The German Standing Committee on Vaccination (STIKO, Robert Koch-Institut) is internationally recognised for the rigour of its GRADE-based recommendations and the clarity of its decision logic for special clinical situations. What travels across borders is NOT the calendar itself but the decision logic per scenario — what to confirm, what to add, what to avoid.
For each vaccine in each scenario, the page shows the universal clinical principle (transferable to any jurisdiction) and the STIKO-specific note (informational — for cross-country comparison only; apply your local schedule).
Adult presenting for occupational health visit without documented vaccination record. Goal: confirm baseline immunity, complete catch-up schedule, document for future reference.
Td booster every 10 years lifelong. If last booster >10 y or unknown: give one Td-containing dose now and document.
Germany combines as Td-IPV every 10 y; next booster after age 18 SHOULD include pertussis once (Tdap-IPV) for adult cocoon protection — then revert to Td-IPV.
One lifetime adult Tdap to extend childhood pertussis protection. Cocoons newborns; reduces transmission to vulnerable contacts.
STIKO recommends giving the next due Td booster as Tdap once after age 18 (combined into the 10-y schedule), then continue plain Td.
Anyone born after 1970 without documented 2-dose MMR or serological immunity: complete to 2 doses (≥4 weeks apart).
Masernschutzgesetz (Measles Protection Act, 1 March 2020) makes measles vaccination MANDATORY for HCW + childcare + school personnel in Germany; fine up to €2 500 if unvaccinated.
Adults without history of chickenpox or documented vaccination: serology + 2-dose vaccination if seronegative.
Three-dose schedule (0-1-6 months) for occupational, sexual or household contact risk. Check anti-HBs 4–8 weeks after final dose to confirm responder status.
In Germany, HBV vaccination is a precondition of employment in most hospitals.
Catch-up indication varies by country — generally up to age 26 routine, 27–45 shared decision. Always discuss in unvaccinated young adults.
STIKO routine HPV recommendation is younger than most: 9–14 y (UK: 12–25; FR: 11–14; US ACIP up to 26 routine + shared decision 27–45).
Hospital, primary care, dental, paramedic, laboratory and care-home staff. Goal: protect worker, protect patients, comply with local mandatory frameworks.
Three-dose schedule + anti-HBs verification 4–8 weeks after final dose. Responder = anti-HBs ≥10 mIU/mL. Non-responders: repeat full series, then assess again.
Two documented doses or serological evidence of immunity. Measles is the highest-incidence HCW-acquired infection in HCW outbreaks.
Mandatory under Masernschutzgesetz 2020 in Germany; analogous mandates exist in Italy + parts of US.
Serology + 2-dose if seronegative. HCW exposure to immunosuppressed patients makes susceptibility a patient-safety issue.
Every season. Single most effective intervention for nosocomial influenza prevention.
STIKO recommends high-dose influenza (Efluelda) for HCW ≥60.
One adult Tdap (then plain Td every 10 y) — protect neonatal contacts in paediatrics, maternity, NICU.
Per local public-health body recommendation each season — typically annual or biannual for HCW.
STIKO updates seasonal COVID guidance annually for HCW + risk groups + adults ≥60.
Vaccines that protect mother and transfer antibodies to the newborn. Inactivated vaccines are safe in any trimester; live vaccines are contraindicated.
One dose every pregnancy to transfer antibodies to the newborn before they receive their own vaccines. Timing varies: WHO recommends 2nd or 3rd trimester.
STIKO: from 28 weeks gestation, every pregnancy. UK (JCVI): from 16 weeks. FR (HCSP): 20–36 weeks. US (ACIP): 27–36 weeks. The exact window differs — the principle does not.
Recommended in pregnancy during influenza season — protects mother (higher complication risk in pregnancy) and infant (passive immunity).
STIKO recommends in the 2nd and 3rd trimester (1st trimester only if very high individual risk).
Maternal vaccination 24–36 weeks gestation transfers RSV antibodies to the infant — alternative strategy to passive infant Nirsevimab.
GERMANY DIFFERS: STIKO currently does NOT recommend maternal Abrysvo; the German strategy is passive infant Nirsevimab (Beyfortus) instead. UK (JCVI 2024), FR (HCSP) and US (ACIP) chose maternal vaccination. Re-evaluation expected mid-2026.
Recommended in pregnancy where local public-health body endorses, especially in 2nd/3rd trimester and for risk groups.
Patients on biologics, high-dose corticosteroids, post-transplant, oncology, HIV with CD4 <200, primary immunodeficiency. Goal: maximise non-live protection, avoid live vaccines.
Strongly recommended every season. Live attenuated influenza vaccine (LAIV) is CONTRAINDICATED.
Sequential schedule recommended: PCV first, then PPSV23 8 weeks later. Re-PPSV23 after 5 years if eligible.
STIKO supports PCV20 single-dose alternative for adults — simplifies schedule.
Recombinant zoster vaccine (Shingrix) is non-live and SAFE in immunosuppression. The old live zoster vaccine (Zostavax) is contraindicated and largely withdrawn.
STIKO recommends Shingrix from age 50 in immunosuppressed (vs standard ≥60). ACIP US: ≥19 years if immunocompromised.
Use double-dose schedule (40 µg) or 4-dose schedule for haemodialysis + immunosuppressed. Verify anti-HBs response.
Recommended if asplenia, complement deficiency, or eculizumab/ravulizumab therapy.
Post-splenectomy, sickle cell disease with functional asplenia, congenital asplenia. Lifelong increased risk of OPSI (overwhelming post-splenectomy infection) by encapsulated organisms — Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b.
MANDATORY at diagnosis or pre-splenectomy (≥2 weeks before elective surgery). Booster PPSV23 every 5 years.
MANDATORY both quadrivalent ACWY and serogroup B. Boost ACWY every 5 years; MenB schedule per product.
MANDATORY single dose if no childhood Hib vaccination or unknown.
Annual inactivated. Asplenic patients have increased complications from secondary bacterial infections post-influenza.
Complete all routine adult vaccines (MMR, VZV, Td/Tdap, HBV, HPV catch-up).
Goal: prevent vaccine-preventable diseases with disproportionate severity in older adults (influenza, pneumococcal, zoster, RSV).
Every season. High-dose or adjuvanted formulations preferred for ≥65.
STIKO recommends high-dose Efluelda from age 60 in Germany.
One dose from age 60–65 depending on local guideline. Strategies vary: PCV20 single-dose (preferred in many guidelines now) vs sequential PCV15 + PPSV23.
STIKO: standard PPSV23 from age 60; PCV20 for high-risk or very elderly. ACIP US: PCV20 single-dose from age 65 OR PCV15 + PPSV23.
Recombinant zoster vaccine from age 50–60 (varies by country). 2 doses 2–6 months apart.
STIKO: standard from age 60; immunosuppressed from 50. ACIP US: ≥50 routine.
Single dose from age 60 (with risk factors) or 75 routine. Most guidelines now recommend.
STIKO: standard from 75; from 60 if risk factors. UK (JCVI): from 75. US (ACIP): from 75 routine, 60–74 shared decision.
Per local public-health body — typically annual or biannual for ≥60.
Continue 10-year booster cadence lifelong. Single adult Tdap if not given previously.
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