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“It’s one of these decisions that, if it’s well managed, could be helpful,” says Heidi Larson, director of the Vaccine Confidence Project and lead author of the survey.“If it’s very top-down, [it] could totally backfire.” Larson says the measure will “undoubtedly” rile up hard-line anti-vaccine activists; the home of a government spokesperson was spray-painted with anti-vaccine slogans this week, and far-right politician Marine Le Pen has already voiced her opposition to the proposal.Sites such as the pro-homeopathy routinely publish articles about unfounded links between vaccines and various conditions, such as autism or sudden infant death syndrome, supported by prominent “experts” like the discredited physician Henri Joyeux.Such conspiracies appear to have resonated with the French public; fourteen of the first 16 results on an Amazon France search for “vaccines” are books that either explicitly condemn or raise doubts about vaccination.“The difference between France and the Anglo-Saxon world is that there are very few citizen groups or associations that mobilize in favor of vaccinations,” says Jocelyn Raude, a sociologist at the EHESP French School of Public Health, who describes the call for mandatory vaccines as “courageous.” Raude says that over time, a “constellation” of anti-vaccine groups has emerged online, uniting both far-left ecologists and far-right nationalists, like Le Pen.Recent controversies have helped fuel vaccine skepticism in France.But Larson says it’s important for the government to engage with more moderate skeptics, and to convince them “that this is not just a control effort, in terms of controlling people’s actions,” but a public health initiative.

Legal cases have also been filed over alleged links between the Hepatitis B vaccine and multiple sclerosis (there is no evidence of such a link), and French media outlets seized on allegations that the WHO was unduly influenced by pharmaceutical companies in launching a H1N1 flu vaccination campaign in 2009.Italy passed a similar decree in May, requiring children to receive 10 vaccines as a condition for school enrollment.Germany, while stopping short of a mandate, has moved to tighten its laws on child immunization.The government’s proposal would expand that list to include eight other vaccines — including those against Hepatitis B, whooping cough, and measles — that were previously only recommended.The proposal, which is to be presented to lawmakers by the end of this year, comes amid an ongoing measles outbreak across Europe, which the World Health Organization (WHO) attributed to low immunization rates.

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