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Bern, Switzerland (GenevaLunch) – Public health directors from Switzerland’s cantons, meeting Monday, recommended that mandatory measles vaccinations should be considered if outbreaks cannot be contained. Vaud is currently seeing an outbreak and 2008 was the worst year for measles in Switzerland in the past 10 years. “This means Switzerland is not accepting the situation as it is, and this could mean children not going to school if they’re not vaccinated, as a last resort,” says Dr Claire-Anne Siegrist, president of the Swiss Federal Vaccination Commission, a group of 16 experts who advise the government on vaccination policy.

She is a specialist in vaccinology at Geneva’s HUG (university hospitals).

The 2008 outbreak saw 3,325 cases, with young people ages 15-19 the largest group. The official federal records currently show 78 cases to date for 2009, but the statistics do not yet include all reported cases, so that Vaud, which has had at least 40 cases, shows only 6 in the tables of reported cases.

The country’s vaccination coverage of 85% falls far below the 95% targeted by the World Health Organization. It varies greatly from one canton to another, however. In Geneva, coverage is now 95% says Siegrist, “and we did this without a campaign. But in other cantons it’s 70% and they’re not doing enough. We want them to reach 95%.”

Mandatory vaccinations are not the only solution, she says, and she would prefer to see Switzerland achieve higher coverage without taking that step. The United States has mandatory coverage, and children cannot attend public school unless they are vaccinated, with exceptions. The US was worried in 2008 about a jump in cases: to 131 for the entire country in the first seven months of the year, far lower than the Swiss figure for the highly contagious disease. Finland eradicated measles in 1996 without mandatory vaccinations, and Australia has just declared itself measles-free, without a mandatory programme. Medical authorities in Australia believe moving the second shot from age four to 18 months has played a role in reducing the number of cases to fewer than onen in a million.

The last national public campaign in Switzerland to vaccinate against measles was in 1986. “If there is going to be an effort, it has to be national to be effective,” Siegrist says.

Ed. note: Dr Siegrist in October 2008 became a consultant to the UK government on its vaccination programme. The Tribune de Geneve ran a profile of her (Fre).

Related story: swissinfo