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Streda, 18. apríla 2018 - Štrasburg Revidované vydanie

26. Zdržanlivosť v otázke očkovania a pokles úrovne zaočkovanosti v Európe (rozprava)
Videozáznamy z vystúpení
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  President. – The next item is the debate on:

– the oral question to the Council on vaccine hesitancy and the drop in vaccination rates in Europe by Renate Sommer, Elena Gentile, Bolesław G. Piecha, Gesine Meissner, Kateřina Konečná, Marco Affronte, and Mireille D’Ornano, on behalf of the Committee on the Environment, Public Health and Food Safety ((O-000008/2018 - (2017/2951(RSP)) (B8-0011/2018)),

– the oral question to the Commission on vaccine hesitancy and the drop in vaccination rates in Europe by Renate Sommer, Elena Gentile, Bolesław G. Piecha, Gesine Meissner, Kateřina Konečná, Marco Affronte, and Mireille D’Ornano, on behalf of the Committee on the Environment, Public Health and Food Safety (O-000009/2018 - (2017/2951(RSP)) (B8-0012/2018)).

 
  
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  Elena Gentile, autore. – Signora Presidente, onorevoli colleghi, grazie al rappresentante della Commissione e alla ministra del Consiglio. La ricerca scientifica ha consentito di liberare milioni di cittadini dal rischio di contagio di malattie infettive tra le più insidiose, perché minacciano la sopravvivenza e molto spesso incidono sui livelli di qualità della vita. L'uso su grande scala delle pratiche di immunizzazione ha contribuito all'eradicazione di molte malattie infettive, che quindi sono state derubricate per lungo tempo dalla cronaca epidemiologica.

Ora il panorama è mutato: cresce il numero dei soggetti che si ammala, per esempio, di morbillo e si allunga dolorosamente l'elenco delle vittime, come è accaduto in Italia, in Romania ed anche, in misura minore, in altri Stati.

I cittadini europei, tra gli altri, sono quelli che mostrano una maggiore perplessità rispetto alla sicurezza e all'efficacia dei vaccini. I dati epidemiologici relativi al periodo che va dal 2008 al 2015 rappresentano la cifra della diffidenza degli europei rispetto alle pratiche vaccinali e, dunque, rispetto alla loro efficacia e alla loro sicurezza: 215 000 infatti sono i casi di malattie denunciate che potevano essere tranquillamente prevenute e questi numeri al netto delle epidemie influenzali.

Voglio aggiungere alcune altre considerazioni: se l'Europa è davvero lo spazio dentro il quale contrastare le diseguaglianze e restituire opportunità, allora l'obiettivo di debellare la malattia coincide con la narrazione di un'Europa che contrasta le marginalità, le povertà e la deprivazione, liberando futuro soprattutto in favore del capitale più prezioso: i nostri bambini e le nostre bambine.

Significa, inoltre, per l'Europa assumersi la responsabilità di riorientare e riqualificare la spesa pubblica a favore della sanità, in modo particolare in questo settore, con la consapevolezza che i benefici sono certamente superiori ai costi, sia sanitari che sociali, perché si investe in salute, perché si investe in qualità della vita.

Chiediamo alle Istituzioni europee di assumano un ruolo più incisivo di governance delle politiche sanitarie per invertire la tendenza in atto, che vede crescere la sottovalutazione dei vantaggi della pratica vaccinale, messi in discussione da campagne di disinformazione che alimentano dubbi sull'efficacia e sulla sicurezza e su cui, purtroppo, specula il populismo più becero.

Spetta dunque all'Europa la responsabilità di un'informazione trasparente, corretta, strettamente collegata alle attività di farmacovigilanza, dentro il rigoroso rispetto del profilo etico e morale di ciascun attore del sistema. Tocca all'Europa richiamare gli Stati membri al rispetto degli impegni sottoscritti, compresa la promozione della ricerca di nuovi vaccini salvavita e la promozione delle pratiche vaccinali in numero certamente maggiore a quello registrato oggi.

Spetta all'Europa l'individuazione di ogni utile intervento che abbatta i costi dell'acquisizione dei vaccini, per renderli dunque facilmente accessibili anche, e soprattutto, nei paesi che presentano maggiori difficoltà di investimento e quindi di spesa.

È del tutto evidente, Commissario, la necessità di riallineare i calendari vaccinali in Europa, chiamata oggi a nuove sfide legate all'immigrazione e alla crescente mobilità per motivi di studio, di lavoro e anche di svago; promuovere un percorso democratico che riconnetta la scienza con i cittadini, con gli operatori del sistema, con le associazioni per mettere a valore i vantaggi, chiarire i dubbi, stigmatizzare le eventuali distorsioni e le contaminazioni del sistema, liberandolo da ogni qualsivoglia sospetto di conflitto d'interessi.

Questo mi pare essere l'obiettivo della nostra discussione e del nostro confronto. Un'informazione democratica, la formazione alla comunicazione: l'educazione è lo strumento più efficace per sconfiggere diffidenze e paure.

Consigliare e raccomandare è certamente meglio che obbligare: ma rendere obbligatoria la pratica vaccinale può essere un passaggio necessario per raggiungere l'obiettivo della immunizzazione di gregge che mette per davvero in sicurezza le persone. L'esperienza italiana può offrire un utile elemento di discussione.

 
  
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  Monika Panayotova, President-in-Office of the Council. – Madam President, it is a pleasure for me to participate today in this important debate. As the honourable Members point out, a widespread vaccine hesitancy is a worrying phenomenon that could cause serious public health problems, as the current measles outbreaks in a number of Member States show.

In order to increase vaccination coverage, which is the only means to counteract the public health threats caused by vaccine-preventable diseases, vaccine hesitancy is however only one of the problems to tackle. It is equally important to prevent vaccine shortages and to find means to develop new vaccines.

The Council has taken several initiatives relating to vaccination. In the Council conclusions of 2014, Ministers agreed on a comprehensive list of actions intended to increase the vaccination coverage in the European Union and invited Member States and the Commission to implement those actions. Among these actions, one of them aims at strengthening the role of healthcare professionals in recommending vaccination, which directly links to the issues raised by the honourable Members.

The Council will further undertake a detailed analysis of the measures in this field, including measures aimed at tackling vaccine hesitancy, when examining the forthcoming Commission proposal for a Council Recommendation on Strengthening Cooperation against Vaccine—Preventable Diseases.

The Bulgarian Presidency is in contact with the Commission with regard to the proposal. As soon as the proposal is published, we will initiate the discussions in the Council.

 
  
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  Vytenis Povilas Andriukaitis, Member of the Commission. – Madam President, thank you very much indeed for this oral question. Vaccination is one of the most powerful public health measures we have at our disposal. Widespread vaccination has eradicated smallpox and made Europe polio—free. It prevents countless deaths and stops millions of people from contracting illnesses each year. There are not so many other interventions that can claim to be so effective.

That being said, sorry, but now over 14 000 people contracted measles in the European Union in 2017 – more than three times than in 2016. And 57 deaths due to measles have been reported here since 2016. It is so painful to see this picture. A safe, effective and cheap measles vaccine exists, so every one of these deaths is unacceptable. They are avoidable deaths, preventable deaths. It is deeply unacceptable.

So why on earth are people avoiding vaccinations? Well, there is a shift away from the individual and collective benefits of vaccinations to increased distrust and fear of possible side effects. That is true. Misinformation by vaccination deniers and the rapid spread of fake information is clearly a factor. But we cannot just dismiss vaccine hesitancy as a question of ignorance. People have concerns about the vaccines and we need to address these.

Vaccine hesitancy is a common problem across Member States. Solving this problem depends on strengthened coordination at European Union level. So I am very encouraged by the Parliament’s resolution. Thank you very much indeed; it is very timely.

I also want to ensure that vaccination is an absolute priority for me as Commissioner and it is very important that I see cross—party engagement on this issue.

Now, you have asked me some important questions and I want to address each of them individually.

First, how does the Commission plan to address this resistance to vaccination? Based on your draft resolution it seems that we share many of the same concerns, including the difference in vaccine rates across Member States and increasing vaccine hesitancy. These issues need a strategic and coordinated response. With that in mind, the Commission is planning to adopt an initiative on a vaccination very soon – maybe next week.

The Parliament’s draft resolution is very much in line with our own proposal. We plan to focus first on tackling vaccine hesitancy and increasing vaccination uptake. Now is the time to act in ensuring vaccine supply and improving cooperation across the European Union. Healthcare workers and health professionals play a crucial role in promoting vaccination and addressing concerns related to hesitancy.

So we are exploring how to create a coalition of health associations to increase vaccination coverage. We also need to find ways to deliver accurate and timely information to the public of these genuine concerns, exchanging best practices and combating myths.

Under the European Union Health Programme we are launching a project or joint action with Member States that will also address vaccine hesitancy. The joint action is led by France and will, first, establish mapping of best practices and analyse the reasons behind high and low vaccination coverage and, secondly, set up social media infrastructures to conduct real—time public vaccine confidence monitoring.

Your second question, how does the Commission intend to ensure that a comprehensive European Union action plan raising the social problem of vaccine hesitancy is elaborated?

As you know, vaccination programmes are the competence of Member States. But given the close border nature of disease outbreaks, some Member States have requested support suggesting the need for coordinated approaches. This makes absolute sense and this is also the reason our initiative is in the form of a Council recommendation.

There is a clear added value in strengthening cooperation at EU level including among health authorities, the vaccine industry, research and innovations, healthcare providers and other stakeholders, keeping all on board. Make no mistake, each of these stakeholders needs to be enrolled if we are to properly address this issue. The Commission will encourage and support Member States’ outreach to the most disadvantaged groups including by promoting health mediators and grassroots community networks.

We will also work with Member States to simplify and broaden opportunities for vaccination. This means identifying the barriers to access and supporting interventions to increase access for disadvantaged and socially—excluded groups.

The Commission initiative would aim to achieve these goals. Indeed, we intend to focus on one of the proposal’s main pillars on tackling vaccine hesitancy.

Your third question, what concrete actions is the Commission planning to facilitate a more harmonised schedule for vaccinations across the EU?

Vaccination schedules vary considerably between Member States due to differences in the way vaccination programmes are organised. These differences take into account, of course, historical vaccine registrations and the specific burden of disease and the cost—effectiveness of single vaccinations. Together, these inconsistencies can give the sense that there is a lack of scientific consensus on vaccine schedules, which could in turn lead to vaccine hesitancy.

A European Union—wide common vaccination schedule would solve many of these problems. For example, it would mitigate the risk that children miss a vaccine by moving, together with their parents, from one Member States to another.

Furthermore, this would decrease supply problems and increase the value of programme monitoring. To address this issue, the joint action on vaccination aims to map the evidence base of national vaccination calendars. This will provide an important basis for a common vaccination schedule in the future.

As a starting point, we need a system to collect and share data on vaccination. This requires the involvement of all Member States and we hope that we can build on the excellent work of the European Centre for Disease Prevention and Control.

The fourth question, how does the Commission plan to address the spread of unreliable and misleading scientific information on vaccinations and to further develop information campaigns aimed at providing more in—depth knowledge about vaccines and increasing vaccination coverage?

The spread of accurate and timely information in an age of information overload is a huge challenge. When it comes to vaccination, we need to be extremely vigilant and responsive to rumours, myth and misinformation.

The Commission will explore, with Member States, how to support their communication activities and awareness—raising on the benefits of vaccination by, first, presenting scientific evidence to counter the spread of fake news. Second, engaging with healthcare workers, education stakeholders and the media, as advocates and multipliers, to fight complacency and increase trust in immunisation.

I want to assist in increasing the bearings and confidence of citizens in their national vaccine programmes. We feel that campaigns are best developed at national level by experts who understand the national and cultural context.

We are working closely with the European Centre for Disease Prevention and Control to propose ways to provide objective and transparent evidence on vaccines and pharmacovigilance processes. We also need to build on synergies with other Commission initiatives such as the upcoming initiative addressing the spread of fake news.

Honourable Members, colleagues, at a time when our health systems are under increasing pressure and are asked to do more with less, we simply cannot afford to waste the potential of vaccinations to save lives. We need to harness our all our resources and energy in a coordinated effort to restore public confidence in vaccination. Our work with Member States is very much in line with Parliament’s resolution.

So we are moving in the right direction together. But this is only the beginning and I invite you to be fully involved in this effort. I look forward to working closely with Parliament and to doing everything in my power to increase vaccine coverage in Europe.

 
  
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  Renate Sommer, im Namen der PPE-Fraktion. – Frau Präsidentin, Herr Kommissar! Danke für diese engagierte Stellungnahme. Ja, es gibt Krankheiten, an die wir uns kaum noch erinnern, die wir vielleicht als Kinder gehabt haben, die, wenn wir etwas älter sind – so wie ich –, lebensgefährlich sein können. Die Menschen haben das ganz offensichtlich vergessen: Masern können lebensgefährlich sein. Es gibt Länder, in denen Masern durch Impfprogramme ausgerottet oder nahezu ausgerottet sind – Guatemala ist so ein Land. Dennoch hat sich eine Schülerin aus Guatemala mit Masern infiziert. Aber sie hat sich nicht in Guatemala infiziert, sondern in Deutschland, wo sie zu einem Schüleraustausch war, und sie hat dann – nicht wissend, dass sie krank ist – diese Krankheit wieder nach Guatemala zurückgetragen. Dort gibt es jetzt plötzlich wieder Masern.

Das zeigt doch, dass in Deutschland zu wenig geimpft wird. Es ist nicht nur in Deutschland so, es ist in der gesamten EU so. In allen Mitgliedstaaten geht die Impfbereitschaft zurück. Das geht zurück auf Fake News über angeblich fürchterliche Nebenwirkungen von Impfungen, die so nicht stimmen. Wir wissen, dass unsere Impfstoffe sicher sind. Kleinere Nebenwirkungen muss man in Kauf nehmen, weil die Wirkung der Krankheit, die damit ja verhindert wird, verheerend sein kann.

Ich halte es fast schon für eine Körperverletzung, wenn Eltern ihren Kindern, für die sie verantwortlich sind, die Impfung verweigern. Sie liefern ihre Kinder damit unter Umständen einer tödlichen Erkrankung aus oder einer Erkrankung, die lebenslange Behinderung verursacht. Das müssen wir den Menschen wieder erklären. Die Menschen haben vergessen, wie wichtig das Impfen ist. Wir müssen es ihnen wieder beibringen.

Ganz besonders sind da die Mitgliedstaaten in der Verantwortung, die müssen es machen. Aber natürlich sollten wir auf der europäischen Ebene eine konzertierte Aktion haben. Deshalb freue ich mich über das, was der Kommissar dazu gerade gesagt hat.

 
  
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  Carlos Zorrinho, em nome do Grupo S&D. – Senhora Presidente, agir em conjunto para enfrentar as reservas em relação às vacinas e inverter a redução das taxas de vacinação na União Europeia é uma prioridade. Nesse sentido, aliás, enviei uma pergunta à Comissão Europeia, coloquei várias questões no recente debate decorrido na comissão ENVI e a resolução que estamos hoje aqui a debater está em linha com aquilo que me foi sendo respondido em todas essas circunstâncias.

Queria saudar a relatora, Elena Gentile, pelo magnífico trabalho, queria saudar o Senhor Comissário, pelo esforço extraordinário que tem colocado na resolução desta questão.

Estão criadas as condições para, em conjunto, Parlamento Europeu, Estados-Membros e Comissão Europeia, podermos concretizar políticas consistentes que enfrentem de facto o problema. Reforçar a base legal do plano europeu de vacinação, desenvolver uma plataforma de compra conjunta que já tem 19 países e deve ser desenvolvida, implementar práticas de partilha de dados, para haver melhor coordenação e uma coordenação informada, desenvolver de forma aberta, transparente, a investigação sobre este tema para aumentar a confiança dos cidadãos e também a fiabilidade das vacinas, integrar estas medidas num plano mais vasto de promoção da saúde à escala europeia, tendo em conta também, por exemplo, a vacinação animal e o combate à resistência aos antibióticos, lançar uma campanha europeia de informação e pedagogia sobre este importante tema para a saúde pública e para a qualidade de vida dos europeus, tudo isto nós temos hoje os instrumentos para fazer.

Temos de ser práticos e capazes de concretizar medidas que melhoram a vida concreta dos cidadãos. Este é um exemplo, é necessária uma concretização rápida, determinada, transparente, porque é importante para as pessoas, porque é importante para o futuro da Europa e para a saúde no mundo.

 
  
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  Arne Gericke, im Namen der ECR-Fraktion. – Frau Präsidentin! Impfung – ein Thema das viele bewegt: Ärzte, Krankenkassen, insbesondere aber auch Eltern. Sie stehen millionenfach vor der Herausforderung, über den Impfkatalog ihrer Kinder zu entscheiden. Die Pharmaindustrie macht es den Menschen mit ihren bunten Riesenimpfpaketen und einem Strauß an Nebenwirkungen nicht einfach.

Ich bin kein Impfmuffel, aber das, was morgen hier zur Abstimmung steht, klingt, als hätten es Pharmalobbyisten geschrieben – dann etwa, wenn wir fordern, künftig noch viel mehr für das Impfen zu werben, den Nationalstaaten quasi eine Impfpflicht zu empfehlen. Ich sehe das kritisch und habe dazu Änderungsanträge im Sinne der Eltern eingebracht. Wir brauchen mehr Informationen bezüglich der Nebenwirkungen.

Die Charta der Grundrechte besagt klar: Im Bereich der Medizin muss die freie Wahl der Behandlung nach ausführlicher Information und Zustimmung durch den Einzelnen respektiert werden. Muss ich Babys mit ein paar Wochen wirklich schon mit dem Cocktail einer Siebenfach- oder Achtfach-Impfung konfrontieren? Als Bürgervertretung müssen wir den Interessen der Bevölkerung zu Impffragen mehr Raum geben, statt immer nur die Phrasen der Pharmaindustrie zu zitieren.

 
  
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  Gesine Meissner, im Namen der ALDE-Fraktion. – Frau Präsidentin, Herr Kommissar, liebe Kolleginnen und Kollegen! Wir haben ganz viel medizinischen Fortschritt erreicht. Die Menschheit ist heute vielleicht gesünder als früher, wenn man mal von irgendwelchen Allergien absieht. Und da hat man das Gefühl, manche denken, wir sind jetzt immun gegen Krankheiten. Das sind wir aber halt überhaupt nicht. Wir müssen auch überlegen, dass vieles von unserem guten Gesundheitsstatus heute darauf zurückzuführen ist, dass wir Krankheiten kennen, dass wir Gegenwirkungen kennen und dass wir auch eben durch Impfungen Krankheiten quasi ausgerottet haben – es ist schon gesagt worden.

Aber die können halt wieder kommen. Das ist ganz wichtig, man darf es nicht vergessen. Es geht hier in keinster Weise darum, irgendwie der Pharmaindustrie zu Gefallen zu sein, lieber Kollege Gericke, das ist es nämlich nicht. Es geht darum, die Menschen zu informieren und ihnen Ängste vor eventuellen Nebenwirkungen zu nehmen. Ich glaube, wenn alle Eltern wissen, was einem Kind eventuell bevorstehen kann, wenn es wirklich krank wird, und was es bedeutet zu impfen, dann werden die meisten Eltern sich für das Impfen entscheiden.

Sie haben auch schon gesagt: Das ist Aufgabe der Mitgliedstaaten – vollkommen richtig. Denen wollen wir auch gar nicht ins Handwerk pfuschen. Aber es gibt so viele Dinge, wo es tatsächlich wichtig ist, darauf hinzuweisen, dass Impfung Leben retten kann, und das ist nun mal Fakt. Das heißt ja nicht, dass wir eine Zwangsimpfung erreichen wollen. In manchen Bereichen ist es notwendig, bei manchen Krankheiten. Bei vielen anderen geht es darum, zu informieren und dann – wie schon gesagt – die Mitgliedstaaten gemeinsam einen Austausch vornehmen zu lassen über Aktionen, auch zum Beispiel gemeinsame Impfstoffe für den Fall einer Seuche, die auch nicht ausgeschlossen ist – Vogelpest oder so etwas –, damit man gewappnet ist, und dann auch zu überlegen: Wir sind jetzt interkontinental, weltweit so weit verbunden. Wir können nicht die ganze Welt regeln, aber in Europa können wir versuchen, einen Anfang zu machen und wirklich zu sehen, dass wir nicht durch Zwang, sondern durch Information die Menschen dazu bringen, tatsächlich gerade für ihre Kinder das Beste zu tun, um später ein gesundes Leben führen zu können.

Ich habe auch Mails bekommen von Leuten, die impfskeptisch sind und die mir gesagt haben: Sie wollen uns jetzt zwingen. Das wollen wir überhaupt nicht. Wir wollen nicht zwingen, wir wollen aufklären. Noch einmal: informieren, transparent. Wir wollen auch Vertrauen schaffen dafür, dass die Ärzte eben auch gut informieren. Und dann wollen wir den Menschen die Wahl lassen, das zu nehmen, was für ihre Familie am besten ist.

 
  
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  Marco Affronte, a nome del gruppo Verts/ALE. – Signora Presidente, onorevoli colleghi, per chi parla non c'è nessun dubbio che i vaccini siano di enorme utilità, perlomeno per il nostro stato di salute e per le nostre condizioni di qualità della vita.

Però non c'è dubbio che la reticenza ai vaccini stia aumentando e questo porta a delle conseguenze: si stanno abbassando le percentuali di copertura della popolazione vaccinata e stanno tornando delle malattie che pensavamo di avere debellato.

Questo può portare poi a delle estreme conseguenze, come è successo per esempio nel mio paese, in Italia, ma anche in Francia, di introdurre l'obbligo di vaccinazione. Si tratta di un'extrema ratio alla quale non dobbiamo arrivare; io la ritengo una sconfitta perché noi dobbiamo combattere la reticenza dei vaccini con la comunicazione e con l'informazione data correttamente, in modo da costruire una fiducia dei cittadini verso i vaccini, che sono uno strumento estremamente utile, e non attraverso un obbligo vaccinale.

Per questo è importante questa risoluzione e l'accordo con la Commissione europea ma chiediamo anche la collaborazione delle case farmaceutiche a non minimizzare e a fronteggiare i problemi a viso aperto, in modo da avere un consenso informato e a non considerare semplicemente gli effetti collaterali come una piccola percentuale, perché le per le famiglie colpite si tratta di qualcosa di molto importante.

 
  
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  Michèle Rivasi (Verts/ALE). – Madame la Présidente, je pense que cette résolution ne répond pas au motif de l’hésitation vaccinale. Les gens ne sont pas opposés à la vaccination, mais ils n’ont plus confiance.

L’un des premiers problèmes, ce sont les conflits d’intérêts des experts qui décident du calendrier vaccinal. Monsieur le Commissaire, quand il y a eu la grippe H1N1, qui a décidé? C’est un groupe d’experts opaque de l’OMS qui a décidé que c’était une pandémie. Or, une enquête au niveau du Conseil de l’Europe a montré que cette pandémie n’était absolument pas valable, qu’elle avait été créée de toutes pièces et que ce comité d’experts était payé par l’industrie pharmaceutique.

Deuxième problème, les adjuvants. Regardez toute la polémique sur l’aluminium. Si des études sur les animaux montrent qu’il y a des effets neurotoxiques, aucune étude sur les humains et sur les enfants n’a été réalisée.

Troisième problème, le vaccin est un médicament. Tous les médicaments font l’objet d’études de pharmacocinétique, mais pas les vaccins. En d’autres termes, on ne connaît pas le devenir de leurs constituants dans l’organisme humain.

Monsieur le Commissaire, je vous demande officiellement d’imposer des études de pharmacocinétique sur tous les vaccins. On n’imposera pas la confiance par la contrainte, on l’imposera par la pédagogie, la transparence et la sécurité des produits.

 
  
 

Catch-the-eye procedure

 
  
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  Sirpa Pietikäinen (PPE). – Madam President, vaccine hesitancy is not the problem, as long as the majority of us are getting our vaccinations and we are providing the herd protection for all the rest of the people. But if the hesitancy is increasing, there is the risk that we could cause serious pandemic infections, very vulgar infections, in Europe.

This is a serious issue that I think gives the Commission the competency, even though I know it is a very delicate situation, to create a European vaccination plan and even to consider having a European, pan-European, not just the suggested list, but a register of vaccinated people or vaccinations. That would be information to be shared. Because it is not only an issue of pandemics; think of people working in hospitals and with fragile people in elderly care centres and not having vaccinations. I know a lot of these cases. They are posing a real threat to someone else that we should be protecting.

 
  
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  Νότης Μαριάς (ECR). – Κυρία Πρόεδρε, η ιλαρά καλπάζει στην Ελλάδα αυτή τη στιγμή. Τα τελευταία στοιχεία δείχνουν ότι από 01/05/2017 μέχρι 05/04/2018 είχαμε 2.431 κρούσματα. Η πορεία των κρουσμάτων ιλαράς στην Ελλάδα είναι αυξητική, ενώ στην υπόλοιπη Ευρώπη είναι καθοδική. Ήδη αυτή τη στιγμή που μιλάμε έχουμε πάνω από 2.500 κρούσματα και φυσικά αυτοί που υφίστανται τις συνέπειες είναι ηλικίας 25 έως 44 ετών. Τα περισσότερα κρούσματα είναι στη νότια Ελλάδα, υπάρχουν Ρομά μεταξύ των ασθενών και φυσικά τα προβλήματα εντείνονται λόγω της προσφυγικής κρίσης. Έχουμε τους επαγγελματίες της υγείας, πολλοί από τους οποίους έχουν νοσήσει, άρα αντιλαμβάνεστε κύριε Επίτροπε ότι τα θέματα είναι πολύ σοβαρά στην Ελλάδα. Επομένως το ερώτημα είναι αν υπάρχει συνεργασία της Ελληνικής Κυβέρνησης με την Επιτροπή για το θέμα αυτό, εάν η Ελλάδα είναι σε αυτή τη «Συμμαχία της Υγείας» και πώς θα αντιμετωπιστεί αυτό το ζήτημα στην Ελλάδα και στις υπόλοιπες χώρες της Ευρωπαϊκής Ένωσης.

 
  
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  João Ferreira (GUE/NGL). – Senhora Presidente, em 2017, o sarampo provocou 35 mortos num conjunto de cinquenta países da região europeia onde se registaram mais de vinte mil casos da doença. Estima-se uma elevada incidência de casos em crianças menores de um ano de idade que ainda são muito novas para receber a primeira dose da vacina. Daí a importância da imunidade de grupo.

Esta fica em causa quando uma parte significativa da população não é vacinada, uma situação que prejudica não apenas aqueles que escolheram não ser vacinados, mas também aqueles que não podem ser imunizados.

A vacinação permitiu erradicar a difteria, a rubéola congénita, o tétano neonatal. Em 2016, Portugal foi reconhecido oficialmente como estando um livro de sarampo, todavia depara—se agora com o terceiro surto da doença no espaço de dois anos.

Impõe-se a necessidade vigorosa e sistemática de ações de formação e de sensibilização por parte dos serviços públicos de saúde, necessariamente articuladas à escala europeia que combatam desinformação e preconceitos cujos malefícios se tornam evidentes e que incentivem à vacinação.

 
  
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  Jonathan Arnott (EFDD). – Madam President, I support medicine, I support education and I support vaccination. I agree that, broadly speaking, the benefits of vaccination vastly outweigh the risks, and low uptake does lead to disease outbreaks. The World Health Organization, for example, rightly recommends immunity levels of 95% to prevent outbreaks. But there is, of course, some evidence that in a tiny minority of cases vaccination can have negative side effects – specifically as regards autoimmune diseases. But for other illnesses, there are dangers in believing every single scare story. For one major condition, even the national charity responsible describes the proposed link as being ‘comprehensively discredited’. The correlation—causation fallacy lead to all kinds of exaggerations, misinformation and bogus claims made by those who would profit from undermining the principle of vaccination. But, ultimately, there are some risks and it is not for the State to force parents into making a particular decision, and nor should the European Union mandate what nation states must do. So will I support education? Yes. Should we counter misunderstandings and misinformation? Yes. But should we remove parental choice? No.

 
  
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  Michaela Šojdrová (PPE). – Paní předsedající, přestože je tak pozdní hodina, tak já považuji za velmi důležité, že tady můžeme slyšet tuto diskusi, a především, že jsem slyšela pana komisaře a jeho odpověď. Je vidět zájem i také odpovědnost, s jakou se k této otázce staví, protože to je vážný zdravotní problém, který mezi občany ve všech členských státech dnes nastává. My chápeme obavy rodičů, za prvé nemají informace a obávají se různých reakcí na vakcinaci. Nicméně je to velká odpovědnost lékařů, aby byli více připraveni a dokázali rodičům vysvětlit tuto potřebnost. V současnosti se šíří opravdu spekulace, teorie, kterým řada rodičů prostě podlehne, když není dobrá osvěta. Ten výskyt, o kterém pan komisař mluvil, se znásobuje téměř na 14 500 nakažených v loňském roce. V České republice také oproti 7 případům v roce 2016 bylo v loňském roce případů 146, čili ten nárůst je obrovský a opravdu zde už musí reagovat i EU. Takže děkuji za přístup pana komisaře.

 
  
 

(End of catch-the-eye procedure)

 
  
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  Vytenis Povilas Andriukaitis, Member of the Commission. – Madam President, I have listened very carefully. Let me start with one remark. I vaccinate myself every year against influenza. I did it many years ago against hepatitis and yellow fever also. As a cardio-surgeon, I had an obligation to vaccinate myself. Why? Because I was responsible. Because it was dangerous for my patients if there was any possibility of my transmitting infection from me to my patients.

In response to Arne Gericke, a very simple message: let’s do it together and let’s save children’s health. When we are talking about children’s rights, about the Convention on Children’s Rights, children have the right to as high as possible a level of health protection. It does not matter that sometimes parents do not understand it, but who is responsible for saving children’s lives? Only the parents? No. We are all responsible. The state has a responsibility to guarantee conventional requirements, to implement. Of course some countries have mandatory vaccination, but more than half of European Union countries have mandatory vaccinations and calendars. That is OK. Some have only voluntary. OK. Some have a mixture. But we know very well that awareness, information and possibilities and our personal willingness to raise awareness and to be together and extend our health immunity is our own obligation also.

I am a medical doctor. For me it is very difficult to listen to today’s issues. Ms Rivasi raised some very important questions. You know that pharmacolovigilance is in place. You know that all vaccines go through very thorough scientific assessment, through WHO checks, through EMA checks. No, no, it is true. And we are always blaming conflicts of interest and showing up a bad industry. Once again there are fears in this House. Please present the evidence. That is the question. And of course we know very well that conflicts of interest should be addressed and we have a lot of tools to do this.

Speaking about general food law, we know very well we will also discuss issues about conflicts of interest. EFSA, EMA or ECDC it does not matter which. But look, that is not the main problem. The main problem is how to really encourage people and restore trust in science, and be together. You and I, we are both responsible for that. We can go on addressing issues and disseminating messages on pandemics saying these are because of industry or experts. I am sorry. What about rabies? What about zoonoses. What about Lumpy Skin Disease? What about African Swine Fever, the pandemics? We are all asking for effective vaccination for animals, but when we are talking about children, about people, immediately we raise different issues. What about rabies? We are using vaccinations and we have eliminated rabies now. Can you explain that to me by using a conspiracy theory only about bad industry? No, of course not.

I am sorry for being a little bit emotional, but people listening to you and to me also need to hear and to have common consensus that it is so dangerous, and it is such a sensitive issue to see children dying.

I would like to address issues relating to Greece. Yes, we are cooperating in a very close manner and now we have some project, which I am sorry to say is called ‘Fevers’. We have dedicated EUR 29 million to addressing the related issues. We are cooperating very closely with the Greek Government, which is in favour of addressing all therse issues. I have a good personal relationship with the Minister. I am happy about this.

Thank you very much indeed generally for the constructive discussion. Your debate is also very timely in that we are showing the political importance of vaccination in Europe precisely on the eve of the World Immunisation Week. I believe we all have a collective responsibility to ensure that today’s debate is actually followed up with concrete action by the Commission, the Council and the Parliament and by each of you in your respective constituencies.

I am worried that if we fail to act, children will continue to die from vaccine—preventable diseases in the 21st century. Once again it is unacceptable. I am not willing to accept that outcome. We should focus in particular on increasing vaccination coverage. The main goal is not about mandatory or voluntary, it is about possibilities to achieve a safe level of coverage, 95% or more. This is the main level, and increasing outreach to the most vulnerable groups. How many vulnerable groups are on our side? Please look at Roma issues and different situations in Romania.

We need to start increasing the compatibility of vaccination schedules, ensuring vaccination supply and, crucially, supporting Member States in their efforts to increase trust and immunisation and, of course, to register all side effects – as who can deny there ate side effects? No one. Because you have side effects when eating a meal, and with allergens you can see side effects. Side effects are a reality, there is a need to register, to be vigilant, to address, to assess the situation, to improve, there is no doubt. But do not disseminate fear about vaccines.

I would like especially to thank Ms Gentile and all of you for your engagement, your passion and commitment to the subject, and in the first place the co—signatories of the motion for a resolution. You have already had the occasion to hear my views on this topic in other fora. Vaccination is a personal priority of mine, and I look forward to working closely with you in the future. I believe that working together we can succeed.

 
  
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  Monika Panayotova, President-in-Office of the Council. – Madam President, honourable Members, ladies and gentlemen, thank you again for giving me the opportunity to exchange with you on these very topical issue. After the emotional and very argumented intervention of the Commissioner, I would like to say that, indeed, vaccine hesitancy is a worrying phenomenon that needs to be addressed, as well as other obstacles to a wider vaccination coverage. Again, the Presidency is looking forward to the forthcoming Commission proposal for a Council recommendation on the strengthening cooperation against vaccine of preventable diseases, which the Council will examine.

 
  
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  President. – I have received two motions for resolutions tabled in accordance with Rule 128(1) of the Rules of Procedure.

The debate is closed.

The vote will take place on Thursday, 19 April 2018.

Written statements (Rule 162)

 
  
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  Ivo Belet (PPE), schriftelijk. – In één jaar tijd is het aantal Europeanen dat besmet raakte met mazelen verviervoudigd tot meer dan 20 000. Van hen overleefden 35 de ziekte niet. Deze tendens bevestigt dat de dalende vaccinatiegraad een enorm risico inhoudt voor de volksgezondheid in de hele EU. Steeds meer ouders en patiënten stellen inenting uit of laten hun kinderen zelfs helemaal niet meer inenten. Ziektes die zo goed als uitgeroeid waren in Europa, zoals de mazelen, steken daardoor weer de kop op, met rampzalige gevolgen. Het positieve effect van vaccinatie is onomstotelijk.

Elke vaccinatie telt, want hoe beter de bevolking gevaccineerd is, hoe moeilijker een ziektekiem zich kan verspreiden. Het is eigenlijk een kwestie van solidariteit zodat ook personen met een verminderde weerstand beschermd kunnen worden. Het is bovendien onaanvaardbaar dat jarenlange medische vooruitgang onderuit wordt gehaald door misleidende informatie. Het kan echt niet door de beugel dat politici fake news verspreiden over vaccins voor electoraal gewin. Medisch personeel speelt een cruciale rol om patiënten duidelijk te informeren over vaccins zodat iedereen een eerlijke kans heeft op bescherming.

 
  
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  Cristian-Silviu Buşoi (PPE), in writing. – The implementation of compulsory vaccinations along with penalties such as substantial fines or refused access to state schools is not a feasible, long—term solution to increase immunisation rates. These measures could generate even a stronger hesitancy to vaccination, where implemented. Feasible solutions would instead be improving communication strategies and boosting information campaigns across the EU in order to promote accurate, science—based arguments and enhance Member States citizen’s knowledge and understanding about the importance of immunisation against severe and sometimes fatal contagious diseases. In the context of the forthcoming EU Action Plan on Vaccination, I stress that the key factor EU bodies and all the other stakeholders involved need to focus on is the understanding of the behavioural drivers of vaccine acceptance. As this factor needs to be maximised, the chances of negative health effects resulting from vaccination needs to be urgently minimised at as close to zero as possible.

 
  
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  María Teresa Giménez Barbat (ALDE), por escrito. – El incremento en la reticencia a la vacunación y la caída de las tasas de vacunación en Europa, con su consiguiente impacto en el rebrote de enfermedades que creíamos olvidadas, no es solo un problema de salud pública; también lo es de confianza política. Se sabe que el escepticismo ante la vacunación está asociado con información falsa difundida en internet, y con la desconfianza emocional hacia los profesionales sanitarios y hacia el Gobierno. Las instituciones deben tomar nota de estas tendencias para fortalecer la confianza ciudadana en medidas sanitarias de probada eficacia, y deberían hacerlo de forma inteligente, empleando estrategias de comunicación política y científica basadas en evidencia, capaces de entender mejor el papel tan significativo que juegan las emociones y las distintas intuiciones morales de las personas. Estoy segura de que estaremos más cerca de lograr nuestros objetivos de salud pública reforzando la conversación entre ciencia y política dentro de las instituciones europeas.

 
  
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  Claudiu Ciprian Tănăsescu (S&D), în scris. – Știind că vaccinările salvează vieți, reticența față de vaccinuri, care se referă la întârzierea acceptării sau la respingerea vaccinurilor, în ciuda disponibilității serviciilor de vaccinare, nu prea are sens. Însă acest fenomen există și conduce la scăderi semnificative ale utilizării vaccinurilor în Europa, așa cum arată datele epidemiologice recente privind situația vaccinării în statele membre.

Vaccinarea este fără îndoială una dintre cele mai rentabile măsuri de sănătate publică disponibile. O vaccinare larg răspândită a eradicat variola și poliomielitele din Europa. Toate țările UE recomandă vaccinarea împotriva bolilor grave, a celor care pun viața în pericol. Cu toate acestea, unele vaccinuri nu sunt utilizate din teama față de efectele adverse după vaccinare, din lipsa informațiilor fiabile și demne de încredere sau ca urmare a implicării insuficiente a profesioniștilor din domeniul sănătății.

Desigur, nici presa sau asociațiile din domeniul sănătății nu au făcut prea multe în acest sens. În acest context, suntem de părere că este necesar un plan de acțiune cuprinzător al UE, care să includă aspectele sociale ale reticenței față de vaccinuri, precum și măsuri de combatere a răspândirii informațiilor nesigure, înșelătoare și neștiințifice privind vaccinarea.

 
  
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  Tadeusz Zwiefka (PPE), na piśmie. – Z ogromnym niepokojem obserwuję debatę, która toczy się poza głównym nurtem mediów, w mediach społecznościach czy portalach internetowych. Debatę, w której największą rolę odgrywają emocje i niepoparte danymi i badaniami naukowymi informacje na temat nieskuteczności czy wręcz szkodliwości szczepień. W związku z tym, niezależnie od przyjętych przez państwa członkowskie zasad i programów, poziom zaszczepialności w UE z roku na rok spada. Spójrzmy jednak na fakty, a faktem też jest, że powracają choroby, o których już dawno zapomnieliśmy. To, że przez ostatnią dekadę nie było zachorowań na odrę, nie oznacza, że ta choroba zniknęła. To szczepienia ochronne zminimalizowały poziom zapadalności na odrę praktycznie do zera. Faktem też jest, że szczepionki są niewątpliwą zdobyczą cywilizacji, a system dopuszczenia na rynek europejski leków jest bardzo skrupulatny. Obecnie jednak coraz szerzej z tymi faktami się dyskutuje. Z pewnością, jak wskazuje na to rezolucja PE, możemy zrobić więcej, by szczepienia i same szczepionki były jak najbezpieczniejsze dla naszych najmłodszych. Uważam także, że rzetelna i szczegółowa informacja ze strony lekarzy i firm farmaceutycznych z pewnością przyczyni się do zmniejszenia niechęci do szczepień. Przestrzegam jednak bardzo stanowczo przed negowaniem sensu i skuteczności szczepień. Nie igrajmy ze zdrowiem i życiem naszych dzieci.

 
Posledná úprava: 5. septembra 2018Právne oznámenie