(CNN) Parents in Germany who fail to vaccinate their children could face hefty fines after the German government backed a bill requiring all children to receive a measles jab before entering school or kindergarten.
If the German parliament approves the bill, parents will be required to provide evidence that their child has been vaccinated before they are enrolled, and will face fines of up to €2,500 ($2,800) if they fail to do so.
"Whether in kindergarten, at the childminder or at school -- we want to protect all children against measles infection," Health Minister Jens Spahn said in a statement.
The move comes as Germany reported one of the highest numbers of measles cases in Europe between March 2018 and February this year, at 651, according to the European Centre for Disease Prevention and Control. In 2019, 429 cases were registered in Germany by mid-June, the Health Ministry said, suggesting the problem is escalating.
Measles is a highly contagious disease caused by a virus that can spread through the air when an infected person coughs or sneezes. It can also spread if someone comes into direct contact or shares germs by touching the same objects or surfaces. Measles symptoms may include fever, cough, runny nose, watery eyes and a rash of red spots.
It takes two doses of the vaccine to protect from measles. While 97% of German children had their first dose, the percentage that received the second dose dropped to 93%, the World Health Organization said for 2017. Experts say about 95% of people must be vaccinated to make communities immune.
Measles has seen a wider resurgence around the world -- in high-income countries in the Americas and Europe and lower-income nations in Asia and Africa -- fueled in part by fear of and lack of access to vaccines, and complacency. And while numerous studies have debunked claims that measles vaccinations cause autism, widespread fear persists.
Under the policy, parents would have to present a certificate proving their child has received both vaccinations.
Unvaccinated children will be excluded from kindergartens, the ministry said.
WHO has deemed vaccine hesitancy -- the reluctance or refusal to vaccinate despite the availability of vaccines -- a top 10 threat to global health in 2019.
Among high-income countries, the United States topped the list of children not vaccinated with the first dose, according to WHO. There have been 1,123 there as of Friday, according to the US Centers for Disease Control and Prevention, the greatest number reported in the United States since 1992 and since measles was declared eliminated in 2000, meaning it was no longer continuously transmitted in the country.