Vaccinations are important for your child's health.

    Before each vaccination it is important to discuss with the parents what the advantages of the vaccination are for your child and what needs to be considered (vaccination information). You can find information sheets on vaccinations under the following links:



    Tetanus - Diphterie - Pertussis - Polio - Hepatitis B - HIB (6-fach Impfung) (hier: international)

    Pneumokokken (hier: international)

    Rotaviren (ihier: nternational)

    Meningokokken B 

    Masern - Mumps - Röteln - Varizellen (hier: international 1 + 2)

    Meningokokken C (hier: international)

    Tetanus - Diphterie - Pertussis

    HPV (hier: international)

    Tetanus - Diphterie - Pertussis - Polio (hier: international)


    You can find the current vaccination schedule on the Robert Koch Institute website.

    Immunization of children


    No evidence to support parents' concerns about vaccinating too much too soon

    from: Dtsch Arztebl 2018; 115 (20-21): A-1007 / B-851 / C-850


    Vaccinations are the most important pillar of health care for children worldwide. The number of recommended vaccinations has increased since the 1990s, also in Germany. Some parents fear that their children could be weakened by the many recommended vaccinations and that they have an increased risk of becoming infected with pathogens that have not been vaccinated. A large “nested” case control study in the USA has addressed this issue.

    The cohort consisted of 495,193 children from 6 US health networks whose data was collected between 2003 and 2013. There were 47 061 infectious diseases caused by pathogens that were not vaccinated against (non-vaccine-targeted infections), of which 193 were found in children between 24 and 47 months. Those were the "cases". They were matched 1: 4 with non-cases (no non-vaccine-targeted infections) that were comparable in the other relevant parameters (n = 751). The mean age of the entire group (n = 944) was 32.5 months. The aim was to estimate the likelihood of non-vaccine-targeted infections in relation to the antigen doses administered.

    During the first 24 months of life, the children in the case group had received an average of 240.6 antigen doses and in the control group 242.9 antigen doses. The difference was +2.3 antigen doses (control vs. cases; p = 0.55; not significant).

    Conclusion: In children aged 24 and 47 months, the risk of infections caused by pathogens that are not part of vaccines does not increase as a result of increasing exposure to vaccine antigens. The vaccinations do not interfere with the immune system's ability to fight off pathogens effectively. "The concern that the many childhood vaccinations ultimately lead to a weakening of the immune system and thus more frequent infections is unfounded," commented Prof. Dr. med. Johannes Hübner, 1st chairman of the German Society for Pediatric Infectious Diseases, Department for Pediatric Infectious Diseases, Dr. von Hauner's Children's Hospital, Ludwig Maximilians University, Munich. “This is shown by this extensive and methodologically very good current study from the USA. The results can easily be transferred to the German situation; the vaccination plans are similar. The study confirms that vaccinations do not lead to more infections, as those who oppose vaccinations often claim. "

    Dr. rer. nat. Nicola Siegmund-Schultze

    Original work:

    Glanz JM, Newcomer SR, Daley MF, et al .: Association between estimated cumulative vaccine antigen exposure through the first 23 months of life and non-vaccine-targeted infections from 24 through 47 months of age. JAMA 2018; 319: 906-13.


    This flyer is intended to help you as a parent or as a teenager to better understand the necessity of the HPV vaccination. In the summer of 2018, the STIKO (Standing Vaccination Commission for Germany) expanded its vaccination recommendation for HPV vaccination and now recommends this vaccination not only (as before) for girls, but for all children and adolescents from 9-14 years of age.
    Missing vaccinations should be made up for before the 18th birthday at the latest. According to the decision of the Federal Joint Committee (G-BA) and publication in the Federal Gazette, the costs for this vaccination are covered by all health insurances.


    What does HPV mean?

    »HPV stands for Human Papilloma Virus. HPV infections are among the most common sexually transmitted infections worldwide. A distinction is made between high-risk and low-risk types for HPV, whereby persistent infections with high-risk types can in rare cases lead to different types of cancer (cervical cancer, vaginal cancer, anal cancer, penile cancer, tongue / throat / throat cancer).

    »There are currently 12 high-risk HPV types classified as carcinogenic, with type 16 playing a dominant role. The low-risk HPV types can trigger genital warts.


    How many cases are there in Germany?

    »In Germany, despite a long-standing early detection program, around 4,600 women develop cervical cancer every year and around 1,600 die from it every year.

    »Approx. 1,750 men and women develop anal cancer every year, around 400 die from it.

    »About 850 people of both sexes develop cancer of the oral cavity or throat caused by HPV every year, with a death rate of 50%.

    »Around 750 men develop penile cancer each year, of which around 170 die



    How does HPV develop into cancer?

    “It is now scientifically proven that almost all cervical cancer cases are due to HPV. With the others mentioned
    So far, science has assumed that at least half of all cancers are caused by HPV.

    »The infection with HPV usually takes place in the first years of sexual activity through direct contact with the skin and mucous membrane of the vagina, uterine neck, anal region or mouth. The infection occurs in around 80% of all men and women, regardless of their sexual orientation.

    »In the vast majority of infections, this goes unnoticed and heals within 1 to 2 years without any consequences. During this time, the affected persons
    at times contagious to their sexual partners.

    “In a few cases, however, the infection does not heal and can lead to the respective types of cancer in a gradual process via various preliminary stages. The-
    This process often takes many years and often goes unnoticed. With the existing gynecological cancer early detection program, some of these disease courses can be discovered and stopped, and often also cured. If the disease is detected at a late stage, the therapy is usually associated with risky surgical interventions.


    And what is the HPV vaccination for?

    »The HPV vaccination helps the vaccinated adolescents to achieve long-lasting immune protection against the HPV virus types on the skin and mucous membranes represented in the vaccines, so that after sexual contact with an HPV-infected partner they do not become infected with these HPVs Types and thus a significantly reduced risk of later cancer.

    “It therefore makes sense and is most effective to vaccinate children against HPV, before starting sexual activity. The more young people are vaccinated, the less the HPV infection can spread later.

    »The effectiveness of the HPV vaccination has been carefully examined both before the introduction of the vaccine (2007) and since then. Around 300 million vaccine doses have now been vaccinated worldwide. Due to the long period between an HPV infection and the development of an HPV-associated carcinoma, the number of prevented HPV-related cancer cases cannot yet be reliably measured. So far, however, all studies on the effectiveness of the vaccine against persistent HPV infections or against precancerous stages caused by HPV in cervical cancer show that the vaccines available are very effective.


    Are there any side effects?

    »The safety of HPV vaccines with regard to side effects, complications and vaccine damage has been checked worldwide since the introduction of this vaccination. The Vaccine Safety Commission of the World Health Organization (GACVS, Global Advisory Committee on Vaccine Safety) last approved the HPV vaccination in 2017 after more
    than 270 million vaccinated doses worldwide. Like numerous national approval authorities, it comes to the conclusion that the HPV vaccines are very safe and classifies the possible side effects (pain, swelling, redness at the vaccination site, mild feeling of illness for 1-3 days) or complications (circulatory problems up to Fainting immediately after vaccination) as acceptable. These side effects are rare, last for a short time and heal completely. The risk of a life-threatening allergic reaction is no greater than with other vaccinations (approx. 1 case in 1.7 million vaccinations).


    Who is not vaccinated?

    »Vaccinations can be given for mild illnesses without a high fever. For more severe illnesses that require treatment, the best time to vaccinate should be with your
    Pediatrician should be discussed.

    »Children or adolescents who have already reacted to another vaccination with clearly allergic symptoms should only be vaccinated after consulting their pediatrician.


    What vaccines are available?

    »There are currently 2 vaccines: Cervarix® protects directly against HPV high-risk types 16 and 18 and indirectly against some rarer high-risk types, Cervarix® achieves protection against approx. 80% of HPV high-risk types. Gardasil9® protects directly against the HPV high-risk types 16, 18, 31, 33, 45, 51 and 58, thus against approx. 85% of the HPV high-risk types as well as the low-risk types 6 and 11.


    Who should be vaccinated?

    “So far only the girls have been vaccinated. Now the recommendation has also been extended to boys. All children should be vaccinated at the age of 9-14 years, twice with an interval of 6 months. The vaccination series can easily be started with the early detection examination U11 (with 9-10 years) or the youth health examination J1 (with 12-14 years) at your pediatrician. If vaccination is not started until the age of 15, a total of three vaccinations are required.

    Who pays for the vaccination?

    »Statutory and private health insurance reimburses the HPV vaccination up to the 18th birthday (after publication in the Federal Gazette).


    Additional information on the Internet:


    Dr. Martin Terhardt, pediatrician, member of STIKO, Berlin

    Dr. Thomas Fischbach, pediatrician, president of the professional association of paediatricians, Cologne

    Status: October 2018







    20 general questions and answers about vaccinations


    This page is a copy of the “Vaccination protection for the whole family” page of the Federal Center for Health Education


    1. Why is it important to have your child or yourself vaccinated?

    Every day we come into contact with a large number of bacteria and viruses. Most of them affect us little or no. In addition, there are also pathogens that can cause serious, even life-threatening diseases.
    In many cases, vaccinations not only protect the vaccinated person, but also prevent the disease from spreading to the population. So-called “herd immunity” is particularly important to protect people who cannot be vaccinated themselves, for example because their immune system is not working properly.
    Whooping cough, for example, can cause severe shortness of breath in very young infants. The vaccination of parents and contact persons protects the infant
    a transmission of the pathogen before one's own basic immunization is completed (“coconut strategy”).

    Info: The Standing Vaccination Commission (STIKO) at the Robert Koch Institute in Germany gives recommendations on vaccinations. You can find the most important information on this at


    1. Why should one be protected from so-called childhood diseases such as measles?

    A frequent question with many of the recommended vaccinations is: "Why should you get vaccinated against supposedly harmless childhood diseases such as chickenpox and measles?" However, they are only called childhood diseases because they are so contagious that many children get sick without vaccination. Without immune protection, however, adults also get sick and often even have a more severe course of the disease.
    Diseases like measles are not harmless. Even if most measles illnesses heal without consequences, in some cases serious or even life-threatening comorbidities such as pneumonia or brain infections occur. As a long-term consequence, a fatal breakdown of the brain can develop. In any case, measles disease is a vaccine-preventable burden for the child.

    Info: In addition to the measles vaccination for children, the STIKO recommends a one-time vaccination against measles for all those born after 1970 who have not yet been vaccinated or only vaccinated once or whose vaccination status is unclear.


    1. What actually happens with a vaccination?

    So that humans are not defenseless against pathogens, their immune system protects them from intruders into their bodies. A defense strategy that the body uses after contact with pathogens is the formation of so-called antibodies. In addition, the body's own defense system can form “memory cells” which can recognize pathogens and fight them quickly even after years.
    The idea of vaccination was born from the fact that the immune system can learn to react to certain pathogens with a targeted defense measure: weakened or killed pathogens are usually smuggled into the body that do not trigger an infection, but which the body reacts to reacts with the formation of antibodies and memory cells. Vaccination is a “training” of the immune system against the respective disease.


    1. What is the difference between live vaccines and inactivated vaccines?

    Various types of vaccines are available for training the immune system through a vaccination: A distinction is made between attenuated live vaccines and inactivated vaccines.
    Live vaccines contain the pathogens in a form in which they are still able to reproduce but can no longer trigger the disease. Inactivated vaccines contain either killed pathogens or even only parts of them to which the immune system can react. Most vaccines are inactivated vaccines.

    Info: The tolerance and effectiveness of vaccines are tested in clinical studies and their safety is regularly monitored after approval. Its success has proven itself in millions of uses.


    1. Why do some vaccinations protect for a lifetime, others need to be refreshed more often?

    You know it from everyday life: some things stay unforgettable because they are connected with strong feelings, others have to be reminded again and again.
    It is similar with the “memory” of the immune system. The more intense the examination of a pathogen, the greater the likelihood that it will be recognized by the body's defense system when it penetrates later.
    Vaccinations with live vaccines in particular (see question 4) have a similarly strong impact on the immune system as a survived illness, but without exposing people to the risks of the illness. Because the weakened pathogens continue to multiply in the body, the body has to do more defensive work - an event that leads to longer protection.

    Attention: Inactivated vaccines in particular require two to three partial vaccinations in order to achieve the so-called basic immunization, i.e. to learn the immune system and to establish reliable vaccination protection.


    1. Which vaccinations are really important?

    Which vaccinations are really important?
    There is an opportunity to protect yourself against many different diseases through vaccinations. The recommendations in the public vaccination calendar reflect the latest scientific knowledge about which vaccinations are important at which age. The aim is - in addition to the personal health of each individual - to ensure the protection of the entire population through high vaccination rates.
    In addition, there are effective and safe vaccinations that are not recommended by the Standing Vaccination Commission for the whole population. These vaccinations can still be useful as a supplement for you, depending on your health situation; get advice from your doctor.


    1. Can there be any side effects from vaccinations?

    Yes - side effects are possible, but they are usually harmless and go away quickly. Every vaccination - like the administration of medication - is an intervention in the body, which is also supposed to trigger a reaction. This can lead to side effects such as redness or swelling at the puncture site. Feelings such as exhaustion, possibly also headaches and body aches, can occur.
    These are signs that the body is dealing with the vaccinated pathogen and building up protection. Such vaccine reactions, however, are much less bad than the symptoms or even the consequential damage of the disease, which can be prevented thereby. In general, vaccinations are very safe and serious complications rarely occur.

    Info: Before the vaccination, your doctor will explain possible side effects to you.


    1. How compatible are the additives contained in the vaccine?

    Some people fear that additives to vaccines that increase their effectiveness (so-called adjuvants) or extend their shelf life (preservatives) may cause intolerance or damage their health. The tolerability of vaccines is checked very carefully when they are approved and monitored afterwards, so that these concerns are unfounded.
    Combination vaccines are often used, which protect against several pathogens at the same time. A single vaccination instead of five or six syringes also keeps the amount of additives as low as possible.


    1. Do you really have to have that many vaccinations at once?

    Even if one could suspect that combination vaccines against three, four or more infectious diseases could overwhelm the body: The immune system of a young child can cope well with these - the organism is exposed to many more pathogens in everyday life.
    In addition, modern combination vaccines contain far fewer components of the pathogen or antigens than older vaccines or the pathogen itself.
    Combination vaccines are a great relief for children and parents because the number of syringes can be significantly reduced.

    Tip: The Standing Vaccination Commission (STIKO) recommends combination vaccines if possible. Get advice from your doctor.

    1. Is It Better To Vaccinate Than Going Through The Disease?

    The child's immune system is trained by both the disease and the vaccination. Both times it has to take action to build up protection.
    A vaccination offers the opportunity to train the immune system on a harmless opponent. Infections, on the other hand, can set children back in their development and cause health complications and even death. This is exactly what can be avoided with vaccinations.
    For example, if a meningococcal infection triggers meningitis, every tenth child dies from it even today.


    1. Can I infect myself or others after a vaccination?

    Most of today's vaccines are inactivated and therefore cannot cause the disease they are designed to protect against, nor can one become infected with it. Even with attenuated live vaccines, it is very rare that vaccinated people can infect others. Immune-weakened people are particularly at risk.
    Those cases in which polio occurred after an oral vaccination have become historic in this country. Such an event was very rare - it only occurred about one in four million vaccinations. But even today, many people are afraid of such a side effect. A vaccination has been administered in Germany since 1998 that does not contain any live viruses and can no longer trigger the disease.

    Attention: In rare cases the vaccination can trigger so-called "vaccination measles". The course is much milder than with real measles and there are no complications. In addition, vaccine measles are not contagious.


    1. Vaccinations and allergies - what should you watch out for?

    An allergy means an "excessive" defense reaction of the immune system against certain substances. Many parents believe that a child with allergy or at risk of allergy will be stressed or the allergy will get worse from vaccination. However, studies show that this concern is unfounded - for example, children with atopic dermatitis are not at increased risk of their disease getting worse; the opposite seems to be the case with some vaccinations.
    An accumulation of allergies through vaccinations cannot be proven either. One experience in this country even points in the opposite direction: In the former GDR, where vaccination was mandatory and almost all children were vaccinated, there were hardly any allergies.

    Caution: Caution is advised if there is an allergy to vaccine components (e.g. egg white). Here the doctor will check whether a possible risk is greater than the benefit of the vaccine.


    1. How do I find out when which vaccination is due?

    The Standing Vaccination Commission (STIKO) recommends suitable times for certain vaccinations. The sequence of the partial vaccinations as well as the periods after which booster vaccinations should be given are clearly shown in a “vaccination calendar”.
    In the case of children, vaccinations are offered routinely as part of early detection examinations and noted in the vaccination certificate. Certain events such as injuries, major waves of illness (due to measles, for example) or travel will also cause your doctor to check your vaccination protection. Any vaccinations carried out should always be entered in a vaccination card by the doctor.

    Tip: You can find the current vaccination calendar here.


    1. What if I miss a vaccination?

    Missing a vaccination means that protection against the disease in question is patchy or may not be complete. For the earliest possible protection, one should therefore adhere to the vaccination schedule recommended by the STIKO.
    Missed vaccinations should be made up as soon as possible. There are usually no impermissibly long intervals between vaccinations. As a rule, every vaccination counts. However, reliable protection only exists when the basic immunization is complete.
    If the doctor is not sure whether a recommended vaccination has been carried out correctly, he or she will make up necessary partial vaccinations or those not noted in the vaccination certificate at the appropriate intervals.

    Attention: Do not forget your vaccination certificate at vaccination appointments - or have your vaccinations added as soon as possible.


    1. Does a vaccination appointment have to be postponed in the event of illness?

    “My child has a cold” - a reason for some parents to cancel the vaccination appointment. However, as long as he does not have a fever, i.e. a body temperature of over 38.5 ° C, it is not necessary to postpone the vaccination. You can vaccinate even during treatment with antibiotics.
    However, anyone who is being treated by a doctor for serious complaints should wait at least two weeks after recovery before getting vaccinated. Patients with immunodeficiencies or diseases such as multiple sclerosis or rheumatism who use drugs that suppress the immune system should speak to their doctor in detail beforehand about an upcoming vaccination.


    1. Can I still get vaccinated if I have already been infected?

    The best vaccination protection is always that which is established in good time before a possible risk of infection. However, in some cases it is also possible to protect yourself after a suspected infection. If vaccination is active quickly, a few vaccines still provide partial protection (e.g. measles, chickenpox).
    With other vaccinations, for example against tetanus and rabies, the active vaccination is supplemented by a so-called passive immunization. The antibodies against the respective infectious disease are given directly so that the time until the antibodies are formed can be bridged. However, passive immunization only offers short-term protection and cannot replace active vaccination.
    In addition, not everyone immediately notices that they have become infected, so the following applies: Prevention is always better than having to intervene in an emergency.

    Tip: Talk to your doctor if you are not sure about your vaccination status.


    1. Do I have to take extra care after a vaccination?

    Everyone learns: When sick, do not do sports and do not exert too much. A vaccination reaction such as reddening of the puncture site or a slightly increased body temperature is not a disease. Therefore there is nothing to be said against light physical exertion after vaccination.
    However, you shouldn't overdo it: Some sporting activities such as long endurance runs or a workout with high weight loads are so exhausting that they are better left off after the vaccination.
    Certain intervals should also be observed before planned operations: If you are vaccinated with a live vaccine, you should wait two weeks; with inactivated vaccines, three days are enough between vaccination and surgery.

    Caution: In the event of intense physical activity, a vaccination reaction - for example pain at the injection site - may be intensified.


    1. I'm pregnant. Can I get vaccinated?

    All vaccinations with inactivated vaccines can in principle also be carried out during pregnancy - for example vaccinations against tetanus, hepatitis A and B or the flu (influenza). A flu vaccination is expressly recommended for pregnant women.
    If you want to have children, it is important to check the immune status in good time before a pregnancy and, if necessary, to vaccinate against whooping cough, chickenpox, measles, mumps and above all rubella. After vaccination with live vaccines such as the measles, mumps and rubella vaccination, it is advisable to only become pregnant after three months to be on the safe side.
    However, if a woman becomes pregnant immediately after the vaccination or if she is vaccinated during an as yet unknown pregnancy, this did not have any harmful effects on the child in the cases observed so far.

    Tip: During the breastfeeding period, the mother can have herself vaccinated after consulting her doctor.


    1. Why should I get the flu vaccine?

    Many people do not differentiate between a cold and real flu (influenza). A flu vaccination only protects against influenza, not against a feverish cold.
    Influenza waves often claim numerous lives. Older people (over 60 years of age) as well as people with chronic illnesses and pregnant women are particularly at risk. The STIKO therefore recommends that these people get vaccinated against flu.
    Influenza viruses are constantly changing and appearing in new varieties. The vaccine is therefore tailored each year to the three virus variants that are expected to appear most frequently in the upcoming flu season. An annual vaccination offers the best protection for the respective season.

    Tip: If you come into contact with many people, it can be useful to get vaccinated. Medical staff are also advised to have the flu vaccine so that they do not infect themselves or even their patients.


    1. When do I have to pay for vaccinations myself?

    The health insurance companies cover the costs for all vaccinations recommended by STIKO. Some vaccinations, for example against tick-borne tick-borne meningoencephalitis (TBE), are only paid for if there is a reason to do so. This can be, for example, the place of residence or residence in Germany.
    Holidays in distant countries often make it advisable to protect yourself against additional diseases that are more common there by vaccination or other measures. Travel vaccinations usually have to be paid for out of pocket. Ask your health insurance company whether and under what conditions it will reimburse the cost of travel vaccinations.

    Tip: Before you travel, remember that vaccination protection does not apply immediately; You should therefore discuss with your doctor in good time which vaccinations are recommended for your travel destination.


    20 critical questions about vaccinations


    This page is a copy of the page “Vaccinations - 20 Objections and Answers from the Robert Koch Institute and the Paul Ehrlich Institute



    The number of vaccinations is increasing - but are we getting healthier as a result? The question has been discussed again and again, by no means only in recent years. When the smallpox vaccination for children was made compulsory by the Reich Vaccination Act of 1874, the debate turned over and critics founded magazines such as “Der Impfgegner” in order to make their arguments heard.

    Even today, the discussion often revolves around vaccinations for children and the question of whether the injection syringe is doing them more harm than good. Are vaccinations dangerous? Or just superfluous? What role do profit interests in the pharmaceutical industry play?

    One thing is clear: Vaccinations differ from other medical interventions. On the one hand, they aim not only at the benefit of the individual but also at the protection of the entire population. On the other hand, they are carried out on healthy people. It is justified to demand special care when vaccinating and to discuss controversial points critically - not least because vaccinations are one of the most common medical measures.

    In 2005, around 44 million vaccine doses were sold in Germany. About half of this was accounted for by the annual flu vaccination, and another large proportion by vaccinations for children. In 2005, more than 90 percent of those starting school were vaccinated against diphtheria, tetanus, whooping cough, polio, the Haemophilus influenzae bacterium and at least once against measles. Around 85 percent had also received the hepatitis B vaccine recommended for infants since the mid-1990s.

    In Germany, however, there is no compulsory vaccination, unlike in the former GDR, for example. Anyone can refuse a vaccination for themselves or their children without giving a reason. And those who see themselves as opponents or critics of vaccination do so from time to time. Your most frequent objections, 20 in number, are listed here. The answers should help to get an idea of ​​the benefits of vaccination.


    1. The effectiveness of vaccinations has never been proven

    The effectiveness of vaccinations has never been proven
    Actually, there shouldn't be any commercially available vaccines - if this thesis were actually true. Because according to the current pharmaceutical law, a vaccine is only approved if it has been proven that it actually works. The manufacturer must provide evidence in experimental and clinical studies. The scientific evidence is checked at EU level under the direction of the European Medicines Agency EMEA, in this country responsibility lies with the Paul Ehrlich Institute as the Federal Office for Sera and Vaccines.
    That's the legal side. The practical test is probably even more important. With many vaccines, for example, it is easy to understand that with the start of routine use, the relevant infectious disease was significantly reduced. A well-known example of this is the introduction of oral vaccination at the beginning of the sixties: while in the Federal Republic of Germany in 1961 almost 4,700 children were diagnosed with poliomyelitis, there were already fewer than 50 in 1965. After this success, there was no longer any accumulation of polio in Germany given (see also answer number 17).
    The vaccination against the bacterium Haemophilus influenzae (type b), which can cause severe meningitis in infants and young children, was equally effective. In the former GDR, where the number of infections was recorded very precisely, around 100 to 120 such meningitis occurred in the years before reunification. When the Haemophilus vaccination was introduced in Germany in 1990, the annual number of cases in the new federal states quickly decimated to less than ten.


    1. None of the alleged pathogenic pathogens has been seen, isolated and proven to exist so far

    No vaccination without pathogens - that is a kind of basic law of microbiology. Vaccines are obtained on the basis of weakened and dead germs or their molecular components. Sometimes closely related strains are also used. In this way, the body's immune system can be prepared for the real illness. Without specific knowledge about the pathogen, however, no systematic vaccine development would have been possible.
    Robert Koch created decisive methodological foundations for bacteriological research. These include the development of solid culture media for breeding bacteria and the introduction of microphotography, which contributed significantly to the spread of bacteriology in medical science. As a district physicist, he discovered anthrax spores, the dormant form of the pathogen, in 1876 and thus explained the chain of infection, which was not understood until then, and the bacterium's high resistance to environmental factors. Robert Koch was the first to prove the connection between a microorganism and the cause of an infectious disease.
    Viruses, on the other hand, could not be visualized for a long time because they are too small for visualization in a light microscope. The physical limits of light microscopy were clearly shown here.
    Due to the development of electron microscopy in the 20th century, which allows a much higher resolution than light microscopy, detailed images of numerous viruses are now available. In many cases, the genetic code of the germs is also known.
    This knowledge is used, for example, for the genetic engineering of the hepatitis B vaccine in yeast cells. The vaccine only consists of a specific surface molecule of the hepatitis virus, the so-called HBs antigen. In contrast, the production of flu vaccines is still much more traditional: the flu viruses are propagated in chicken eggs, then killed and processed into highly purified vaccines.


    1. Vaccinations do not protect in the long term and have to be repeated constantly

    Whether a vaccination has to be repeated or not varies greatly from case to case. If, for example, a child receives two combination injections against measles, mumps and rubella during the so-called primary immunization, it can be assumed that the immune protection will actually last a lifetime.
    The situation is different with tetanus, diphtheria, polio or whooping cough. For these diseases, you can rely on the vaccination for five to ten years - after which it should be repeated. A flu vaccination offers even shorter protection: because the flu pathogen changes extremely quickly, people at risk have to refresh their immune protection every year with a newly composed vaccine.
    The fact that the effect of a vaccine is limited in time does not mean that it is useless. An annual flu vaccination can prevent life-threatening courses of illness in chronically ill or old people. Immunization against tetanus every ten years also appears to be a minor effort in view of the sometimes fatal infection.
    But even those who have survived an infectious disease are not necessarily permanently immune. Tetanus, diphtheria or whooping cough can affect you several times in your life. There are even some known cases in which a person got measles twice.


    1. You can get sick despite being vaccinated

    It is correct: not a single vaccination protects 100 percent of those vaccinated, just as no drug works for all patients. However, vaccinations can significantly reduce the likelihood of illness.
    Imagine the following scenario: a measles epidemic occurs in a primary school. Half of the children are vaccinated and half are not. From a purely statistical point of view, it would be expected that around 97 to 98 percent of students without immune protection would fall ill - but only two to three percent of those vaccinated.
    With the flu vaccination, however, the effect is less good. Depending on age and state of health, it protects 50 to 90 percent of those vaccinated against flu, with the vaccination usually having the worst effect on the elderly.
    Even if a necessary booster vaccination was not carried out in time or the immune protection has not yet fully developed, the effect of a vaccination often remains incomplete. The classic children's vaccinations must first be repeated several times according to a time-regulated scheme before one can count on a reliable and permanent protective effect.
    In addition, there are vaccinations that only prevent particularly severe disease courses. This is the case with the so-called BCG vaccination against tuberculosis, which was carried out as standard in infants in this country until the end of the 1990s, but has since been abandoned as a standard vaccination due to the comparatively low probability of the disease. The vaccination did not protect the children from tuberculosis per se - but from their worst complications involving the whole body and brain.


    1. Going through illness is important for the normal development of the child and provides better protection than vaccination

    So far there are no scientific studies that would show that unvaccinated children develop mentally or physically better than vaccinated children. This would also not be plausible.
    Vaccinations are directed against around a dozen particularly notorious and dangerous pathogens - the immune system has to deal with hundreds more every day. The vaccination itself is also a stimulus for the immune system and trains the immune system. Accordingly, it would be extremely surprising if vaccinated children generally had a weaker constitution or permanently had fewer immune systems. There is no evidence to support this thesis.
    In addition, even if one might ascribe a positive value to some illness experiences, there is no question that infections can also set children back in their development and cause health complications and even death. This is exactly what can often be avoided with vaccinations.


    1. We parents went through these infectious diseases and got through well

    It is true that many infections heal without consequences. However, so-called teething troubles can also be very drastic in certain cases. Childhood disease does not mean that the disease is harmless, but that it tends to occur in childhood. The best example is measles: about 1 in 1,000 children who develop measles develop an inflammation of the brain, the so-called measles encephalitis. This often leads to permanent brain damage or is even fatal.
    In about one in a million cases, such encephalitis also occurs after vaccination - this is a thousand times less common than with the disease. The febrile seizures, which are quite common in measles, can also be largely avoided with a vaccination syringe. While the cramps affect about one in 15 measles sufferers, only one in 100 vaccinated people suffers from it.
    The same applies to childhood illnesses such as mumps or rubella. When mumps occurs in young men, it can cause testicular inflammation with fertility problems. Rubella, on the other hand, can cause serious malformations in the unborn child in pregnant women who are not immune to the disease. Both consequences of the disease can be prevented in practically all cases by vaccination.
    Finally, there was also the fact that in the past there was no vaccination for many diseases, just as there used to be no seatbelt in the car, no motorcycle helmet or no protective bicycle helmet. Today all these protection options exist and they are gladly used.


    1. A baby also gets antibodies with breast milk, this natural protection is enough

    In fact, the pregnant woman transfers antibodies to the unborn child via the bloodstream. With the breast milk, the infant then receives further antibodies. This so-called nest protection is a crucial support for the developing child's immune system, especially in the first months of life - but it is not comprehensive. Since these antibodies are broken down very quickly, the child lacks any protection as soon as the mother stops breastfeeding.
    The mother can pass on antibodies against diseases that she has gone through or against which she has been vaccinated. With certain infections such as Whooping cough, however, the immune system does not produce any transmissible antibodies even in the event of illness - the baby is therefore in no way protected against these diseases. It is also known that nest protection is less developed, especially in premature babies, who therefore benefit from vaccinations.
    In any case, nest protection and vaccination do not have to conflict with each other; in some cases they rather complement each other. Swedish paediatricians have found that breastfed children are less likely to develop severe meningitis caused by the bacterium Haemophilus influenzae type b (Hib) and that they also develop more antibodies against the germ after an Hib vaccination. However, meningitis can almost always be avoided only with a completed vaccination.


    1. Women who have had an illness themselves give their newborn children more antibodies against infections than vaccinated mothers

    This has been shown to be the case for measles, mumps and rubella. A vaccination against these diseases stimulates the mother's immune system less strongly than a wild virus infection, which is why there are fewer maternal antibodies in the infants. For this reason, pediatricians generally carry out the first vaccination against measles, mumps and rubella a little earlier than they did 20 years ago.
    However, this relationship does not apply to some other infections. Since the maternal immune system does not produce any transmissible antibodies in the case of whooping cough infection, for example, the baby does not enjoy nest protection either. Rather, it is known that adults can become infected with whooping cough several times in their lives and the germs can then often pass unnoticed to their children. According to a 2007 US study, parents and close relatives are by far the most common source of infection when an infant develops whooping cough. The Standing Vaccination Commission at the Robert Koch Institute therefore recommends immunization of the contact persons before the child is born.
    For other diseases such as Tetanus or diphtheria is a nest protection in newborns of vaccinated mothers, which is not detectable in newborns of mothers who have gone through an infection.


    1. Too early vaccinations expose children to avoidable risks

    Certain infections affect infants much more severely than older children - this is a major reason why babies are vaccinated against various diseases after they are two months old. Classic examples are infections with the Haemophilus influenzae bacterium and whooping cough. With whooping cough, complications such as pneumonia or respiratory arrest occur in around 25 percent of cases if the child is younger than six months. After that, the complication rate drops to around five percent. An infant therefore benefits particularly from a whooping cough vaccination.
    Even the first dose of vaccine at two months old can reduce the likelihood that an infant will have to be hospitalized for whooping cough by around two thirds. The repetitive vaccination during the first year of life completes the whooping cough protection.
    It has not been proven that infants generally tolerate vaccinations worse than older children. In extremely premature babies born before the 32nd week of pregnancy, heart and lung function should be monitored after certain vaccinations in order to quickly identify any vaccination complications. On the other hand, however, premature babies are also more susceptible to infections - the risk-benefit ratio is therefore also positive here for the vaccines.
    However, by no means all vaccines are administered in infancy. Immunization against measles, mumps and rubella, as well as against particular pathogens causing meningitis - so-called meningococci - does not take place until around the age of one.


    1. Due to the many vaccinations and multiple vaccines, the immune system of the small child is overloaded

    It is true that children are now vaccinated against more diseases than in the past. The number of foreign molecules transferred in the process, the so-called antigens, has nevertheless decreased significantly. The old whooping cough vaccine alone contained around 3,000 such molecular foreign substances. In all current vaccinations taken together, however, there are only 150 antigens. The reason for this is that modern vaccines are highly purified and mostly only contain individual components of the pathogen. In fact, the child's immune system has to deal with a much larger amount of foreign molecules every day than is the case with vaccinations.
    There is also no evidence that multiple vaccines would overload the immune system. It is known, however, that certain components of the combination vaccinations stimulate the immune system less than if they were given alone, which is why, for example, four instead of three injection syringes may be necessary. The bottom line, however, is that multiple vaccines can significantly reduce the number of syringes required.
    Up to six vaccines - against tetanus, diphtheria, whooping cough, Haemophilus influenzae, polio and hepatitis B - can now be combined in a single vaccine. A frequent criticism of the six-fold vaccination is that hepatitis B is predominantly - if by no means exclusively - transmitted through sexual intercourse and the likelihood of illness in an infant is low. However, hepatitis B disease in infants is almost always very severe and becomes chronic in 90% of cases. In addition, pragmatic considerations also come into play when vaccinating infants with hepatitis. It is known that the vaccination rates for adolescents are low, but that a hepatitis B infection can lead to a serious illness and, if it is chronic, can even trigger liver cancer. This is why the Standing Vaccination Commission at the Robert Koch Institute and the World Health Organization (WHO) recommend immunization against hepatitis B in children. According to current knowledge, long-term, possibly even lifelong protection could be achieved for the majority of those vaccinated.


    1. Vaccinations cause the diseases they are designed to protect against

    Certain vaccines can actually cause disease-like symptoms - but full-blown disease practically never develops. The best known example are the "vaccine measles". Since the measles vaccine contains a weakened but still living measles virus, around five percent of those vaccinated develop a measles-like rash after about a week. However, middle ear infections or pneumonia, which may be associated with the actual infection, do not occur. The dreaded inflammation of the brain, measles encephalitis, is an absolute rarity after the vaccination: it affects about one in a million people who are vaccinated, whereas every thousandth child is affected with real measles.
    In this country, cases in which polio occurred due to an oral vaccination have become historic. The live vaccine that helped reduce poliomyelitis on a large scale caused a few infections of its own every year. Since 1998, however, a polio vaccine has been administered by syringe in Germany that does not contain any live viruses and cannot cause the disease. Many vaccines consist of killed pathogens or, like the flu vaccines, from components of pathogens, only very few contain weakened, living pathogens.
    Quite apart from these connections, vaccinations sometimes lead to fever, nausea or sleepiness as well as swelling and redness at the injection site. However, these are general, usually quickly subsiding reactions of the organism. They have nothing to do with the infectious disease that is being vaccinated against.


    1. Vaccinations promote allergies

    One thing is certain: these days there are more vaccinations - and more allergies. However, it has not been proven whether one is related to the other. Swedish doctors had shown a few years ago that children from anthroposophically oriented families are less prone to eczema. In fact, these children were not vaccinated as often. But they were also given antibiotics less often, had different diets, and their parents smoked less. In another study, American allergists found that parents who refuse vaccinations are less likely to see asthma or hay fever in their children. But even in this study it remained unclear whether there really was a causal connection.
    Many other studies speak against such a connection. An analysis by Rotterdam doctors, for example, who evaluated all of the specialist articles published on the subject between 1966 and 2003, showed that the methodologically more reliable studies in particular did not reveal an increased risk of allergies.
    An experience in this country also points in this direction: In the former GDR, where vaccination was mandatory and almost all children were vaccinated, there were hardly any allergies. They only increased in East Germany after reunification, while vaccination rates fell at the same time.


    1. The side effects and risks of vaccinations are incalculable

    The assumptions are numerous: In the past few years there has been a lot of argument about whether autism, diabetes or even multiple sclerosis could be triggered by vaccinations. However, there is still no evidence of this, but there are numerous studies that speak against it. For example, at the end of the 1990s a group of British scientists hypothesized that the measles, mumps and rubella vaccination could lead to damage in the intestine and thus to the penetration of neurotoxic substances into the organism. This hampers mental development and promotes autism. In the meantime, however, several studies have invalidated the thesis - ten of the original 13 authors officially withdrew their interpretation.
    However, it is undisputed that vaccines have side effects. In 2005 a total of around 44 million vaccine doses were sold in Germany, around half of which was for the annual flu vaccination. In the same period, doctors and pharmaceutical manufacturers reported almost 1,400 suspected vaccination complications - this corresponds to a rate of around three suspected cases per 100,000 doses sold. As a detailed analysis of all suspected complications by the Paul Ehrlich Institute showed, there was no evidence of a possible causal relationship with the vaccination in almost a third of the reported cases. In addition, a large part of the health disorders reported - for example high fever - were of a temporary nature. A permanent health impairment, which might have been caused by the vaccination, was reported in only five vaccinated persons. In the case of an adult who died after the vaccination, a causal link with the vaccination could not be ruled out.
    Indeed, this is a major difficulty in risk assessment: Vaccinations are so common that many health disorders can happen quite randomly after immunization. A real connection does not have to exist. A few years ago, for example, the assumption was discussed that cot death could be promoted by vaccinations, since in a number of cases children died shortly after immunization. Studies now point in the other direction. In an extensive analysis of a good 300 child deaths recently, doctors from the University of Magdeburg found that the babies who had died had been vaccinated less often and later than usual.


    1. Vaccines contain dangerous chemicals that are knowingly used to poison children

    Some vaccines contain formaldehyde, aluminum, phenol or mercury - but in extremely low concentrations (below the toxicological limit values). The substances are used, for example, to kill vaccine viruses (formaldehyde), to strengthen the immune response (aluminum hydroxide) or to make the vaccine durable (phenol).
    A few years ago, two American doctors suggested that the increase in autism cases registered in the USA was related to the mercury-containing preservative thiomersal in some vaccines. The World Health Organization WHO, the US “Institute of Medicine” and the European Medicines Agency EMEA have come to the conclusion independently of one another that the available studies speak against such a connection.
    Nonetheless, the pharmaceutical manufacturers have reacted to the heated debate: Mercury-free vaccines are now available for all generally recommended vaccinations.


    1. The production of vaccines can lead to contamination that is responsible for diseases such as BSE and AIDS

    It is true that, for example, when cultivating some vaccine viruses, the serum of calves is necessary as a nutrient medium for the corresponding cell cultures. However, only certified products from BSE-free countries such as New Zealand may be used.
    The controls for certain protein components, so-called human albumin, from the plasma of blood donors are similarly strict. In some cases, these proteins serve to stabilize live vaccines and make them more durable. Plasma products are systematically tested for the pathogens so that there is no transmission of HIV or hepatitis viruses. In the further course of production, there are processes that kill any undetected viruses.


    1. There are doctors who advise against vaccinating

    Few doctors are completely against vaccination. However, there are indeed some who take a critical stance towards individual vaccinations - which does not necessarily mean that there are good scientific reasons for this. Personal experiences, religious or philosophical convictions also play an important role.
    However, an alternative medicine orientation does not have to contradict the idea of ​​vaccination protection. A few years ago, Freiburg researchers found in a survey of more than 200 homeopathically oriented doctors that they administer the "classic" vaccinations against tetanus, diphtheria and polio almost as often as their purely conventional medicine colleagues. However, the homeopaths were more cautious about other immunizations.
    The German Central Association of Homeopathic Doctors (DZVhÄ) emphasized in a statement from 2002 that a discussion about the benefits and disadvantages of vaccinations is perfectly legitimate and the decision for or against it must be made individually. At the same time, however, the DZVhÄ reaffirmed the importance of the Standing Vaccination Commission at the Robert Koch Institute. Their recommendations are "carefully considered and take into account the current state of knowledge with the aim of fundamentally preventing the occurrence of many infectious diseases."


    1. Most of the diseases that are vaccinated against no longer occur in Germany

    Some infections such as polio or diphtheria have become a rarity in this country. However, this is already the result of vaccination programs. Falling vaccination rates would in principle also harbor the risk of new epidemics.
    This is shown, for example, by outbreaks of poliomyelitis in 1978 and 1992 in Dutch communities where vaccinations were rejected due to religious reservations. In the first epidemic 110 people fell ill with polio, in the second 71 people. Far more dramatic were the waves of diphtheria in Russia and the other successor states of the USSR, where more than 150,000 people fell ill and more than 6,000 died as a result of falling vaccination rates in the 1990s. In the course of such epidemics, infections can also be brought into Germany through international travel. Polio still occurs, for example, in India and Egypt, where many holidaymakers also go.
    But measles epidemics also occur again and again in Germany, most recently in North Rhine-Westphalia, where around 1,700 children fell ill in 2006. Overall, the measles rate in Germany is still high compared to other European countries. In addition, there are other germs such as the hepatitis B virus or certain pathogens of severe systemic inflammation in childhood - so-called pneumococci - which are practically constantly circulating in the population. When young children develop pneumococcal inflammation, they often need hospital treatment. Meanwhile, an extensive US study has shown that routine pneumococcal vaccination, which has also been recommended for infants in Germany for several years, can almost halve the number of hospital admissions.
    A completely different type of vaccination has been on the program since the beginning of 2007: immunization against certain types of so-called human papillomaviruses in girls between the ages of 12 and 17. The viruses, which are often transmitted during sexual intercourse, can cause cervical cancer later in life. The new vaccine could prevent the majority of cases.


    1. Vaccinations are superfluous as the diseases can be treated with antibiotics, for example

    Today's treatment options are undoubtedly better than they used to be - but by no means random. Medicines are rarely used for viral infections, and antibiotics are not effective against viruses. And some bacterial diseases are also extremely difficult to treat. Among other things, tetanus infections, meningitis and whooping cough can be fatal even under modern treatment conditions.
    In fact, vaccination and therapy are not opposing options, but part of the same chain of protection. Sometimes the vaccination does not prevent the infection, but it does prevent the most severe courses.


    1. The decline in diseases is a result of improved hygiene and nutrition and has nothing to do with vaccinations

    There is no question that prosperity and hygiene make a significant contribution to the prevention of infectious diseases. For example, the supply of clean drinking water and the establishment of good hand hygiene are essential for the prevention of hepatitis A, typhoid or cholera. However, there is no general connection between hygienic conditions and infectious diseases. For example, some pathogens such as measles, hepatitis B and polioviruses are only housed in the human organism and passed on from person to person, for example through sexual contact or coughing.
    It is true that measles, for example, is often particularly severe in malnourished children. The actual likelihood of infection is directly related to how many children are vaccinated against measles. If the vaccination rate is around 95 percent, measles can be completely eradicated.
    As a result of consistent vaccination programs, the entire South American subcontinent is practically measles-free. In sub-Saharan Africa, India and Southeast Asia, on the other hand, measles is still a common cause of death. In 1999, well over 800,000 children there died of measles. Large-scale vaccination campaigns that vaccinated over 360 million children in Africa and Asia have reduced the number of deaths to around 350,000 in 2005. In the long term, the World Health Organization is striving to eliminate measles worldwide.
    Further efforts are also necessary in this country. It is true that vaccination rates have risen in recent years. But according to school entry examinations from 2005, over 90 percent of children received the first and around 75 percent also received the second measles vaccination. At least 95 percent are required for both vaccinations.


    1. The pharmaceutical industry only wants to do business with vaccinations

    Companies in other branches of industry also earn money with their products, that is the goal of all companies. However, lifelong medication for the chronically ill should be more profitable than vaccines, which are typically administered only a few times. The sales of the pharmaceutical industry are also often offset by considerable savings. In the old federal states, for example, at the time of oral vaccination, 90 marks were saved in therapy and rehabilitation costs for every mark that went into the vaccination. Today's vaccination against whooping cough reduces direct treatment costs by more than 200 million euros per year. For the now generally recommended vaccination against hepatitis B, it was calculated that, after initial additional costs for the health insurance companies, the burden on the health system would be relieved in the long term.


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