Information

For the administration of the vaccination, please contact the attending paediatrician.

For healthy children and adolescents under 18 years of age, there is currently no general vaccination recommendation (basic immunization or booster). Nevertheless, there are still no safety concerns for vaccination of children and adolescents, but potential adverse events (e.g., myocarditis) could not be excluded with certainty.  

Babies, children, and adolescents 6 months of age and older with underlying diseases who are at increased risk for severe COVID-19 are recommended to receive basic immunization and booster shots. Further information on this can also be found in the recommendations of the STIKO (as of 18.09.2023)

Infections with temperatures >38°C are a temporary contraindication; vaccination can be given after the fever has subsided.

According to the RKI, only a few persons cannot be vaccinated due to allergies to components of the COVID-19 vaccines. As a rule, persons who cannot be vaccinated with one of the vaccine types can be vaccinated with one of the others.

Yes, basic immunization plus booster vaccination is recommended for pregnant women from the 2nd trimester.

Pregnant women should be vaccinated with Comirnaty and not Spikevax regardless of their age. Basic immunization is recommended with two doses of mRNA vaccine. A minimum interval of 6 months should be observed.Please note that vaccination with Nuvaxovid and Valneva is not recommended during pregnancy and lactation.

Furthermore, there is an explicit vaccination recommendation for persons of childbearing age, especially those of childbearing potential, to be well protected against COVID-19 in a future pregnancy.

For breastfeeding women, the same recommendations apply according to their age as for the general population or, in the case of disease- or work-related indications, the same recommendations as for groups of persons at increased risk.

The STIKO assumes that a passed symptomatic or asymptomatic infection with SARS-CoV-2 is not sufficient to prevent subsequent COVID-19 disease. Rather, immunologic studies and observational clinical studies have shown that solid protection against infection and severe disease caused by variants of SARS-CoV-2 can only be obtained by repeated exposure to the spike protein of SARS-CoV-2. This can be achieved by vaccination three times or by a combination of natural infection and vaccination (hybrid immunity). Therefore, individuals with one or more past confirmed SARS-CoV-2 infections* should also be vaccinated. The chronological order of occurrence of the three immunological events (SARS-CoV-2 infection or COVID-19 vaccination) is irrelevant.

However, there must be a minimum time interval between the respective events for them to be evaluated as two separate immunologically effective events. The following basic rules should be observed:

• The minimum interval between the 1st and 2nd vaccination is 3 (Comirnaty, Nuvaxovid) or 4 weeks (other vaccines).
• There must be an interval of >3 months between two consecutive SARS-CoV-2 infections.
• Since August 2022 (see 21st update), the STIKO recommends an interval of >3 months between a passed SARS-CoV-2 infection and a subsequent COVID-19 vaccination.
• The minimum interval between second and third events is 3 months.
• If the minimum interval between two events is not met, only the later event is usually considered an immunologically effective event.
• To achieve the best possible immunity (hybrid immunity), booster vaccination is also recommended for unvaccinated individuals who have experienced three or more SARS-CoV-2 infections.

Based on these basic rules, the STIKO has summarized in Table 7 of the 22nd update of the COVID19 vaccination recommendation for different vaccination and infection histories the further procedure with the necessary immunizations in each case.

Persons with an indication for a 2nd booster vaccination who have experienced a SARSCoV2 infection within an interval of > 3 months after the 1st booster vaccination are not recommended a 2nd booster vaccination for the time being. If the infection occurs ≤ 3 months apart, it is not considered an independent immunologic event. In this case, the indicated 2nd booster vaccination should be administered at least 3 months apart after the infection.

* Evidence of confirmed, passed-through SARS-CoV-2 infection can be obtained by direct pathogen detection (PCR) at the time of infection or by detection of specific antibodies that prove passed-through infection. The laboratory diagnostic findings should have been collected in a laboratory working according to the guideline of the German Medical Association for quality assurance of laboratory medical examinations (RiLiBÄK) or accredited according to DIN EN ISO 15189.

The current recommendation of the STIKO no longer provides for a vaccination interval between the Corona vaccination and the administration of inactivated vaccines. Provided that there is an indication for vaccination against other diseases such as influenza, as well as against COVID-19, simultaneous administration of the two vaccines is possible.

When 2 vaccines are administered simultaneously, it should be noted that vaccine reactions may occur more frequently than when administered separately. Efficacy and safety with concurrent use of different vaccines are generally equivalent to those with each used alone.

There is no general vaccination obligation for all citizens in Germany.

Until now, the Standing Committee on Vaccination (STIKO) has recommended that all persons vaccinated abroad with a vaccine not licensed in the European Union should receive a new vaccination series with a vaccine licensed in the EU.

With the 19th update of the COVID-19- vaccination recommendation dated March 31, 2022, STIKO has now adapted this recommendation. A new complete vaccination series is now no longer necessary in every case.

Recommendation for fully basic immunized persons

The recommendation of the Standing Commission on Vaccination (STIKO) concerns the following vaccines not licensed in the European Union:

• CoronaVac by Sinovac
• Covilo from Sinopharm
• Covaxin from Bharat Biotech International Ltd.
  (inactivated whole virus vaccines)
   
• Sputnik V from Gamelaya
  (vector-based vaccine).

Individuals who have been fully primed (i.e., vaccinated twice) with any of these vaccines or have received a priming plus booster vaccination with any of the above vaccines are recommended to receive 1 mRNA vaccine dose at least 3 months apart from the previous vaccine dose.

If a laboratory-diagnostically confirmed SARS-CoV-2 infection has occurred after completed basic immunization with one of the above-mentioned vaccines not licensed in the EU, the mRNA vaccination should be administered no earlier than 3 months after infection.

Here, the age-dependent use of Comirnaty and Spikevax should be considered. The STIKO recommends the vaccine Spikevax from Moderna only for persons over 30 years of age and - regardless of age - not for pregnant women.

Persons with one vaccine dose

Persons who have received only one dose of one of the above vaccines should, however, receive a new vaccination series with basic immunization and booster vaccination according to the COVID-19 vaccination recommendation of the STIKO.

Rationale for the recommendation

According to STIKO, current data show that after basic immunization with inactivated whole virus vaccines, which have not yet been licensed in the EU, booster vaccination with an mRNA vaccine leads to good protection. This is comparable to the protection achieved with three mRNA vaccinations.

According to STIKO, there are no corresponding data for Sputnik V so far. However, for immunological reasons, it can be assumed that a single mRNA vaccination after Sputnik V basic immunization is similarly effective as the mRNA booster vaccination after the vector-based vaccines Vaxzevria or COVID-19 vaccine JCovden.

Recommendation on other vaccines not licensed in the EU
For persons who have received vaccines not licensed in the EU other than those mentioned above, the STIKO recommendation of a renewed vaccination series with a vaccine licensed in the EU continues to apply. Here, the age-appropriate COVID-19 recommendations of the STIKO must be observed.

The Standing Commission on Vaccination publishes the epidemiological bulletin several times a year. Here, the recommendations of the STIKO for the administration of COVID-19 vaccinations are explained in detail.

An overview of the issues of the Epidemiological Bulletin can be found on the pages of the RKI.