“New Stiko Recommendations for COVID Booster Vaccinations and Endemic State”

Only older people over the age of 60 and people with risk factors for a severe course of the corona virus should continue to receive booster vaccinations, preferably in autumn, when they are also vaccinated against influenza or pneumococci. This also applies to employees of nursing homes and clinics. However, the Stiko has not yet determined whether these boosters have to be given annually or whether a certain maximum number of vaccine doses is sufficient. This must be shown by data on the development of immunity over a period of several years, which is not yet available.

At a press conference on Monday, members of the Stiko justified the revision with the end of the pandemic. After more than 200 million doses of vaccine were issued in Germany in the past two years, most people are now basic immunized. Many have also been infected with Corona once or several times, so that there is now relatively broad immunity in the population.

For most, this prevents an infection from developing into a life-threatening illness that requires hospital treatment. In addition, although the virus has become more contagious during its evolution, it does not make you more ill. That is why the previous special role for corona vaccinations no longer applies. They can now be included in the general vaccination canon, said the immunologist Christian Bodgan from the University Hospital in Erlangen.

The new recommendation is intended to replace the previous 25 updates and remain in place in the long term. At the same time, the withdrawal of the vaccination recommendation for certain groups could mean that they have to pay for further immunizations themselves if they still want to be vaccinated.

“It’s good that there will be a clearer future vaccination recommendation there, that helps the doctors,” said Carsten Watzl, Secretary General of the German Society for Immunology, who is not a member of the Stiko Instead, the risk of severe courses in children and adolescents is very low, which is why there is not much benefit from vaccination.

Stiko member Martin Terhardt, a pediatrician in Berlin, explained that with the appearance of the omicron variant, the number of PIMS and MIS-C cases had fallen sharply. “That no longer plays a major role with the current variants.” The Stiko also assumes that there is now a relatively high level of basic immunity among children. Newborns, on the other hand, received nest protection from the antibodies of their vaccinated mothers. For pregnant women, on the other hand, the general vaccination recommendations for adults over the age of 18 apply. Booster shots for women who have been vaccinated before pregnancy are not recommended.

Both Watzl and Bodgan emphasized that the vaccinations could not prevent respiratory infection with Corona. “We have to get away from the idea that the vaccines totally prevent a respiratory infection,” said Bogdan. That was not the goal of vaccine development either. Instead, the main thing is to prevent severe courses and the vaccinations have been a great success here.

Also regular updates of vaccination protection in healthy adults are not necessary from Stiko’s point of view. “Corona is not a new influenza virus,” said Bogdan. In contrast to the flu pathogen, which changes regularly, the mutations in Corona are mainly limited to the spike protein. The cellular immune response by the so-called T-cells has never been bypassed by the new virus variants.

Bogdan and his colleague Terhardt emphasized that the current debate about the so-called post-vac syndrome had no influence on the current Stiko recommendation. It can certainly happen that people develop severe reactions to a vaccination, which sometimes lead to long-lasting, sometimes even permanent damage. “However, this often has less to do with the vaccine and more to do with immunological effects that are unusual but known,” said Bogdan.

This included, for example, when someone develops so-called autoantibodies, which represent an overreaction of the immune system. However, such overreactions are much more common after infections than after vaccinations. It is also difficult to distinguish which complications were actually triggered by the vaccination and which only occurred by chance at the same time. “We have vaccinated over 200 million doses. It is practically inevitable that vaccinations will appear at the same time as a new clinical health picture,” explained the immunologist.