Table 3 COVID-19 vaccine policies of Germany

Vaccination sequence (Four priority groups)

1. Highest priority: people aged 80 years and above; Persons receiving treatment, care or work in inpatient facilities for the elderly or persons in need of care; Nursing staff in outpatient care services; Employees of medical institutions; Employees of medical facilities that treat, care for, or provide care to at-risk populations

2. High priority: people over 70 years old; People with trisomy 21 syndrome, dementia or mental retardation after organ transplantation; Persons in close contact with persons over 80 years of age or residents of nursing homes and homes for the mentally handicapped; Close contacts with pregnant women; A person who works in an inpatient facility for a mentally handicapped person or who regularly treats, cares for or cares for a mentally handicapped person in an outpatient care service; People who work in healthcare facilities with a high or increased risk of coronavirus exposure, especially doctors and other personnel who have frequent contact with patients, blood and plasma service personnel, and personnel in testing centers; Police and law enforcement personnel are at high risk of infection while on duty (e.g. during demonstrations); People in positions related to public health services and hospital infrastructure; Individuals living or working in refugee and homeless facilities

3. Higher priority: people over 60 years old; Individuals with the following conditions: obesity, chronic kidney disease, chronic liver disease, immune deficiency or HIV infection, diabetes, heart disease, stroke, cancer, chronic obstructive pulmonary disease or asthma, autoimmune diseases and rheumatism; Exposure to low-risk health care facilities (laboratories) and employees who do not care for patients with suspected infectious diseases; Persons holding relevant positions in government, executive and constitutional bodies, armed forces, police, fire brigade, disaster control and THW, judiciary; Key infrastructure companies, pharmacy and pharmaceutical industry, public supply and disposal, food industry, transportation, information technology and telecommunications; Educators and teachers; A person whose work or living conditions are precarious

4. Other people

Vaccine development and supply

1. In mid-November 2020, BioNTech of Germany and Pfizer of the United States successfully developed the COVID-19 vaccine (Comirnaty)

2. On December 21, 2020, EMA recommended granting a conditional marketing authorization for the vaccine Comirnaty, developed by BioNTech and Pfizer

3. On 31 December 2020, Comirnaty received an emergency use authorization from the WHO

4. In August 2021, Comirnaty received official FDA approval (for people over 16 years of age), becoming the first fully marketed COVID-19 vaccine

5. Since August 2021, Germany had committed to support COVAX, the global vaccination initiative. In 2021 and 2022, around 136 million vaccine doses were transferred to COVAX. In addition, the Federal Government bilaterally donated approximately 10 million doses to six different countries(Egypt, Ghana, Namibia, Thailand, Ukraine and Viet Nam). This means over 146 million doses were donated in total

6. On 2 September 2022, the European Commission approved the improved booster vaccine Comirnaty Original/Omicron Ba.1

7. As of 15 September 2022, the European Commission has authorized the use of the Comirnaty Original/ Omicron BA.4–5 modified booster vaccine

8. On October 10, 2022, the European Commission converted Comirnaty from a conditional marketing authorization to a standard marketing authorization

Vaccination of minors

1. On June 7, 2021, German federal and state governments agreed to start offering COVID-19 vaccination to children over the age of 12

2. On December 13, 2021, Germany began vaccinating children between the ages of 5 and 11 against COVID-19

3. In mid-November 2022, the German Standing Committee on Vaccination (STIKO) said that young children at increased risk of severe COVID-19 due to pre-existing conditions should be vaccinated, and the recommendation applies to children between six months and four years of age

4. In late April 2023, the German Standing Committee on Vaccination (STIKO) will no longer recommend that healthy children and adolescents in Germany be vaccinated against COVID-19 in view of the waning of the pandemic. Children who are in the risk group for severe Covid-19 due to illness are still recommended to be vaccinated starting at six months of age

Compulsory vaccination

No compulsory COVID-19 vaccination

Vaccination boosters

1. In September 2021, Germany began offering the first booster dose of the COVID-19 vaccine to the elderly and people with weakened immune systems

2. In October 2021, the German Standing Committee on Vaccination (STIKO) recommended the booster vaccination against COVID-19 for people over 70 years of age and for certain indications, as well as additional doses of mRNA vaccination for people receiving the COVID-19 vaccine Janssen. It is recommended that the third dose should be given 6 months after the formation of basic immunity

3. On 18 November 2021, the German Standing Committee on Vaccination (STIKO) recommended that all people aged 18 and over receive an mRNA booster vaccination with the third dose to be given six months after basic immunity has developed

4. At the end of December 2021, the German Standing Committee on Vaccination (STIKO) recommended that adults be given the booster vaccination after 3 months of full vaccination (previously it was recommended after 6 months)

5. In January 2022, the German Standing Committee on Vaccination (STIKO) recommended the first dose of booster vaccination for all children and adolescents aged 12–17 years

6. In mid-February 2022, the German Standing Committee on Vaccination (STIKO) recommended that people over 70 years of age, residents and caregivers of nursing facilities, persons over 5 years of age with immune deficiencies, and staff of medical and nursing facilities (especially those in direct contact with patients and residents) receive a second booster dose, at the earliest three months after the first booster dose. For people working in healthcare and nursing facilities, it is recommended to get the vaccine 6 months after the first booster dose of the vaccine

7. In mid-August 2022, the German Standing Committee on Vaccination (STIKO) recommended that people aged 60–69 years and those over 5 years old who are at risk of severe COVID-19 due to underlying diseases should receive a second booster dose of COVID-19 vaccine

Incentivize vaccination

From September 13 to September 19, 2021, Germany will start a nationwide "Vaccination Week" (Impfaktionswoche), in which people can voluntarily receive free COVID-19 vaccinations without prior appointment at any place marked "Hier wird geimpft" (Vaccination available here), including buses, libraries, football stadiums and shopping malls

Vaccination support policies

1. From mid-June 2021, the German Digital Vaccination Certificate was put into use, and doctors' clinics, vaccination centers and pharmacies were able to provide QR code digital authentication for vaccinated people. People can prove they have been vaccinated simply through the CovPass or Corona-Warning-app mobile App. The certificate showed whether the holder had been vaccinated and how long it had been vaccinated, and can be used in place of a negative test certificate in situations such as travel

2. EU Digital Covid Certificates, also known as "Green digital Certificates", was officially launched on July 1, applicable to the 27 EU Member States (excluding Ireland) and four non-EU countries: Iceland, Norway, Switzerland, and Liechtenstein