Mandatory Vaccination in Romania: Back to Vax


As anti-vaccination sentiments resurface globally, so have once-eradicated diseases. This situation is especially prevalent in Romania and has become a severe economic, social, and health threat.


Romania’s Struggle with Anti-Vax Sentiments

The newly appointed minster of health of Romania—Dr Victor Costache—has announced that mandatory vaccination is a priority for the new administration. With 87 percent measle coverage, Romania has the sixth lowest vaccination rate in Europe, falling behind neighbours such Hungary (99 percent), Slovakia (96 percent), the Republic of Moldova (93 percent), and Bulgaria (94 percent).

According to Ildikó Hórvarth, State Secretary of Health in Hungary, remnants of the communist mandatory vaccination policy has made the country an “island of safety” in Europe amid recent outbreaks. Unfortunately, the same policy was abandoned in Romania after the 1989 revolution and attempts to reinstate vaccinations in recent years met with anti-vaccination sentiments.

The first strong anti-vaccination opinions started to appear more than 10 years ago when the first vaccination campaign against cervical cancer was introduced, a campaign that was haunted by false side effects and hysteria. These anti-vaccination campaigns went so far as to spread false information such as MMR vaccines containing cells from aborted foetuses and pesticides while using the logos of the World Health Organization (WHO), Health Ministry and UNICEF.

In 2017, this led the Romanian Senate to pass a bill that would fine parents up to RON 10,000 (USD 2,329) for refusal to vaccinate their children. Additionally, employers were required to pay the vaccination coverage for their employees, and radio and television stations had to promote the vaccination campaigns for free.

Romanians are now broadly in favour of vaccinations, with 62.7 percent of the population agreeing with the compulsory vaccination of children and 81 percent saying that vaccinating children is necessary, according to a survey conducted by INSCOP for the National Society for Family Medicine (SNMF). With the new administration in place and sentiments changing, it seems that Romania is on its way to curb the vaccination crisis in the coming years.


Haunted by the Past

Around the world, outbreaks of once long-gone diseases have re-emerged and sparked national debates about vaccination and the role of governments. In Europe, 7570 cases of measles were reported in Romania, 5006 in Italy, 4667 in Ukraine, and 891 in Germany, demonstrating that whether mature or emerging, no country is safe.

87 percent of cases occurred in unvaccinated people and these outbreaks have led to discussion on vaccination policies in every European country. All the European Union Countries have a long tradition of vaccination programs but there is still much that can be done to improve and accelerate immunization coverage.

In this European scenario, there are large differences between countries considering the type of vaccine used, number of doses and timing of vaccinations but also differences in whether vaccinations are recommended or mandatory. This is where the alignment between policies, patient registries, and procurement is of utmost importance as to provide the right vaccine and dosage to the population. This can be a challenge for countries that suffer from emigration such as Hungary and Romania, as it can lead to discrepancies with severe health ramifications.


Vaccination Overview

Vaccines were one of the largest medical discoveries in history and contribute to saving 2-3 million lives globally every year by preventing infectious diseases. Approximately 30 diseases are prevented by vaccinations at a cost of less than EUR 4,000 (including the cost of administering the vaccine) by which a person is protected for life against 17 of the most relevant vaccine preventable diseases, including typhoid, measles, rabies, rubella, polio, Hepatitis A&B, smallpox, and shingles.

Additionally, vaccines protect not only the individual but also those around them: new-borns, children, adults, tourists, and patients with chronic conditions. The production of a vaccine takes between 3 and 36 months and 70 percent of this period is dedicated to quality control with over 100 control tests carried out before launching the vaccine.

Furthermore, more than 80 percent of vaccination doses are produced in Europe by pharmaceutical campaigns that invest significantly in research and development activities. Thanks to these efforts, once fatal diseases are no longer a threat today: HIV is no longer a death sentence, Hepatitis C is a treatable disease, and the rate of return to work after a cancer diagnosis has increased by 75 percent. Currently there are over 700 drugs and vaccines in the research phase, representing many hopes for patients suffering from various diseases.

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