The most important questions and answers about the booster vaccination

Vaccination certificate with a coronavirus vaccination entry

The booster vaccination enhances the immune system – it can significantly increase vaccination protection against the coronavirus.

Photo: Getty Images/Jens Schlueter

Why is a booster vaccination important?

First of all: COVID-19 vaccines provide effective protection against severe disease. The vaccines used in Germany have a significant effect on preventing coronavirus infections as well as reducing the risk of infecting others.

Studies show that vaccine protection can diminish over time, especially in the very elderly or in those who have a weakened immune system. It is also the case that the overall immune response after vaccination is lower for older people, for whom a booster vaccination can significantly increase vaccination protection. The body makes more antibodies, allowing it to establish even more effective protection against the virus. The booster vaccination enhances the immune system – hence the name.

When does a vaccination require a booster?

A booster vaccination is essentially recommended no earlier than six months after the initial vaccinations – i.e. six months after the second dose.

For those with immunodeficiency: about six months after the initial vaccinations, an additional dose of an mRNA vaccine should be provided. In severely immunodeficient persons this should be as early as four weeks after the second vaccine dose, as a means of optimising the primary vaccinations.

Who does the Standing Commission on Vaccination recommend a booster vaccination for?

The Standing Committee on Vaccination (STIKO) recommends a booster vaccination with an mRNA vaccine (no earlier than six months after the initial vaccinations) for

  • all those aged 70 and over,
  • residents and persons in care in facilities for the elderly – even if they are aged under 70,
  • caregivers and other professionals who have direct contact with multiple individuals requiring care – in care facilities for the elderly and for other people at increased risk of contracting COVID‑-19‑ severely,
  • staff who work in medical facilities with direct patient contact

The STIKO also recommends the following:

  • People with immunodeficiency should be offered an additional dose of an mRNA vaccine approximately six months after the first two vaccines, while severely immunodeficient individuals should receive the booster as early as four weeks after the second vaccine dose as a means of optimising the primary vaccinations,
  • People who have received basic immunisation with one dose of the Johnson&Johnson vaccine (COVID-19 Vaccine Janssen) are advised to receive a further vaccination with an mRNA vaccine (from four weeks after vaccination with the Johnson&Johnson vaccine), regardless of their age. The aim here is to optimise vaccination protection.

For an overview of the STIKO recommendations for coronavirus vaccinations, see the 

website.

Who else is to be offered a booster vaccination on request?

Beyond the STIKO recommendation, the health ministers of the federal states have decided, in agreement with the Federal Minister of Health, that the following groups of people should also be offered a booster vaccination on request and after consultation with their doctor:

  • all those over the age of 60,
  • residents of care facilities, such as facilities for people with disabilities and other facilities housing vulnerable groups,
  • all nursing staff and other employees working at such facilities,
  • people whose profession regularly brings them into contact with infectious individuals, such as medical personnel, including those who have contact with outpatients, emergency service personnel and mobile vaccination teams,
  • people in need of care in their own homes,
  • people who have received a full series of vaccinations with the AstraZeneca vaccine

An overview of the resolutions adopted by the Conference of the Ministers of Health of the Länder is to be found at the Conference of the Ministers of Health website.

Which vaccines are used for the booster vaccination?

Only mRNA vaccines (BioNTech, Moderna) are used for booster vaccinations. This decision was made based on current scientific evidence regarding the efficacy and safety of the vaccines approved to date for widespread use, as well as their availability.

Data has shown that a heterologous vaccination scheme (so-called cross-vaccination) – first vector vaccine, then mRNA vaccine – results in significantly higher antibody formation than a homologous vaccination scheme with a vector vaccine. The aim of the booster vaccination with an mRNA vaccine is to ensure that, in addition to the high level of protection provided by vaccination with the mRNA vaccine, protection against COVID-19 disease is further increased for those who have undergone a complete vector vaccine series.

Another important point to note: If an mRNA vaccine was used for the initial vaccinations, the same vaccine should be used if possible.

Are the vaccines that are used for booster vaccination (mRNA vaccines) adapted to the new virus variants?

The booster vaccination is currently provided using the available mRNA vaccines. This is possible under the current authorisation of these vaccines. The mRNA vaccines available for booster vaccination have not yet been adapted to new variants, and studies on the adaptation of vaccines to new variants are still ongoing. For this reason, newly adapted vaccines are not yet available. In addition, various clinical trials results show that, although the efficacy of the mRNA vaccines available is slightly weakened with regard to the Delta variant, it still remains high. In terms of hospitalisation, there has been no loss of efficacy so far as compared to the Alpha variant.

Where can I get a booster vaccination?

Booster vaccinations are available from mobile vaccination teams or from general practitioners and in-house doctors, for example. Organisation and implementation of the booster vaccination programme is the responsibility of the federal states.

What applies to fully vaccinated people who have received a series with AstraZeneca and Johnson&Johnson?

Those who received their first series of vaccinations with AstraZeneca’s vector vaccine only will be offered a booster vaccination with an mRNA vaccine six months after the initial vaccinations.

The offer is not intended for those who have received a cross-vaccination. This is because, based on the current state of scientific knowledge, cross-vaccinated individuals (vector vaccine + mRNA vaccine) are considered to have sufficient protection against COVID-19. Whether and at what intervals booster vaccinations are to be given to non-vulnerable, cross-vaccinated individuals is currently still under consideration.

For those who have received their first vaccination with the Johnson&Johnson vector vaccine, the STIKO recommends a vaccination with an mRNA vaccine from the fourth week after receiving the original vaccination in order to optimise vaccination protection.

Is the booster vaccination free of charge?

Yes. All vaccinations against the coronavirus that are carried out under the Vaccination Ordinance are available to citizens free of charge. This also applies to booster vaccinations.

Can the flu vaccination and the coronavirus booster vaccination be given at the same time?

Yes. A flu vaccination can be administered together with a vaccination against the coronavirus. The STIKO recommends flu vaccinations for those aged 60 and over, those who are pregnant, people with pre-existing conditions and medical staff, among others.

For all the main questions and answers about the coronavirus vaccination, see the other

.

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