Child vaccinations

and Sabine Schrör, medical journalist

Sabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.

More about the experts All content is checked by medical journalists.

To vaccinate or not to vaccinate? This is a question that worries many parents. They fear side effects and, above all, vaccine damage. The latter, however, are extremely rare. And in view of the sometimes enormous health risks associated with so-called childhood diseases such as measles, mumps and rubella, there is no alternative to vaccinating babies and children. Read here why, when and what children should be vaccinated against.

Which vaccinations are important for babies and children?

Vaccinations protect against serious illnesses that can be potentially serious and even fatal - such as measles, mumps, rubella, diphtheria and whooping cough. Unlike in many other countries, there is no compulsory vaccination in Germany, but detailed vaccination recommendations. These are developed by the Standing Vaccination Commission (STIKO) of the Robert Koch Institute (RKI) and published in the vaccination calendar, which is checked and updated every year.

The STIKO recommendations provide for vaccinations for babies, children and adolescents up to the age of 18 against the following pathogens or diseases:

Rotaviruses: The rotavirus is one of the most common causes 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: Even the smallest skin injuries can cause bacteria of the type Clostridium tetani get into the body and cause a dangerous infection. The poison of the germs causes very painful muscle spasms. If left untreated, patients die, and tetanus infection is often fatal even with treatment.
Diphtheria: This infection caused by certain bacteria is usually associated with (high) fever, sore throat, difficulty swallowing and shortness of breath. In severe cases, there is a danger to life (e.g. from suffocation).
Whooping cough (pertussis): The bacterial infection is accompanied by long-lasting, convulsive coughing fits that can recur over the course of weeks. Whooping cough can be particularly dangerous for newborns and infants.
Haemophilus influenzae type B (HiB): An infection with HiB bacteria can be associated with serious complications such as meningitis, pneumonia, epiglottis 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 liver inflammation caused by viruses takes a chronic course in children in 90 percent of cases. Those affected then have an increased risk of developing liver cirrhosis or liver cancer.
Pneumococci: These bacteria can cause meningitis, pneumonia and otitis media, for example. Children with immune deficiencies or previous illnesses are particularly prone to severe disease and life-threatening complications.
Meningococcal C: These bacteria can cause severe meningitis and blood poisoning. Every year around 10 percent of those infected die; in around 20 percent of cases there are long-term effects (e.g. deafness, amputation of limbs).
Measles: Contrary to popular belief, the viral disease is by no means harmless.It can be severe and with complications, such as inflammation of the middle ear, lungs, or brain infection (encephalitis), especially in children under five and the elderly. In 2018 alone, 140,000 people worldwide died of measles (mostly children under the age of five).
Mumps: This viral infection, popularly known as goat peter, leads to a painful inflammation of the parotid glands. The disease is usually harmless in childhood, but complications occur more often in adolescents and adults, sometimes with permanent consequences such as hearing damage, reduced fertility or infertility.
Rubella: This viral infection occurs mainly in babies and toddlers and is usually without complications. It is different with pregnant women: a rubella infection can cause severe damage to the unborn child, especially in early pregnancy (e.g. organ malformations). Miscarriage is also possible.
Chickenpox (varicella): This virus infection usually runs smoothly. Complications (such as pneumonia) are rare. Chickenpox is dangerous in the first six months of pregnancy - the child can be harmed (e.g. eye damage, malformations). Infection shortly before birth can lead to the death of the child.
Human papillomavirus (HPV): These common viruses are transmitted through sexual intercourse. Certain types of these are considered to be the main risk factors for cervical cancer. In addition, some types of HPV can cause genital warts in both sexes.

All vaccinations recommended by STIKO are paid for by health insurance companies.

Child vaccinations: when which vaccination for children?

The basic vaccination takes place by multiple vaccinations between 6 weeks and 23 months of age. If vaccinations were missed during this time, they can and should be made up as soon as possible. Between the ages of two and 17 there are also some booster vaccinations.

Vaccination recommendations for infants and young children (6 weeks to 23 months)

Rotaviruses: basic immunization with up to three vaccinations. First vaccination at 6 weeks, second vaccination at 2 months, possibly third vaccination at 3 to 4 months.
Tetanus, diphtheria, pertussis, HiB, poliomyelitis, hepatitis B: three basic vaccinations as standard at the age of 2, 4 and 11 months (for premature babies four vaccinations with an additional one in the third month of life). Make-up vaccinations between the 15th and 23rd month of life. Usually a six-fold combination vaccine is used, which is used to immunize against all diseases mentioned at the same time.
Pneumococci: basic vaccination with three vaccinations: first vaccination at 2 months, second vaccination at 4 months, third vaccination at 11 to 14 months. Catch-up vaccination at the age of 15 to 23 months.
Meningococci C: a vaccination for primary immunization from 12 months.
Measles, mumps, rubella, varicella: basic immunization with two vaccinations, once at 11 to 14 months and once at the age of 15 to 23 months. A combination vaccine (MMR vaccination) is usually administered against measles, mumps and rubella, and the varicella vaccination is then carried out separately. But there is also a combination vaccine that immunizes against all four diseases at the same time (MMRV vaccination).

Vaccination recommendations for children and adolescents (2 to 17 years)

Tetanus, diphtheria and pertussis: any necessary catch-up vaccinations are recommended at the age of 2 to 4, 7 to 8 or 17. Two booster vaccinations - one between 5 and 6 years of age and the second between 9 and 16 years of age. A quadruple combination vaccine is often used, which in addition to protection against tetanus, diphtheria and pertussis also offers protection against polio.
Poliomyelitis: A catch-up vaccination that may be necessary between the ages of 2 and 8 years or at the age of 17. Booster vaccination recommended between 9 and 16 years of age.
HiB: possibly necessary catch-up vaccination at the age of 2 to 4 years
Hepatitis B, meningococcal C, measles, mumps, rubella, varicella: possibly necessary catch-up vaccinations between 2 and 17 years.
HPV: two basic vaccinations between the ages of 9 and 14. Possibly necessary catch-up vaccinations up to the age of 17.

Vaccinations for children: A table with the current vaccination recommendations of the STIKO can be found here.

Child vaccinations: why are they so important?

Vaccinations have been able to eradicate or at least massively contain life-threatening diseases in the past few decades. One example is smallpox, which, thanks to a long-term, global vaccination campaign since 1979, has not occurred anywhere anymore, according to the WHO. Other diseases such as typhoid, diphtheria, anthrax or the plague occur only sporadically as a result of broad-based mass vaccinations, and hardly at all in the western industrialized countries.

Most vaccinations do not offer 100% protection against infection, but make it more difficult for the pathogen to multiply and spread. They reduce the duration of illness and the rate of serious complications. That is why doctors and reputable medical institutions advise vaccinations for babies and children - from the WHO to national health authorities such as the German Robert Koch Institute. Because the experts agree: Epidemics and pandemics can only be effectively halted or even ended with early vaccination.

Risky vaccination waiver

Some parents wonder whether the many vaccinations in early childhood really have to be. Finally, vaccinations can also have side effects. Wouldn't it be better to let nature run wild and just let the offspring go through the "harmless" teething problems?

But it's not that simple: childhood diseases such as measles, whooping cough, mumps or rubella are not harmless, they can even lead to death - also in Germany. In addition, there are always permanent disabilities such as brain damage, paralysis, blindness and deafness.

Early vaccinations can prevent these diseases and their consequential damage. In addition: Parents who do not have their children vaccinated not only endanger their offspring, but also themselves. Because those who are not vaccinated serve as a possible breeding ground for the pathogens and become a potential danger to their fellow human beings.

Take measles, for example: What happens if many people do not have the measles vaccination?

Around 790,000 children were born in Germany in 2019. Without a vaccination, most of them would get measles. About 170 children would die from the dangerous complication of meningitis; mental damage remained in around 230 children. There are also other complications of measles, such as bacterial pneumonia and otitis media with later organ damage.

Lethal measles parties

Some parents send their children to measles parties to target the infection. Experts consider this to be irresponsible because the children are deliberately exposed to a life-threatening risk.

For those who have not been vaccinated and those who are not sick, the risk of becoming infected as adolescents or adults also increases. The main risk is on long-haul trips, because in many travel countries there are high numbers of illnesses due to a lack of vaccination rates. However, the older the infected, the more serious the complications.

Child vaccinations: side effects

The most common side effects of the vaccination include redness, swelling and pain at the injection site. A slight fever, vomiting, diarrhea, headache and body aches, fatigue, nausea, restlessness, general malaise and loss of appetite are possible in the first few days after the vaccination. The side effects mentioned will go away on their own after one to three days. Strictly speaking, these are not side effects of the vaccination at all, but rather signs that the immune system is dealing with the vaccine as desired.

If you are vaccinated with a live vaccine, you may experience temporary mild symptoms of the disease you were vaccinated against for one to three weeks later. Examples are mild diarrhea after a rotavirus vaccination and a mild rash after a measles vaccination.

Vaccinations in the baby: side effects

Most vaccinations for basic immunization take place as early as infancy. The aim is to protect the offspring from threatening diseases as early as possible. All vaccines are generally very well tolerated and have been thoroughly tested. They are also expressly approved for this young age group. The vaccine side effects mentioned above (redness and swelling at the injection site, slight discomfort, restlessness, etc.) can of course also occur in babies. However, they are usually harmless and disappear on their own after a few days.

Vaccinations Baby: Pros and Cons

Some parents are insecure and wonder whether they should actually have their child vaccinated when they are babies. They fear that the young organism is not yet able to cope with the vaccine and that serious 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 "teething problems".

However, there are serious medical arguments in favor of vaccinating in infancy against these considerations, for example:

Unvaccinated people are at the mercy of serious illnesses such as measles, rubella, diphtheria or whooping cough. Babies in particular often have little to counteract aggressive pathogens. Your risk of severe disease and even death is therefore significantly increased.
Infection can cause permanent damage.
Getting through the disease weakens the organism, making it more susceptible to further infections.

Meaning of vaccine damage

Permanent vaccination damage is very rare in Germany. A look at the national vaccination plan shows that: In 2008, for example, 219 applications for recognition of vaccination damage were made nationwide, 43 of which were recognized. An extremely small number if you compare the number of vaccinations administered: In 2008 alone, almost 45 million vaccine doses were administered at the expense of statutory health insurance.

A few years ago, a British study with only twelve participants unsettled the population. She reported a possible connection between the combined vaccination against measles, mumps and rubella (MMR vaccination) and autism. The consequence was that many parents no longer allowed their children to be vaccinated. In the meantime, however, it has emerged that false and fabricated results were deliberately published - the public prosecutor brought the responsible doctor and researcher to court in Great Britain. The study was withdrawn from The Lancet in February 2010 and removed from the list of publications.

With this in mind, most experts recommend parents to have their children vaccinated in accordance with the STIKO recommendations. Because child vaccinations are the only effective protection against the spread of potentially life-threatening diseases.

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