In exceptional situations the Ministry of Health of the Federal Republic of Germany or the local federal governments are authorized by legal decree to oblige parts of the population to be vaccinated. Provided that an infectious disease with serious clinical end arises and epidemic spreading is estimated (Infectious Diseases Protection Law – IfSG – §20, 6,7). The Fundamental Right of being physically unscathed may be limited.Following §34, 10a IfSG have to furnish proof of an consultation about immunization protection by a physician. Certain employers are authorized to collect informations about the immune status of employees (e.g. in hospitals) to decide about an occupation or its kind (§23a IfSG).Recommendations exist for the following immunizations (over and above that there are recommendations for certain cases, e.g. travelling):
- children (6 weeks and older): rotavirus (one or two more doses following 4 weeks later each time)
- children (completed 2nd month): tetanus, diphtheria, pertussis, hib, polio, hepatitis B, pneumococcal; repeated at completed 3rd (not pneumococcal) and 4th month; last dose at 11-14 months
- children (11-14 months): meningococcal C (1 dose), measles, mumps, rubella, varicella (2 doses, the second following 4 weeks later)
- girls (9-14 years): HPV (cervical cancer) 2 or 3 doses
- adults: pneumococcal (1 dose at 60 years), influenza (annualy starting at 60 years), measles (when born after 1970 and immune status is unclear)
- children (at 5-6 years): tetanus, diphtheria, pertussis
- teenager (9-17 years): tetanus, diphtheria, pertussis, polio
- adult (18 years and older): tetanus and diphtheria (repeating every 10 years), one dose pertussis, catch up (if not vaccinated in childhood)
Unvaccinated children in Germany: no legal regulations exist for mandatory vaccination when visiting kindergarten, school or university. If somebody caught an infectious disease or is suspicious of having caught it or of being infected, health institutions may forbid to go to kindergarten or school (§28 IfSG). Suspicious means being without immunity (by artificial immunization or by natural disease) and having been in contact to an infectious person.
Adverse event following immunisation public reporting system
Compulsory informing about benefit and risk before immunization should guarantee an informed choice for vaccinees and parents. Instruction leaflet is an information for parents and vaccinees.
Several vaccine-preventable infectious diseases are notifiable to the local health authority by law. The suspicion of the disease and even of the infection are notifiable too, as well as death (§6 IfSG). Mandatory notification exists for physicians and other members of health professions (e.g. midwives). Failing of notification may be punished (fine), in case of intention with prison sentence.Notifiable as well is the suspicion of an injury (vaccine damage) following vaccination exceeding “usual” reactions. Members of the listed professions are obliged to notify. Everybody else is allowed to do so.