Which vaccinations are important for babies and children?
Vaccinations protect against serious diseases that can be potentially serious and even fatal – for example, measles, mumps, rubella, diphtheria and whooping cough. Unlike in many other countries, there is no mandatory vaccination in Germany, but there are detailed vaccination recommendations. These are developed by the Permanent Vaccination Commission (STIKO) of the Robert Koch Institute (RKI) and published in the vaccination calendar, which is reviewed and updated annually.
The STIKO recommendations provide for vaccinations for babies, children and adolescents up to 18 years of age against the following pathogens or diseases:
- Rotavirus: Rotavirus is one of the most common triggers of gastrointestinal diseases in children. The highly contagious pathogen can cause severe diarrhea, vomiting and fever. Rotavirus infections can be particularly dangerous for young children.
- Tetanus: Bacteria of the Clostridium tetani type can enter the body through even the smallest skin lesions and cause a dangerous infection. The germs’ poison causes very painful muscle cramps. If left untreated, patients die, and even with treatment, a tetanus infection is often fatal.
- Whooping cough (pertussis): The bacterial infection is accompanied by prolonged, cramping coughing fits that can recur over a period of weeks. Whooping cough can be particularly dangerous for newborns and infants.
- Haemophilus influenzae type B (HiB): Infection with HiB bacteria can be associated with severe complications such as meningitis, pneumonia, epiglottitis, or blood poisoning (sepsis), especially in the first year of life.
- Polio (Poliomyelitis): This highly contagious viral infection is also known as “polio” for short. It mainly affects children. Polio is characterized by symptoms of paralysis that can last a lifetime. In severe cases, cranial nerves are also affected, which can lead to death.
- Hepatitis B: The virus-triggered liver inflammation takes a chronic course in children in 90 percent of cases. Those affected then have an increased risk of developing cirrhosis or liver cancer.
- Pneumococcus: These bacteria can cause meningitis, pneumonia and otitis media, for example. Children with weak immune systems or pre-existing conditions are particularly susceptible to severe courses and life-threatening complications.
- Measles: Contrary to popular belief, this viral disease is by no means harmless. It can be severe, especially in children under five and older people, and can lead to complications such as middle ear, lung or brain inflammation (encephalitis). In 2018 alone, 140,000 people worldwide died from measles (mostly children under five).
- Mumps: This viral infection, popularly known as goat peter, leads to a painful inflammation of the parotid glands. In childhood, the disease is usually harmless, but in adolescents and adults complications occur more often, sometimes with permanent consequences such as hearing damage, reduced fertility or infertility.
- Rubella: This viral infection occurs primarily in babies and young children and usually runs its course without complications. It is different in pregnant women: A rubella infection can cause severe damage to the unborn child (e.g., organ malformations), especially in early pregnancy. Miscarriage is also possible.
- Chickenpox (varicella): This viral infection usually runs smoothly. Complications (such as pneumonia) are rare. Chickenpox is dangerous in the first six months of pregnancy – the child may suffer damage (e.g. eye damage, malformations). Infection shortly before birth can lead to the death of the child.
All vaccinations recommended by the STIKO are covered by health insurance.
Childhood vaccinations: When which vaccination for children?
Basic immunization takes place through multiple vaccinations between the ages of 6 weeks and 23 months. If vaccinations were missed during this time, they can and should be made up for as soon as possible. Between the ages of two and 17 years, several booster vaccinations are also due.
Vaccination recommendations for infants and young children (6 weeks to 23 months)
- Rotavirus: basic immunization by up to three vaccinations. First vaccination at 6 weeks, second vaccination at 2 months, third vaccination at 3 to 4 months if necessary.
- Tetanus, diphtheria, pertussis, HiB, poliomyelitis, hepatitis B: standard three vaccinations for basic immunization at 2, 4, and 11 months of age (for premature infants, four vaccinations with an additional one in the third month of life). Follow-up vaccinations between 15 and 23 months of age. A six-dose combination vaccine is usually used to immunize against all of the above diseases at the same time.
- Pneumococcus: basic immunization by three vaccinations: first vaccination at 2 months, second vaccination at 4 months, third vaccination at 11 to 14 months. Follow-up vaccination at 15 to 23 months of age.
- Meningococcal C: one vaccination for basic immunization from 12 months of age.
Vaccination recommendations for children and adolescents (2 to 17 years)
- Tetanus, diphtheria, and pertussis: any needed booster vaccinations recommended at 2 to 4, 7 to 8, or 17 years of age. Two booster vaccinations – one at 5 to 6 years and the second between 9 and 16 years. A quadruple combination vaccine is often used, which provides protection against polio in addition to protection against tetanus, diphtheria and pertussis.
- Poliomyelitis: booster vaccination may be needed between 2 and 8 years of age or at 17 years of age. Booster vaccination recommended between 9 and 16 years of age.
- HiB: booster vaccination may be required at 2 to 4 years of age.
- Hepatitis B, meningococcal C, measles, mumps, rubella, varicella: any necessary catch-up vaccinations between 2 and 17 years of age.
- HPV: two vaccinations for basic immunization between the ages of 9 and 14. Possibly necessary catch-up vaccinations up to 17 years.
Childhood Immunizations: A table with the current vaccination recommendations of the STIKO can be found here.
Childhood vaccinations: Why are they so important?
Although most vaccinations do not provide 100 percent protection against infection, they do make it more difficult for the pathogens to multiply and spread. They reduce the duration of the disease and the rate of serious complications. That’s why doctors and reputable medical institutions recommend vaccinations for babies and children – from the WHO to national health authorities such as the German Robert Koch Institute. Because experts agree: only early vaccination can effectively stop or even end epidemics and pandemics.
Risky avoidance of vaccination
Some parents wonder whether the many vaccinations in early childhood are really necessary. After all, vaccinations can also cause side effects. Wouldn’t it be better to let nature take its course and simply let the offspring go through the “harmless” childhood diseases?
But it’s not that simple: childhood diseases such as measles, whooping cough, mumps or rubella are not harmless, and can even lead to death – even in Germany. In addition, permanent disabilities such as brain damage, paralysis, blindness and deafness occur time and again.
Example measles: What happens when many people forgo the measles vaccination?
Around 790,000 children were born in Germany in 2019. Without vaccination, most of them would contract measles. About 170 children would die from the dangerous complication of meningitis; mental damage would remain in about 230 children. In addition, there are other complications of measles, such as bacterial pneumonia and middle ear infections with subsequent organ damage.
Life-threatening measles parties
Some parents send their children to measles parties so that they can specifically become infected. Experts consider this irresponsible because the children are deliberately exposed to a life-threatening risk.
For non-vaccinated and non-infected persons, the risk also increases that they will not become infected until they are teenagers or adults. The risk is particularly high on long-distance trips, because many travel countries have high rates of the disease due to inadequate vaccination rates. However, the older the infected, the more serious the complications.
Childhood vaccinations: Side effects
For vaccinations with a live vaccine, mild symptoms of the disease that was vaccinated against may temporarily appear one to three weeks afterwards. Examples include mild diarrhea after rotavirus vaccination and mild rash after measles vaccination.
Vaccinations in babies: side effects
Most vaccinations for basic immunization take place during babyhood. The goal is to protect the offspring from threatening diseases as early as possible. All vaccines are generally very well tolerated and thoroughly tested. They are explicitly approved for this young age group as well. The above-mentioned side effects of vaccination (redness and swelling at the injection site, slight discomfort, restlessness, etc.) can, of course, also occur in infants. However, they are generally harmless and disappear by themselves after a few days.
Baby vaccinations: pros and cons
Some parents are uncertain and wonder whether they should actually have their child vaccinated as a baby. They fear that the young organism is not yet up to the vaccine and that bad side effects or even vaccine damage will occur. In addition, some believe that it is good for the immune system to go through the typical “childhood diseases”.
- Non-vaccinated people are defenceless against serious diseases such as measles, rubella, diphtheria or whooping cough. Babies in particular often have little to oppose the aggressive pathogens. Their risk of serious illnesses and even death is therefore significantly increased.
- An infection can leave permanent damage.
- Getting through the illness weakens the organism, making it more susceptible to further infections.
Significance of vaccine damage
Permanent vaccine damage is very rare in Germany. This is shown by a look at the National Vaccination Schedule: For example, 219 applications for recognition of vaccination damage were submitted nationwide in 2008, 43 of which were recognized. This is an extremely low number when compared to the number of vaccinations administered: In 2008, almost 45 million vaccine doses were administered at the expense of statutory health insurance alone.
Against this background, most experts recommend that parents have their children vaccinated in accordance with the STIKO recommendations. This is because childhood vaccinations are the only effective protection against the spread of potentially life-threatening diseases.
