Oh, all the things we’ve tried. Appeals to social conscience (“herd immunity!”), campaigns with professorial strictness based on fear scenarios or with wit (“Germany’s Next Top Immunization Card”). But Germany still isn’t reaching its key vaccination targets. Even around the world, humanity seems to have fallen behind what it had previously achieved. The WHO lists “vaccine hesitancy” among the “ten threats to global health,” right next to antibiotic resistance and air pollution.^[1]It isn’t doing this because the authorities want to vilify certain groups, but because false claims are circulating that are unsettling people and endangering the progress that has been made in past years in eliminating or containing vaccine-preventable illnesses: People are getting sick and even dying because false information is circulating and being spread with gusto. It’s just become so easy these days – thanks, social media.

And now SARS-CoV-2. It’s not the first pandemic that has plagued the human race. But it’s definitely the first that’s hit a society as interconnected as ours. There are certainly advantages to this. Whether this ultimately helps the notion of vaccination, however, hasn’t been decided – and remains rather doubtful. In answer to the question of whether we should get vaccinated or not – given an available vaccine against the pandemic – no clear picture emerges: Approval ratings rise and fall with the perceived threat level. The pandemic, then, is also an infodemic: The WHO has dryly ascertained that false information is spreading even more quickly than the virus itself.^[2] Sure, you could try to phrase it more diplomatically, but there’s nothing left in the upwardly limitless stupidity scale above what we’re already seeing.

The problem is this: Conspiracy theories affect us – whether we like it or not. “Studies have established that someone who has been confronted with a vaccination conspiracy is subsequently less likely to have their child vaccinated,” explains social psychologist Pia Lamberty (her book “Fake Facts” was released this summer).^[3] Uncertainty is a bad advisor.

When you think about it, you really can’t be against vaccination. A medical invention that prevents diseases before they occur, and thus boasts, among other things, many millions of saved lives on the positive side of the balance sheet – why would someone be against that? “Some of the best training you ever received were the vaccines you were given in your very early childhood,” writes German researcher Max Roser from Oxford.^[4] “Without even realizing it, you learned how to battle the pathogens that ravaged the lives of your ancestors for many millennia.” But it’s probably also a little zeitgeist: Measures in the fight against the climate crisis also are something you really can’t be against. Even if they failed – which the facts unfortunately don’t reveal – we would have fought for more nature and biodiversity, for cleaner air and better health.

The rising skepticism about science doesn’t make things any easier. Without science, we’d never even have come close to where we are today. But today no one remembers the grief of those who lost loved ones before the first measles vaccine was introduced in 1963 – on average 2.6 million people (!) worldwide every year.^[5] And even simpler than that: You just declare those facts to be inventions. It’s become endlessly hip to dismiss anything that doesn’t fit into your own worldview (any more) as fake news.

The fact is: If you want to make progress with “vaccinating,” you have to turn so many screws that you end up dizzy. But those who believe that the umpteenth relaunch of a vaccination campaign will bring real change have learned little from the past. Don’t misunderstand me: I don’t have anything against well put-together, clever campaigns – quite the opposite! You need them if only to protect those who are being hit by a flood of (false) information – as a communicative counterweight. But they’re not enough alone. Not to mention the fact that it’s hard to convince people to get vaccinated when vaccination rates among doctors and nurses themselves remain low.^[6] Because obviously they serve as role models.

The numerous attempts at advancing the idea of vaccination are noble, but ultimately nothing more than patchwork. Both at the level of health policy as well as in the healthcare system in Germany a strange dissonance prevails between insight into the effectiveness of vaccines, the existing evidence and the – modest – power people expect to expend to achieve high vaccination rates. To put it more plainly: Vaccination and disease prevention need to come down from the soapbox and become a clear goal for political action.

I’m not seeing a clear, loudly audible commitment to vaccination. It’s great to have a prevention law or a national vaccination plan, but vaccination itself has to be lived and modeled for others.

Now you’re not going to win any creative awards by suggesting a round table, but in this case it’s long overdue. Its task: To systematically identify and exterminate any hurdles in the way of better vaccine acceptance. Because there are so many of these that we only have one choice here:

• We’re not paying doctors enough for consultation and vaccination. And even the expenditures of the public health insurance companies for vaccines (2019: < 1% of their total expenditures^[7]) are bizarrely out of proportion to the impact of vaccine-preventable illnesses and their treatment.
• We’re offering too few options for vaccination – because if people don’t come to the vaccine, shouldn’t the vaccine come to the people? Pilot projects like flu vaccinations in pharmacies are a step forward, but others have to follow. In Australia there are already vaccination programs against the HP virus that causes cervical cancer. The country is now eliminating cervical cancer as a “public health problem”. Where do you see this kind of country-wide program in Germany, where the scientific foundations for the vaccine were first established?
• It needs to become much easier to get yourself vaccinated – our vaccination system has missed the social transformation where both parents now work and even young people have “full calendars”.
• On the whole, the topic of prevention needs to become more prominent in the overall social agenda. It’s great that we all keep living longer. But it’s just as important that we stay as healthy as possible, too.

To repeat: the list is by no means a complete one. By the way, vaccine developers and manufacturers also need a seat at this round table, too – not only because they’re vaccine experts. It’s also because it doesn’t help to push the quotas for various vaccines without making sure that sufficient doses are ultimately available. This is why the vaccination targets are so important. They provide the possibility of planning security.

In the field of oncology, leading cancer specialists and researchers as well as health experts have joined forces for “Vision Zero 2020.”^[8] The concept, which is already familiar through traffic and occupational safety, works under the motto: Every cancer death is one too many. It’s an ambitious project: They want to “leave no stone unturned” when it comes to promoting cancer prevention, treatment and research. They want to identify any factors that hinder our growth in fighting cancer. Because one thing is sure: We’re chasing after possibilities that modern prevention and treatment methods already offer today, but which aren’t being consistently applied.

So why not a Vision Zero for vaccine-preventable diseases? With the ambition of leaving “no stone unturned” when it comes to making sure nothing keeps us from preventing illnesses and their complications before they occur?

One more thing: You can always shout for political change – it’s just so amazingly easy – but at the end of the day, every single one of us has to ask ourselves if we’re doing enough: for us, for our health, for the health of those who need our protection, maybe because they’re already older or too young to be vaccinated or suffer from chronic diseases. At the end it’s a question of our civic duty and moral courage if we hand over Facebook, Twitter and the like to those unwilling to accept the fact that their spreading of false information contributes to people getting sick. Or dying.

It’s a question every single one of us must face. “It starts with the man in the mirror,” Michael Jackson once sang. Will we do our part for vaccination?

^[1]  https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019 (last accessed october 2020).

^[2]  https://www.bpb.de/mediathek/306997/folge-2-der-mensch-und-das-netz (last accessed october 2020; German only).

^[3]  https://www.bbc.com/news/technology-51497800 (last accessed october 2020).

^[4]  https://www.pharma-fakten.de/news/details/980-wissenschaft-forschung-entwicklung-die-killer-fuer-krankheitserreger/ (last accessed october 2020; German only).

^[5]  https://www.who.int/news-room/fact-sheets/detail/measles (last accessed october 2020).

^[6]  https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2018/Ausgaben/32_18.pdf?__blob=publicationFile (last accessed october 2020; German only).

^[7]  https://www.gkv-spitzenverband.de/gkv_spitzenverband/presse/zahlen_und_grafiken/gkv_kennzahlen/gkv_kennzahlen.jsp (last accessed october 2020; German only).

^[8]  https://www.vision-zero-2020.de/ (last accessed october 2020).