in the region. They see vaccination as a human act that interferes with God’s will. The Netherlands has a National Immunisation Programme to inoculate children at the age of 14 months against the mumps, measles and rubella, but participation is not mandatory. In 2013 just over 96 per cent of all infants born in 2010 had been vaccinated. In the Bible belt the percentage is considerably lower. In some localities vaccination coverage is down to around 60 per cent. 

Peer pressure
Health authorities say the risk to unvaccinated babies visiting the affected area is limited.  Still, some doctors are warning parents to avoid unnecessary risks, urging them to stay away from the area between Zeeland and the Veluwe, a popular domestic holiday destination. The virus that causes measles is highly contagious. According to The National Institute for Public Health and the Environment (RIVM) a sick child can easily infect ten others by coughing and sneezing. The disease can cause complications such as pneumonia and meningitis and is lethal in some cases. During the previous measles outbreak in The Netherlands, in 1999 and 2000, 150 children ended up in hospital. Three died of complications. In an effort to control the current outbreak, health minister Edith Schippers has decided to insert an extra round of vaccinations for children most at risk. It concerns 6,000 infants between six and 14 months old, from municipalities with a vaccination coverage of less than 90 per cent. Children from reformed protestant families, wherever they live, are also invited to get a jab. Community Health Services (GGD) in the affected region had written to parents a few weeks earlier to offer discreet home vaccinations. The offer was aimed at bypassing social control and peer pressure in the tight-knit Reformed Christian community. The GGD also offers a DTKP-jab on the house visits, which offers protection to diphtheria, whooping cough, tetanus and polio. Interest has been modest, but every vaccination counts, says the GGD.

Regulation
The measles outbreak in the Orthodox Reformed community has prompted a public debate about the question whether vaccination should become mandatory. Prime Minister Rutte stopped short of saying that, but did make an urgent plea to pastors to encourage their constituents to have their offspring vaccinated. Remarkably, he called on his own reformed Christian faith to make his point. From a Christian persuasion one could just as well support the argument that God made the vaccines possible, and that vaccination is therefore His will too, argued the Prime Minister. According to the PM it can never be God’s intention to have children suffer from measles. The fact that the Prime Minister spoke as a believer to fellow believers, publicly interpreting Scripture, is a notable breach of his party’s stance on religion. The VVD regards faith as something that belongs in the privacy of people’s homes. A personal matter the government should not interfere in. But in this instance the Prime Minister appeared to view this differently. Other politicians, mostly liberals, made similar pleas as Prime Minister Rutte. VVD health minister Edith Schippers blatantly said that not vaccinating was irresponsible. Her fellow party member from the Senate, theologian and former professor of medical ethics Heleen Dupuis, went one better by pleading for mandatory vaccination. Compulsory education is an infringement of parental authority in the interests of children, she argued, so an important health matter as vaccination can be made into law too. RIVM director Roel Coutinho does not believe compulsory vaccination is the answer however. It can undermine the strong public support for the National Immunisation Programme, he warned, which would worsen the situation.
 
Freedom of choice
Erik van der Staaij, leader of the SGP, the political party that many residents of the Bible Belt vote for, sighed that the insistent pleas to his community should cease. He pointed out that his people are not exactly convinced by opportunist religious argumentation from people like former D66 health minister Els Borst. She had also said it could not possibly be God’s intention to let children suffer when a good vaccine is available. He pointed out that SGP voters remembered Mrs. Borst as the cabinet minister who had pushed for a supple euthanasia law only a few years ago. When that law was in the making, God’s intentions did not appear to be on the forefront of her mind, Mr. Van der Staaij remarked wryly. He did not take a clear position on whether children should be vaccinated or not. The SGP party leader said parents have a duty to inform themselves and make their own careful decision whether to participate in the vaccination drive. The SGP is not against vaccination programmes, he said, but against any compulsion to take part. Van der Staaij advocated room for different points of view, and above all, freedom of choice. All in all, it seemed as if liberals and the preachers of immovable morals had traded places in the debate about vaccinating children.