Vaccinations: what needs to be known about them?

Vaccinations are often also referred to as protective vaccinations or immunizations. Doctors also talk, simply, of vaccines.

Vaccinations enable many infectious diseases to be prevented, and their spread to be restricted or even halted. So the statutory health insurance schemes also assume the costs of many vaccinations in Germany.

Vaccinations protect against infectious diseases 

Infectious diseases are often caused by bacteria or viruses. But there are also infectious diseases caused by fungi or single-celled organisms (protozoa). The spectrum of illnesses caused by pathogens ranges from mild sicknesses such as the common cold through to serious illnesses such as meningitis, lockjaw (tetanus), infantile paralysis (polio), or malaria. The pathogens are transmitted, for example, through direct contact with other people, when handling animals, via the air, or through the shared use of objects such as door handles. 

Many infectious diseases can be prevented by good hygiene measures, and a healthy immune system protects against many pathogens. However, even when the immune system is healthy, some pathogens can cause serious illnesses, such as tetanus or measles. In such cases, vaccinations can provide reliable protection. 

Vaccinations restrict the spread of infectious diseases 

Vaccinations also often do more than just protect the people who get vaccinated. They can also help to restrict, or even halt, the spread, i.e. the infection being passed on from person to person (transmission), of the infectious disease concerned.

As a result countries with high vaccination rates (such as Germany) have managed to greatly restrict diseases such as infantile paralysis (polio), diphtheria, measles, and tetanus. According to the World Health Organization (WHO), smallpox were eradicated in 1979 due to a global vaccination campaign, and the fight against polio is now underway.

Amongst the most powerful weapons in the human immune defense system are the so-called antibodies. If a person is infected with pathogens such as bacteria or viruses, the body usually tries to produce the appropriate antibodies itself. These antibodies then attach themselves to the pathogens. The body’s own defense cells can then identify the intruders, remove them and fight the illness successfully.

After a repeat contact with the pathogens the immune system can usually react far more quickly because the body remembers the pathogens to a certain extent: it produces the right antibodies more rapidly, so it can counter the pathogens faster and more effectively. For this reason some infectious diseases such as mumps, rubella and chickenpox only usually occur once in a person’s life. The person is then immune, i.e. protected from that infectious disease.

Active and passive vaccinations

Active vaccinations stimulate the body to produce antibodies to counteract one or more pathogens. They have a preventive effect against the infectious diseases caused by the pathogens. With a passive vaccination, antibodies which are aimed at a pathogen are administered. Passive vaccinations can quickly provide protection of short duration, or they are used to treat infectious diseases.

Active vaccinations stimulate the production of antibodies

Active vaccinations make use of the immune system’s “memory”, and prepare the body for the worst case – i.e. infection with specific pathogens such as viruses, bacteria, or parasites.

A vaccine contains, for example, dead, harmless pathogens or pathogen elements: these are inactivated vaccines, also known as killed vaccines. Or it contains seriously weakened pathogens, so-called live vaccines. Genetic vaccines contain the genetic information for the blueprint of pathogen components.

All these vaccines stimulate the body – like the real pathogen – to produce suitable antibodies. If a vaccinated person is then later infected by the pathogen, thanks to the vaccination the immune system is prepared for it and a serious illness is prevented or weakened.

One or more vaccinations are required for basic immunization, to develop robust immunity. With some vaccinations, the protection remains throughout the person’s life, but others need to be boosted at certain intervals.

Passive vaccines contain antibodies

As well as active vaccinations, there are also passive vaccinations. With these, the body is not stimulated to produce antibodies against certain pathogens itself, but rather the right antibodies are delivered directly. These antibodies usually come from people who are already immune to the illness concerned. Passive vaccination can provide fast protection against certain pathogens. For example, they are used if someone might have recently been infected with a pathogen and there is insufficient active immunization against the illness. Unlike active vaccinations, passive vaccinations do, indeed, produce a very quick effect, but do not last long, often only for about three months.

There are many infectious diseases that can now be avoided through vaccinations. In Germany there is an independent expert body, the Ständige Impfkommission (STIKO - Standing Committee on Vaccination) which is continuously evaluating current scientific understanding of vaccinations and which then makes vaccine recommendations for Germany. The Robert Koch Institute website has information on this (www.rki.de/impfen). It should be noted that some vaccinations are only recommended for specific age groups or groups of people, because they can particularly benefit from the vaccinations: for example, because they suffer from specific illnesses.  

The website impfen-info.de provides a vaccination calendar with an overview, plus more information on immunizations: the website belongs to the Federal Center for Health Education (Bundeszentrale für gesundheitliche Aufklärung – BZgA). 

The STIKO currently recommends standard vaccinations against the following illnesses: 

• diphtheria
• lockjaw (tetanus)
• whooping cough (pertussis)
• infantile paralysis (polio)
• haemophilus influenzae type B
• hepatitis B
• measles
• mumps
• rubella
• chickenpox
• infection with the human papillomavirus (HPV)
• shingles (herpes zoster)
• flu (Influenza)
• pneumococcal disease
• meningococcal disease
• rotavirus 

Vaccines are one of the safest of all medicaments. There are various reasons for this. Every vaccine marketed in Germany must be approved by the Paul Ehrlich Institute (PEI), the Bundesinstitut für Impfstoffe und biomedizinische Arzneimittel (Federal Institute for Vaccines and Biomedicines), or by the European Commission after an evaluation process at the European Medicines Agency (EMA) involving the PEI.

The Paul Ehrlich Institute verifies the quality of every batch of vaccines produced before it is marketed, and clears every single batch for marketing in Germany. A legally regulated reporting system ensures that adverse reactions to vaccines are identified quickly.

How tolerable are additives in vaccines?  

Some inactive vaccines contain, for example, aluminum compounds as enhancers (adjuvants) in order to develop effective protection. Adjuvants are used in vaccines against tetanus, diphtheria, and whooping cough, for instance. They are needed because those vaccines only contain killed pathogens or parts of them, which on their own do not sufficiently stimulate the immune system. The aluminum compound content in vaccines approved in Germany and Europe is less than the maximum specified by the European Pharmacopoeia. The additional aluminum compounds taken in via vaccines is minimal in relation to the daily absorption via the air, drinking water and food. Moreover, the tolerability of vaccines is not only very closely studied during the approval process, but it also continues to be monitored after approval has been granted. Other enhancers, for example water-oil emulsions, are tested with the vaccine before and after approval. 

A mild physical reaction to a vaccine is not dangerous. This is a natural vaccine reaction that normally fades away within one or a few days. Typical complaints after a vaccination are reddening, swellings and pain at the injection site. 

Examples of general reactions after vaccinations include a high temperature, headache and limb pain, nausea, and diarrhea. When live vaccines are used, for example against measles, mumps, or rubella, mild symptoms that resemble the illness concerned may occasionally appear after the vaccination. However, they are not comparable with the real illness and neither are they infectious. 

Very rare side effects 

In recent decades, vaccinations have become more and more tolerable, so that serious side effects only occur very rarely. These include, for example, severe allergic reactions, febrile seizures with children’s vaccines, or bowel obstruction after the rotavirus vaccine.  

Vaccinations and albumen allergy 

Some vaccines contain production-related traces of albumen. If a person has an albumen allergy, the doctor should always be told so that he or she can take suitable cautionary measures.

Anyone with questions about immunization in general or about specific vaccinations can speak directly to a doctor. There are also reliable online sources with a wide range of information. These include:

impfen-info.de

Bundesgesundheitsministerium: Impfungen (Federal Ministry of Health: Immunizations)

Paul-Ehrlich-Institut: Impfstoffe (Vaccines)

Robert Koch-Institut: Impfungen A – Z (Vaccines A – Z)

Robert Koch-Institut und Bundeszentrale für gesundheitliche Aufklärung: Das Impfbuch für alle (The Vaccination Book for Everyone: also available free of charge from pharmacies)

 When traveling abroad:

Auswärtiges Amt: Reisemedizin (Foreign Office: Travel Medicine)