Information on booster vaccinations
Why is a booster vaccination important?
The COVID-19 vaccines licensed in Germany provide effective protection against severe illness. However, studies show that vaccination protection decreases over time and that the immune response is weaker in those who are older or have pre-existing conditions, for example.
A booster vaccination significantly increases protection. The body makes more antibodies, allowing it to protect itself more effectively against the virus. The booster vaccination enhances the immune system – hence the name. A booster of his kind is necessary in view of the increasing spread of the very contagious Omicron variant in Germany: both for individual protection and to prevent overloading of the health system.
Who should have their vaccination refreshed for the first time (“1st booster”)?
The Standing Commission on Vaccination (STIKO) recommends that everyone aged 18 and over should get a booster jab at least three months after their last vaccination. Further information can be found on the website of the Robert Koch Institute.
The STIKO also recommends a booster vaccination for children and adolescents aged 12 to 17, but within a time window of three to six months after their last vaccination. Children and adolescents with pre-existing conditions should receive their booster vaccination as early as possible; for 12 to 17 year-olds without pre-existing conditions, the STIKO recommends a longer vaccination interval of up to six months. See the recommendations for details.
Children aged between 5 and 11 years of age with pre-existing conditions should receive an initial immunisation with two vaccinations and also a booster vaccination. Healthy children who have received a single vaccination or have already received two vaccinations should not be vaccinated again for the time being.
A second booster vaccination is also recommended for certain groups of people. You will find more information on this in the course of this FAQ.
Who should have their vaccination refreshed for the second time (“2nd booster”)?
Many people received their booster some time ago, such as those living in nursing homes and the staff who work there. For this reason, the STIKO recommends a second booster with the existing mRNA vaccines – BioNTech or Moderna – for certain groups:
Those particularly at risk – including all those aged 60 and over, people who live in or receive care in nursing homes, at-risk groups in the area of integration assistance for people with disabilities and people with immunodeficiency. These groups should receive a second booster three months or more after the first booster.
In addition, health workers – especially if they are in direct contact with vulnerable people entrusted to their care – are recommended to obtain a second booster six months or more after the first booster. In justified individual cases, however, the second booster vaccination can also be considered for this group after no earlier than three months.
– People (from the age of 5) who are subject to an increased risk of severe COVID-19 due to an underlying disease
For an overview of the STIKO recommendations for coronavirus vaccinations, see the Robert Koch Institute (RKI) website.
When should the second booster vaccination take place?
The second booster vaccination should occur at a minimum of six months from the first booster vaccination. In justified individual cases, the interval may be reduced to four months.
Even after a SARS-CoV-2 infection, a regular interval of six months should be observed for a booster vaccination. If a SARS-CoV-2 infection has occurred after receiving the first booster vaccination, the second booster vaccination should be administered at an interval of six months after the infection.
Which vaccines are used for the booster vaccinations?
Regardless of which vaccine was used for the first and second vaccination, an mRNA vaccine (BioNTech, Moderna) should be used for the boosters. Both mRNA vaccines are equally suitable as boosters: they are effective, safe and efficient. The STIKO recommends vaccination exclusively with the BioNTech vaccine for all persons under 30 years of age. Both mRNA vaccines are equally suitable for those aged 30 and over.
As soon as variant-adapted vaccines are approved and available, the STIKO will review the evidence and adapt its recommendation if necessary. Postponing an indicated vaccination to wait for an adapted vaccine is not recommended.
Where can I get a booster vaccination?
Anyone who wishes to get a vaccination can make an appointment with a doctor or at a vaccination centre.
Similarly, dentists and pharmacies are also able to offer coronavirus vaccinations. Appropriately trained pharmacists are allowed to give vaccinations; see www.mein-apothekenmanager.de for details.
For up-to-date details of local arrangements, see the information page of your federal state government.
When does protection start after a booster vaccination?
International studies suggest that booster protection starts after about seven to twelve days after vaccination. For more information, see the page “Together against the coronavirus”.
Coronavirus vaccination for children from the age of 5
Should I have my child vaccinated?
The STIKO recommends that all children aged 5 to 11 years receive a coronavirus vaccination with an mRNA vaccine. The purpose of the initial one-off vaccination is to build up as effective a basic immunity as possible.
The one-off vaccination should preferably be given with the BioNTech and Pfizer vaccine; alternatively a children’s dose of Moderna is possible from the age of 6.
In addition, the STIKO recommends that children with pre-existing conditions receive initial immunisation with two vaccinations and also a booster. Children without pre-existing conditions should receive the initial vaccination (two doses of vaccine) if they live with relatives or other contact persons who are at a high risk of contracting COVID-19 severely and cannot be safely protected by vaccination themselves. Healthy children who have received two vaccinations should not be vaccinated again for the time being.
For more information on this point, see the page “Together against the coronavirus”.
Coronavirus vaccination is a sensitive issue for many parents. Ask your doctor or paediatrician for advice if you have any questions.
How effective is the coronavirus vaccination for children aged 5 to 11?
Clinical trials indicate that BioNTech/Pfizer's paediatric vaccine is effective for use in 5 to 11-year-olds, and it was possible to establish a positive benefit/risk profile. Vaccination can effectively reduce the risk of contracting COVID-19.
Data from a clinical trial in children aged 5 to 11 showed that administrating the vaccine at a concentration as low as ten micrograms per dose reduced the risk of COVID-19 by 90.7 percent. What is more, the immune response after vaccination in children aged between 5 and 11 (measured by the amount of antibodies against SARS-CoV-2) was comparable to that of vaccinated adolescents and young adults.
Where can children get vaccinated against COVID-19?
Parents who would like to have their children vaccinated can contact their local paediatrician or specialist in adolescent medicine. In addition, hospitals with paediatric departments and in some cases vaccination centres are also available for parents and their children. For details, see the relevant municipality websites.
Will my child suffer any disadvantages if they are not vaccinated?
No. There is no mandatory vaccination for children in Germany. It is up to the parents or guardians to decide whether or not their children should receive the vaccination. The federal states decide how much testing is to be carried out and at what intervals, for example for non-vaccinated pupils. Please consult your federal state authorities for details.
Information on the coronavirus vaccination
Why is it important to get vaccinated against the coronavirus?
The main reason to get vaccinated against the coronavirus is to protect yourself from a severe or deadly infection. In addition, each coronavirus vaccination helps contain the spread of the virus, so everyone who gets vaccinated is also protecting their own family, friends and the community at large.
How effective is the vaccination?
All approved vaccines are effective and safe. According to the latest research, the mRNA vaccines Comirnaty (BioNTech/Pfizer) and Spikevax (Moderna) are the most effective. For this reason, all those who were first vaccinated with a vector vaccine once or twice are recommended to receive an mRNA vaccine at the next vaccination. The STIKO recommends the Moderna vaccine only for those aged 30 and above.
Even though the vaccines are very effective according to the current state of knowledge, it is still possible to catch COVID-19 in spite of being vaccinated. Vaccination does not offer one hundred percent protection. However, studies indicate that those who have been vaccinated are much less likely to contract a severe infection, generally only have mild symptoms if they do fall ill, and often remain completely asymptomatic.
This is also borne out by the data: the weekly situation reports published by the RKI on Thursdays regularly show how effective the vaccinations are, broken down by age group and disease severity.
For further information on the effectiveness of the COVID-19 vaccination, see the RKI website.
When am I considered “fully vaccinated”, such as in connection with access regulations?
“Fully vaccinated” status is required under certain Länder regulations, for example, as well as for employees at nursing homes, hospitals and the like who wish to prove they are vaccinated under the so-called facility-based vaccine mandate.
Two vaccination doses are necessary for to obtain full vaccination protection – as stipulated in § 22a of the Infection Protection Act – even for those who received the Johnson & Johnson vaccine for their first vaccination. Exceptions apply after a previous infection with the coronavirus: in this case, a single vaccination is enough
- if this vaccination was preceded by an infection proven by an antibody test or PCR test, or
- if the vaccination was followed by an infection detected by PCR test and 28 days have elapsed since testing.
Different rules will apply from 1 October 2022. Three vaccinations will be necessary. Exceptions will apply after a previous infection with the coronavirus: In this case, two vaccinations will be enough,
- if the first vaccination was preceded by an infection proven by an antibody test, or
- if the second vaccination was preceded by an infection detected by PCR test, or
- if there was an infection detected by PCR test after the second vaccination and 28 days have passed since testing.
When does my vaccination certificate expire?
Important when travelling: For adults who have not yet received a booster vaccination, the certificate is valid for 270 days after completion of initial vaccination. Minors (under 18) are exempt from this regulation. For them, the certificate remains valid for an unlimited period even without a booster. The scheme applies to cross-border travel in EU member states.
The situation differs at national level: In Germany, there are currently no national regulations limiting the period of recognition of vaccination certificates.
Is vaccination compulsory?
Vaccination against the coronavirus is voluntary. In order to protect vulnerable groups, however, a facility-based vaccine mandate applies. This is because very old people, people in need of care and people with acute or chronic underlying diseases are at a significantly increased risk of a severe, possibly even fatal infection with the SARS-CoV-2 coronavirus (vulnerable groups). Health and care workers have a particular responsibility since they come into close and intense contact with groups of people at high risk of a severe, very severe or even fatal infection with the SARS-CoV-2 coronavirus. Reliable protection against the SARS-CoV-2 coronavirus based on a very high vaccination rate among staff in these occupations is particularly important since this reduces the risk of the particularly vulnerable groups of people becoming infected with the SARS-CoV-2 coronavirus.
Due to the situation in the fourth wave, the deplorably high numbers of new cases and deaths and the extremely serious and sometimes even dramatic situation in the healthcare system, the Länder requested the Federal Government to impose a so-called facility-based vaccine mandate as soon as possible: all employees who have contact with vulnerable persons in hospitals and integration assistance facilities as well as in nursing homes, care homes and mobile care services will be required to be vaccinated against the coronavirus. As a result, the Bundestag and Bundesrat passed an amendment to the Infection Protection Act. Employees who work at hospitals, nursing homes and similar institutions must therefore provide proof of being vaccinated against or having recovered from COVID-19.
Who is to be vaccinated with which vaccine?
Five vaccines are approved in Germany: the mRNA vaccines by BioNTech/Pfizer and Moderna, the vector vaccines by AstraZeneca and Johnson & Johnson, and the protein vaccine by Novavax.
The Standing Committee on Vaccination (STIKO) recommends that people under 30 should be given the Novavax and the BioNTech vaccine. The recommendation for BioNTech applies both to initial vaccinations and any later booster vaccination. Even if a different vaccine was used initially, the BioNTech vaccine should be used for additional vaccinations. Since the introduction of the mRNA vaccines by Biontech/Pfizer and Moderna, rare cases of myocarditis and/or pericarditis have been known to occur in younger people after receiving these vaccines. Current analyses indicate that myocarditis and pericarditis are observed more frequently in those under 30 after receiving Moderna than after receiving Biontech.
By way of a precaution, those who are pregnant – regardless of their age – should only be vaccinated with the Biontech vaccine.
For those aged 30 and over, there is no increased risk of myocarditis or pericarditis after receiving a vaccination with Moderna.
According to the STIKO recommendation, the AstraZeneca and Johnson & Johnson vaccines should be used primarily for those aged over 60. The reason for this is that very rare but severe side effects (cerebral vein thrombosis) have been observed in connection with these vaccines. According to the STIKO, younger people can receive both vaccines if they wish and have been fully informed by their doctor.
The STIKO also recommends that those who have already received a first dose of the AstraZeneca vaccine should generally receive an mRNA vaccine as their second dose (cross vaccination or heterologous vaccination). Cross vaccination is also recommended for those who have received the Johnson & Johnson vaccine. Four weeks after receiving the initial vaccination, the STIKO recommends a supplementary vaccination with an mRNA vaccine to significantly increase protection against COVID-19. The reason for this is that vaccine breakthroughs have been observed more frequently in those vaccinated with Johnson & Johnson.
The protein vaccine Nuvaxovid developed by Novavax was approved by the EU Commission on 20 December 2021. The STIKO recommends the vaccine for initial vaccination for everyone aged 12 and over. The vaccine has been available in Germany since the end of February.
What applies during pregnancy and breastfeeding?
The Standing Commission on Vaccination (STIKO) recommends the coronavirus vaccination for those who are pregnant or breastfeeding. In addition, the STIKO recommends vaccination for everyone of childbearing age in order to ensure sound protection from COVID-19 before pregnancy. From the fourth month of pregnancy onwards and during breastfeeding it is possible to receive two doses of an mRNA vaccine such as Biontech or Moderna. The STIKO recommendation is based on data on the risk of contracting COVID-19 severely during pregnancy and on the effectiveness and safety of vaccination in those who are pregnant or breastfeeding.
How many people have been vaccinated to date?
For current vaccination figures, see the vaccination dashboard of the Federal Ministry of Health.
Where are vaccinations currently available?
Anyone who wishes to get vaccinated can make an appointment with a doctor or at a vaccination centre. Dentists and pharmacies have also been able to offer coronavirus vaccinations – appropriately trained pharmacists are allowed to give the vaccinations in this case.
For up-to-date information on opportunities for vaccination in your federal state, see the information page of your federal state government.
What happens if I am sick on the day of my vaccination appointment?
Vaccination should be postponed for those suffering acute, severe, febrile illness. Mild illness without fever is not usually a reason to postpone the vaccination.
If you have a vaccination appointment and cannot keep it due to illness, please cancel it yourself: this is the only way the appointment can be assigned to someone else.
Do I have to get vaccinated after being infected with SARS-CoV-2?
Anyone who is infected with the virus forms antibodies: this is comparable to receiving a vaccination. For this reason, a COVID-19 infection can often “replace” a vaccination – but further vaccinations are still necessary in order to ensure complete protection.
Talk to your doctor to decide how many vaccinations are advisable and when they should be given. Consult the Vaccination Guide for advice.
Who pays for the vaccination?
Vaccination is free of charge to citizens, regardless of their insurance status. The costs of the vaccine are covered by the Federal Government. The federal states bear the costs of operating the vaccination centres together with the statutory and private health insurance companies.
Information on the approved vaccines
Which vaccines have been approved to date?
Five vaccines have been approved: On 21 December 2020, the EU Commission approved the BioNTech vaccine; this was followed on 6 January 2021 by approval of the Moderna vaccine. The AstraZeneca vaccine has been approved in the EU since 29 January 2021. The Johnson & Johnson vaccine has had EU approval since 11 March 2021. On 20 December 2021, the EU Commission approved the vaccine Nuvaxovid developed by Novavax.
These approvals are based on the relevant recommendations issued by the European Medicines Agency (EMA). For an overview of the current development status of the various vaccines, see the EMA website.
According to the World Health Organisation (WHO), more than 100 potential vaccines are currently undergoing clinical testing worldwide. Here you will find the WHO list
What are the differences between the five approved vaccines?
The vaccines produced by BioNTech and Moderna are mRNA vaccines. These contain parts of the genetic information of the coronavirus in the form of messenger RNA (mRNA). Acting as a kind of blueprint, this stimulates muscle cells in the body to produce the spike protein that is typical of the coronavirus itself.
The immune system recognises the spike protein as foreign and forms natural defences – namely antibodies and immune cells. When the vaccinated person later comes into contact with the “real” coronavirus, the latter is recognised by their immune system. The antibodies formed then provide protection from severe disease. The mRNA from the vaccine does not stay in the body but is degraded shortly after vaccination.
The vaccines offered by AstraZeneca and Johnson & Johnson are vector vaccines. In this case, an attenuated virus that is harmless to humans serves as a means of transport (vector) for parts of the genetic information of the coronavirus. Here again, some body cells obtain a blueprint for producing the characteristic spike protein of the coronavirus and are able to replicate it.
The immune system recognises the spike protein as foreign and forms natural defences – namely antibodies and immune cells. When the vaccinated person later comes into contact with the coronavirus, the latter is recognised and intercepted by the immune system. Vector vaccines are already well-established and are used to provide protection against Ebola, for example.
The Novavax vaccine is a recombinant protein vaccine, which is a so-called “inactivated vaccine” in the broader sense. The vaccine is based on a conventional mechanism: it contains tiny particles of the coronavirus produced in a laboratory – the so-called spike proteins. When these enter the body by means of vaccination, they are identified as foreign and stimulate the immune system to produce antibodies.
In contrast to mRNA and vector vaccines, which stimulate the body to produce harmless copies of the spike protein itself, the Novavax vaccine enters the body directly with components of the viral protein envelope that are grown in cell cultures. For more information about the Novavax vaccine, see the website of the Federal Ministry of Health.
Digital certificate of vaccination
How can I prove that I have had the coronavirus vaccination?
The coronavirus vaccination is recorded in your vaccination certificate. If you do not have a vaccination certificate, you will receive a replacement. In addition, you should obtain a digital vaccination certificate in the form of a QR code. In combination with the Corona-Warn-App and the CovPass App issued by the Robert Koch Institute, this allows you to use your digital vaccination certificate on your smartphone. Click here for further information about the digital vaccination certificate.
How can I prove that I have had a booster vaccination?
You also obtain a “2D barcode” for booster vaccinations. Here again: you can transfer the certificate to the Corona-Warn-App or the CovPass app in the same way as for the first and second vaccination.
Is the yellow analogue vaccination card still valid?
Yes. According to the Infection Protection Act (Infektionsschutzgesetz, IfSG), the vaccination card is an important international document that shows which vaccinations you have received or still need. The digital vaccination certificate is in fact only offered on a voluntary, supplementary basis.
If vaccinated individuals do not have digital proof of vaccination, the familiar “yellow booklet” remains a valid means of proof.
How safe is the vaccination?
In Germany, a vaccine is only approved if it has successfully passed all three phases of the clinical trial programme. These national and international quality standards apply to the approval of a coronavirus vaccine just as they do to all other vaccines that are developed. After market approval, vaccine use is closely monitored and evaluated on an ongoing basis so as to be able to record even very rare side effects.
Even if vaccine development has been much faster on this occasion than it has been in the past, this does not mean that the approval standards were any less rigorous. The accelerated development of the vaccines is firstly due to the fact that large amounts of money have been invested, allowing studies to be carried out on a large scale without delay. Secondly, the regulatory authorities are currently monitoring and reviewing vaccine development as quickly as possible. This prioritisation allows the companies and laboratories conducting the research to save time and move more quickly from one trial phase to the next.
Are side effects possible?
Side effects can never be ruled out. Even long-established vaccines have side effects. It is important to be fully familiar with these, since this is the only way to ensure sound decisions are made regarding who can safely receive the vaccine and who is more likely to be at risk from vaccination than to benefit from it. One key purpose of the testing and approval process is to be able to describe the side effects clearly. This also includes being able to determine which groups of people are subject to such effects and to what extent.
Even after approval, a newly introduced vaccine continues to undergo monitoring and research. Sometimes very rare side effects are not observed until after approval. Very rare might mean one case in more than 10,000 vaccinated people, for example. For Germany, the Paul Ehrlich Institute (PEI) centrally records all side effects and vaccination responses – regardless of the manufacturer.
By pooling national and international observations, it is possible to ensure that all vaccine risks are recorded – even when they are so rare that they only become known after very large numbers of people have been vaccinated.
As the vaccination against COVID-19 is rolled out in Germany, the Paul Ehrlich Institute publishes safety reports at regular intervals on all suspected cases of adverse reactions or vaccination complications that are reported. You can find the safety reports here.
Who should not be vaccinated?
Anyone suffering from an acute illness including a temperature of over 38.5°C should not be vaccinated until they have recovered. However, a cold or slightly raised temperature (below 38.5°C) is not a reason to postpone vaccination. In case of hypersensitivity to a vaccine ingredient, the vaccination should not be administered: please inform the doctor administering the vaccination beforehand if you have any allergies.
Source: Information sheet on the COVID-19 vaccination/Robert Koch Institute
For information on vaccination in your region and to make an appointment, go to www.116117.de.
The Federal Centre for Health Education has compiled an extensive collection of information on coronavirus vaccinations.
The Federal Ministry of Health provides answers to numerous questions about vaccine types, the distribution of the coronavirus vaccination and other topics.
The Federal Ministry of Education and Research provides information on the special national programme and the status of vaccine research.
The Robert Koch Institute also offers FAQs on the subject of the coronavirus and vaccination.
In Germany, the Paul Ehrlich Institute is the body responsible for the approval of vaccine studies. The Institute provides information on how vaccines are developed and approved.
An overview of vaccine candidates has been compiled by the World Health Organisation (WHO) .
The European Medicines Agency is responsible for the approval procedure.
Source: Federal Ministry of Health/Press and Information Office of the Federal Government