To vaccinate or not to vaccinate? This question is asked by all parents when the baby grows up to a certain age. Many Russian families believe that such a practice is not accepted in the European part of the continent, and therefore, aligning with the West, face a huge choice - to let the child get sick and develop immunity (which does not end well in all cases) or still protect him from dangerous consequences. ... Vaccinations in Germany are the responsibility of STIKO, the Permanent German Commission for Vaccinations, which operates at the Robert Koch Institute in Berlin.
What you need to know about vaccination in Germany
According to the STIKO classification, all vaccinations are divided into:
- mandatory - in the presence of certain chronic diseases;
- recommended - developed by the Koch Institute;
- those that the citizen wants to do at his own discretion - for example, when traveling to tropical countries.
In general, vaccination of children in Germany is not mandatory. Parents have the opportunity to decide on their own whether it is worth doing it or not.
However, most of the little Germans are still vaccinated. According to research by the Koch Institute, about 95% of first-graders have basic vaccinations.
Almost every pediatrician during the appointment will consider it necessary to convince parents that it is still necessary to vaccinate if they are not too sure of their decision. But he will not insist too much. This is not accepted in Germany.
Whether revaccination is required depends on the drug itself and on the disease that it is supposed to prevent. For example, the flu shot must be repeated annually, especially for those at risk.
Vaccination schedule in Germany
What vaccinations are given in Germany is determined by the plan drawn up by STIKO (Ständige Impfkomission). Information about all vaccinations is recorded in a special book.
If a newborn baby has not been exposed to any illnesses during the first two months of his life, the first vaccination will be given to him at the 9th week after birth. For this period, it is planned to introduce a combined drug that protects against 6 diseases at once:
- hepatitis B,
- diphtheria,
- Haemophilus influenzae type b,
- polio
- tetanus
- whooping cough.
Among the side effects, doctors call the following: a local reaction from the injection and an increase in temperature up to 39 degrees. This is observed in 5-15% of cases in the first few hours after drug administration. The effect on the cardiovascular system is possible in extremely rare cases - one child in one million vaccinated babies.
The most effective and easily tolerated vaccine is considered to be the vaccine against jaundice (hepatitis A). It can be administered at any age and, together with the previous drug, protects a person from the listed diseases for a long time - about 20 years.
From the second month of life, vaccination against pneumococcus is recommended. This type of pathogen causes meningitis, an inflammation of the lungs, sinuses, and middle ear. Until the moment when the child is six months old, it is necessary to get 3 vaccinations, the fourth is shown at 2 years old. In the presence of severe chronic diseases (asthma, diabetes), it is recommended to carry out additional vaccinations up to the age of five.
The Koch Institute strongly recommends that German citizens vaccinate children against mumps, rubella, measles. For this, a combination vaccine is used for children from 11 months. It protects about 90% of children in the country.
Since 2004, STIKO specialists have advised to vaccinate against chickenpox, the cases of which have become more frequent in recent years in the country. One vaccination is performed at the age of 11-14 months, the second in the interval of 15-23 months.
There is a separate recommendation for girls (12-17 years old) - the HPV vaccine (papillomavirus). This must be done before the first sexual intercourse. Vaccination is performed in three passes over 6 months. This vaccine can help reduce the incidence of cervical cancer.
Influenza immunization has gained particular relevance in recent years. Children with metabolic disorders, chronic bronchitis, kidney, heart and vascular diseases are vaccinated without fail.
Children are allowed to be vaccinated from six months of age. This protects the baby for about 1 year. Revaccination is indicated in the fall, before the cold season begins. Pregnant women can get vaccinated after the 12th week of their term or before the planned pregnancy occurs.
But the BCG vaccination, which protects the body from tuberculosis, has been canceled here since 1998. This is due to the fact that the risk of contracting it in Germany is 0.1%. With this indicator, the World Health Organization does not recommend general vaccination. Actually, the drug itself is no longer produced in the country.
The German national vaccination calendar, developed by the Koch Institute, looks like this:
| Age | Vaccination serial number | Vaccination type |
|---|---|---|
| 6 weeks | 1 | Rotavirus infection |
| 2 months | 1 | Tetanus, pertussis, diphtheria, poliomyelitis, haemophilus influenza type b, pneumococcus, hepatitis B. |
| 2 months | 2 | Rotavirus infection |
| 3 months | 2 | Tetanus, pertussis, diphtheria, poliomyelitis, haemophilus influenza type b, pneumococcus, hepatitis B. |
| 3-4 months | 3 (if necessary) | Rotavirus infection |
| 4 months | 3 | Tetanus, pertussis, diphtheria, poliomyelitis, haemophilus influenza type b, pneumococcus, hepatitis B. |
| 4 months | 2 | Pneumococcus |
| 11-14 months | 4 | Tetanus, pertussis, diphtheria, poliomyelitis, haemophilus influenza type b, pneumococcus, hepatitis B. |
| 11-14 months | 3 | Vaccination against pneumococcus |
| 11-14 months | 1 | Mumps, measles, rubella, chickenpox |
| 12-23 months | 1 | Meningococcemia C |
| 15-23 months | 2 | Mumps, measles, rubella, chickenpox |
| 5-6 years old | 1 revaccination | Diphtheria, tetanus |
| 9-14 years old | Two doses six months apart | HPV for girls |
| 9-17 years old | 2 revaccination | Diphtheria, tetanus |
| 9-17 years old | 1 revaccination | Polio |
| 9-17 years old | 1 | Type B hepatitis (the main stage of immunization of all children who have not been vaccinated) |
| 9-17 years old | 1 | Chickenpox (for those who have not been previously vaccinated and have not had this disease) |
| from 18 years old | After treatment or revaccination | Diphtheria, tetanus |
| from 18 years old | After treatment, if necessary | Measles (main vaccination for all those born before 1970 who do not have the measles vaccine). |
What the vaccination process looks like
Even if you started the vaccination process in your home country, you can easily continue it in Germany. To do this, you must have with you a list of vaccinations that you have already done. You need to compose it in German or English. It is important that the document contains the following data:
- name of the disease;
- date of vaccination.
All information is contained in the child's card. You just need to translate it and show it to your doctor during your appointment. Further, the doctor himself will tell you which vaccination is recommended for you according to the schedule. The next thing to do is fill out a questionnaire. In it you need to display data about the health of your baby:
- the presence of allergies;
- previous illnesses;
- developmental deviations;
- other complaints.
In a word, indicate everything that you consider necessary to tell the doctor. But remember that you need to enter the information in German.
The vaccine itself is done by the doctor. Sometimes a nurse helps him. Next, you should be explained what to do and what not to do after vaccination, what reaction may occur, what to do if the temperature rises.
Medical terms in German
The most difficult thing for foreigners who do not know German is listening to medical terminology. And although for many diseases Latinisms are used, which are understandable even to ordinary people, it is still better to have before your eyes the basic concepts that the doctor will appeal to:
| Russian variant | German translation |
|---|---|
| Haemophilus influenza type b | Haemophilus influenzae type b |
| Diphtheria | Diphterie |
| Viral hepatitis A | Hepatitis A |
| HPV | Humanes Papillomvirus |
| Viral hepatitis B | Hepatitis B |
| Flu | Influenza |
| Measles | Masern |
| Measles-rubella-mumps | MMR |
| Meningococcal conjugate vaccine | Meningokokken Konjugatimpfstoff |
| Whooping cough | Pertussis |
| Parotitis | Mumps |
| Pneumococcal conjugate vaccine | Pneumokokken Konjugatimpfstoff |
| Polio | Poliomyelitis |
| Smallpox | Pocken |
| Rubella | Röteln |
| Tuberculosis | Tuberkulose |
| Tetanus (tetanus) | Tetanus |
| Chicken pox | Windpocken |
| Shingles | Gürtelrose |
| Rotavirus | Rotavirus |
| Vaccination | Impfung |
| Vaccine | Impstoff |
| Live vaccine | Lebendimpfstoff |
| Syringe | Spritze |
| Needle | Nadel |
| Revaccination | Auffrischimpfung |
| Dead vaccine | Totimpfstoff |
| Side effects | Nebenwirkung |
| Contraindications | Kontraindikation |
| Allergy | Allergie |
| Heat | Fieber |
| Pregnancy | Schwangerschaft |
| Edema, swelling | Schwellung |
| Redness | Rötung |
| Doctor | Arzt |
| Date of next vaccination | Nächster Impftermin |
| Vaccination passport | Impfausweis |
Vaccination cost in Germany
It should be recalled that medicine in Germany is based on compulsory insurance. This means that every month every citizen makes contributions to the so-called health insurance funds. As far as vaccinations are concerned, not all vaccinations are free. Those recommended by the Koch Institute are covered by insurance (see calendar).
Most often, the funds also pay for the booster vaccination against whooping cough, tetanus and diphtheria for Germans aged 18 to 60 years. Older people can also count on the German flu and pneumococcal vaccine to be free of charge as well.
There is also such a thing as "compulsory vaccination". For example, it is required for those who have diabetes or bronchial asthma. In this case, the funds also cover the costs of this type of immunization.
The only exceptions are injections that are necessary for travel to exotic countries and those that the patient wants to do on his own initiative. These vaccinations will be paid for. On average, one consultation and vaccination session in 2021 can cost about 50 euros.
Is it possible to refuse
Since the vaccination of children in Germany is not compulsory, parents have every right to refuse. According to pediatricians, the main problem is not that parents do not want to vaccinate their babies, but that they agree, but do not adhere to the calendar. This can be judged by the low rates of repeated vaccinations - against chickenpox, rubella, measles.
Knowing the organization of the Germans, it is difficult to imagine that they can “forget”, “not be in time” or succumb to the influence of circumstances. In fact, a person is really capable of deviating from the schedule for personal reasons, even if he is not at all opposed to vaccinations. On his way, there are always some obstacles, the main one of which is the insufficiently flexible health care system.
For example, the vaccine cannot be given at the pharmacy. It is imperative to make an appointment with a doctor, sit out the queue, and get specialist advice. And this does not always fit into the rhythmic day of the average citizen.
The percentage of parents who flatly refuse to vaccinate their children is very low in Germany. At the same time, most of the opponents are well-educated people who read a lot and know a lot. But German doctors warn that even in Germany there is a lot of pseudo-medical literature that forms the wrong opinion among the population.
The middle option between those who strongly oppose vaccinations and those who agree to follow the calendar are anthroposophists - supporters of alternative medicine, based on the treatment not of a specific disease, but of the body as a whole system.
Do I need vaccinations when I enroll in kindergarten?
The greatest concern of parents is the question of the need for vaccinations by the time the baby will have to be sent to kindergarten. Given the fact that vaccination in the country is recommended and not mandatory, it can be assumed that there will be no big problems with this.
All injections are recorded in the vaccination diary. Admission to kindergarten for those who have not done them is not prohibited by law. In some cases, they may ask if the child is protected from tetanus. But they will do this only so that if he gets hurt, the educators would know how to treat him.
There is no need to write a refusal to vaccinate. This is considered voluntary here. All you need to do is simply explain to the doctor that you do not want to put your baby's health at risk.
U-Untersuchung in Germany: what is it
As soon as a baby is born in a German family, parents must perform two steps:
- find a pediatrician for him who will conduct a control examination when the child is 1 month old;
- inform the insurance company about the addition to the family, which will make it possible to issue a policy for a new family member. The doctor will not conduct an examination without insurance.
During the first year of life, the baby will have to undergo 6 control examinations, which are called Untersuchung and are indicated in the child's card with the letter U. The first two are carried out in the maternity hospital. In general, the graph looks like this:
- U1 - immediately after birth;
- U2 - after two days;
- U3 - 4-5 weeks;
- U4 - 3-4 months;
- U5 - 6-7 months;
- U6 - 10-12 months;
- U7 - 2 years old;
- U7a - 34-36 months One of the recently introduced inspections. Its main task is to make sure that the child is ready for kindergarten.
- U8 - 46-48 months;
- U9 - 60-64 months;
- U10 - 7-8 years old;
- U11 - 9-10 years old.
After that, the next visit to the doctor is scheduled for 13 years. It is worth noting that the last 4 examinations were introduced recently and are not yet paid for by all health insurance funds.
Summarizing
Vaccination of children in Germany is carried out on a voluntary basis. No doctor will force parents to go against their will, but will try to give the necessary arguments so that they change their mind. All issues of immunization in the country are handled by the STIKO Standing Commission, which operates on the basis of the Koch Institute.
As in any other country, in Germany there are both supporters of vaccination and its opponents. And yet, most of the children here are vaccinated according to the calendar developed by the Institute. It is noteworthy that even with admission to kindergarten, they do not oblige to get all the vaccinations. But if you still decide to protect your child with the help of special drugs, you will have to make an appointment with a doctor who will conduct an examination to identify contraindications. The vaccinations recommended by STIKO are paid for by the health insurance funds.
