Immunization advisory committees are usually responsible for providing those in leadership positions with information used to make evidence-based decisions regarding vaccines and other health policies.

[29] These policies stirred resistance from a variety of groups, collectively called anti-vaccinationists, who objected on ethical, political, medical safety, religious, and other grounds.

[29] Common objections included the argument that governments should not infringe on individuals' freedom to make medical decisions for themselves or their children, or claims that proposed vaccinations were dangerous.

A passive reaction could be construed as endangering the health of society, whereas a heavy-handed approach can threaten the values of individual liberty and freedom of expression that we cherish.

[30]An ethical dilemma may emerge when health care providers attempt to persuade vaccine-hesitant families towards receiving vaccinations as this persuasion may lead to violating their autonomy.

[41] One argument among public health professionals is that compulsory vaccination is necessary in severe circumstances, but that it should be approached carefully in order to avoid polarizing the population and decreasing trust in the long term.

[44] In November 2021, during a COVID-19 outbreak, Austria banned unvaccinated individuals from leaving their home apart from going to work, buying essential supplies, or exercise, in an effort to reduce the spread of disease.

[50][51] Doctors who refuse to treat unvaccinated children harm both the child and public health, and may be considered unethical when parents are unable to find another provider.

[52] Opinion on this is divided, with the largest professional association, the American Academy of Pediatrics, saying that exclusion of unvaccinated children may be an option under narrowly defined circumstances.

Modelling predicted that vaccinating children would increase the number of cases amongst adults due to the absence of natural boosting from exposure to chickenpox in day-to-day life.

The may, e.g., compare the sequence of age groups to be vaccinated and study the outcome in terms of caseload, deaths, length of a pandemic,[65] healthcare system load,[66] and economic impact.

Today, the medical and scientific communities obviously face a big challenge where vaccines are concerned, namely enhancing the trust with which the general public regards the entire endeavor.

[77][78] The first economic analysis of routine childhood immunizations in the United States took place in 2001, and reported cost savings over the lifetime of children born that year.

[86][87] There is an economic incentive to establish vaccination programs for older adults as the general population is aging due to increasing life expectancy and decreasing birth rates.

[france 2] Therefore, criminal trials based on vaccine refusals may be referred to the Cour de Cassation, which will then certify whether the case meets certain criteria.

[172] Most recently, the Prime Minister's 2015–2017 roadmap for the "multi-annual social inclusion and anti-poverty plan" includes free vaccinations in certain public facilities.

The Robert Koch Institute in Berlin (RKI) compiles data of immunization status upon the entry of children at school, and measures vaccine coverage of Germany at a national level.

[174] Vaccinations recommendations that are issued must be in accordance with the Protection Against Infection Act (Infektionsschutzgesetz [de]), which regulates the prevention of infectious diseases in humans.

[179] Criteria for the recommendation include disease burden, efficacy and effectiveness, safety, feasibility of program implementation, cost-effectiveness evaluation, clinical trial results, and equity in access to the vaccine.

[179] Children aged 15 and over can legally consent to being vaccinated, even if their parents expressly object, provided the child gives the impression of being mature, informed, and capable of understanding the risks and benefits of their decision.

[182] As of January 2022, COVID-19-vaccination is mandatory for staff and students of secondary and tertiary education, employees in all arms of government, health workers, security personnel, and commercial drivers.

[citation needed] The law compelling children to have ten vaccinations to enroll at state schools came into effect in March 2018 but in August 2018 the Five Star Movement pushed legislation through the Italian Senate abolishing it.

[189] By November 2018, the government had changed its stance because of the "measles emergency" and decided to uphold the obligation for children up to the age of 16, teachers and health professionals to be vaccinated.

Funded vaccinations include tuberculosis, diphtheria, measles, hepatitis B, human papillomavirus for 12-year-old girls, and tick-borne encephalitis until age 18 in endemic areas and for orphans.

In a statement from Pakistani Police Commissioner Riaz Khan Mehsud, "There is no mercy, we have decided to deal with the refusal cases with iron hands.

Failure to comply results in a fine and compliance rates top 95%, Kraigher says, adding that for nonmandatory vaccines, such as the one for human papillomavirus, coverage is below 50%.

[217] SAVIC works with the WHO and the South African National Department of Health to educate, research, provide technical support, and advocate for country-wide vaccinations.

[225] An Electronic Immunisation Register has been established, which permits online access to the medical records of mothers and infants, enabling vaccination teams in remote areas to operate more effectively, especially with nomadic people.

In addition, the 13 other required vaccines prevent highly contagious diseases communicable through the respiratory route, while HPV is spread only through sexual contact.

Resistance proceeded during the mid-1900s and in 1977 a nationwide Childhood Immunization Initiative was developed with the goal of increasing vaccination rates among children to ninety percent by 1979.