Berlin (dpa) – Federal and state health ministers are expanding the Corona vaccination offer for children and adolescents between the ages of 12 and 17, although the Permanent Vaccination Commission (Stiko) has not yet issued a general vaccination recommendation for the group. A contradiction? There are also questions and answers.
Who is the Permanent Vaccination Commission?
De Stiko has 18 members from different disciplines who work on the independent committee on a voluntary basis. They are each appointed for three years by the Federal Ministry of Health in consultation with the state’s top health authorities.
The committee, led by Ulm virologist Thomas Mertens, is supported by experts from the Robert Koch Institute (RKI). What must be achieved with the vaccination advice is laid down in the Protection of Infections Act.
What relevance does Stiko’s work have in medicine?
When the Stiko recommends a vaccination, it outweighs doctors than the term “recommendation” lays out suggests: it’s not just well-intentioned advice, but rather a guiding principle. Some doctors strictly adhere to it.
Normally, the Stiko judgment is important for questions about liability and the reimbursement of costs by statutory health insurers – however, with the corona vaccination campaign this is regulated by the federal government. Vaccination is formally possible without a Stiko recommendation, but it contradicts the “practice that has always been established,” the German Association of General Medicine and Family Medicine said weeks ago.
How does the board work?
According to its own information, Stiko continuously evaluates studies and data and weighs the following: What are the benefits and what are the risks of a vaccination for the individual and for the community? The recommendations are not set in stone, but are adapted depending on the level of knowledge: The eighth update is now available for the Covid-19 vaccination.
De Stiko gives detailed, long-term scientific reasons for this. Mertens emphasized in an interview with the Public Prosecution Service on Tuesday: “We work under the greatest pressure anyway. The calls from politicians in recent weeks for us to reconsider our advice were as unnecessary as a goiter.”
Why do Stiko’s and EU institutions’ assessments of childhood vaccinations differ?
The European Medicines Agency (EMA) and the EU Commission gave the green light to approve vaccines from Biontech/Pfizer and Moderna from the age of 12, while Stiko has so far only recommended their use to a limited extent.
That should come as no surprise: the Stiko refers to the different tasks. More generally, EMA is about assessing data on effectiveness, safety and quality. At Stiko, the focus is on regulating the use of vaccines for the best benefit of the individual and the population in this country. In other countries, for example with a larger share of children, the considerations may be different.
What does Stiko advise so far when vaccinating children against Corona?
The recommendation supports the vaccination of a group that, according to Mertens, includes about 350,000 children and young people between the ages of 12 and 17. It concerns children and adolescents with certain pre-existing conditions such as obesity or chronic lung disease – and those with relatives or contacts who are at high risk for corona.
According to federal health minister Jens Spahn (CDU), more than 900,000 people between the ages of 12 and 17 have been vaccinated at least once, about 20 percent of this age group.
How does Stiko assess the decision to expand the vaccination offer?
The decision was “not a catastrophe”, but also not ideal, according to Mertens. He refers to a passage in the vaccination advisory that covers the decision: According to this, the use of the vaccine is “possible after medical advice and with individual wishes and risk acceptance”.
The virologist also speaks of “unfortunate hecticism” and complains about political activism, which he explains at the start of the school, the abundance of vaccines and the vaccination centers that are no longer used at full capacity. Stiko only needs ten days to update its advice, according to Mertens.
Does that mean there will be a general recommendation next week?
According to the Stiko boss, that is by no means clear: “The outcome is open, we are weighing up.” His Stiko colleague Christian Bogdan spoke about the currently unfulfilled demands for this. Meanwhile, Stiko member Ulrich Heininger said on “Deutschlandfunk”: “Either it stays as it is, or – and that is my personal hope – we come to a somewhat broader recommendation.”
What does the decision depend on?
The Stiko is now mainly concerned with the safety of the vaccination: According to Mertens, data on the possible consequences of myocardial inflammation are lacking, although the acute course is usually not serious. This heart muscle inflammation occurred in about one case per 18,000 vaccinees in the United States. However, this information comes from a system in which data subjects report the complaints themselves, an unreported number must be assumed.
In some cases, those affected had to go to intensive care, but the exact extent is unknown, Mertens said: “No one has this number yet, not even Karl Lauterbach.” The SPD health expert had declared the Stiko an “outsider” in “Deutschlandfunk” and said that the main studies had led to “that the infection with the Delta variant would be much more dangerous than the vaccination, that the vaccination is now well researched” .
Why did the vaccination recommendations for adults go so much faster?
Because adults, unlike children, get sick more from Covid-19 and the benefit of the vaccination for the individual is clear, argues Mertens. He confirmed that, according to the modeling, it is important to significantly increase vaccination coverage among 18 to 59-year-olds to fight the pandemic. “That’s the problem, not the kids.”
It is crucial to make it clear to people of this age group that the further course of the pandemic in Germany depends largely on their willingness to be vaccinated – with consequences for the lives of individuals, the community and ultimately the economic recovery.
What do the politicians and medical associations say?
Spahn defended the planned additional vaccination options. “It’s emphatically not about exerting pressure, we don’t do that either.” If parents and kids said they wanted to wait for more data, that was okay and no problem. He opposed constructing a contradiction – the decision of the federal and state governments was “fully consistent with the Stiko”.
The spokesperson for the professional association of pediatricians, Jakob Maske, has long supported the Stiko. Because corona infections in children and adolescents were relatively mild, there was no need to rush – you could wait a week for the re-evaluation, he told broadcaster Phoenix. The German Association of General Practitioners criticized that the procedure could lead to uncertainty.