Germany: Top advisers hold off endorsing vaccine for teens

The head of Germany's Standing Committee on Vaccination (STIKO) has again defended the advisory group's decision to not endorse the vaccination of teens. "We cannot issue a blanket recommendation as long as we are lacking the necessary [medical] data," Thomas Mertens recently said in an interview.

So far, he said, there was insufficient data regarding potential health issues linked to vaccinating 12 to 17-year-olds. Mertens added that STIKO may eventually change its view and endorse teen vaccinations. But it would not do so, he said, because politicians are calling for this step.

Mertens instead urges as many 18 to 59-year-olds as possible to get the jab. This, he said, would significantly reduce the severity of the fourth coronavirus infection wave. "Vaccinating children may garner more media attention, but will prove less effective from an epidemiological perspective."

This is not the first time the advisory body and German lawmakers have disagreed over how to handle the coronavirus pandemic. Earlier in the spring, STIKO said the Astra-Zeneca vaccine ought to be administered only to certain age groups. It similarly recommended administering the Johnson&Johnson vaccine to older cohorts only. German politicians, however, approved the vaccine for younger people as well.

What is STIKO?

The advisory body has been around for nearly 50 years. STIKO was set up in 1972 as a branch of the federal health agency, a research institute dissolved in 1994. The committee was then moved to the Robert Koch Institute (RKI), Germany's disease control and prevention agency.

The RKI is part of the federal Health Ministry, which is led by Health Minister Jens Spahn of the governing conservative Christian Democratic Union (CDU). Though formally independent, the body is therefore not entirely free from political pressure or influence. 

STIKO makes its own procedural rules in consultation with the Health Ministry and was last revised in 1994. It states that STIKO should carry out "medical-epidemiological cost-benefit analyses and focus on matters of practical implementation" on the basis of the latest scientific findings.

The body also only deals with vaccines that have already been approved. The institution responsible for authorizing vaccines is the Paul Ehrlich Institute.

STIKO disseminates its advisory guidelines via its epidemiological bulletin. Last published on July 8, it recommends inoculating children and teens between the ages of 12 and 17 only in rare exceptions. It said vaccinations within this group are only advised in the cases of pre-existing medical conditions, or if vulnerable family members cannot get vaccinated due to medical reasons.

STIKO, however, added that children and teens may nevertheless get the jab if their parents approve, provided everyone has been briefed on and accepted the potential risk involved.

Seeking: impartial expertise

STIKO is an interdisciplinary 18-member body, comprised of experts from a variety of fields such as tropical medicine, epidemiology, virology and microbiology. Many STIKO members are professors, though some are practicing doctors, while others have a background in working for state public health institutions. The role is unpaid. 

Germany's Ministry of Health and federal states together appoint all 18 STIKO members for a period of three years. The current group will serve until 2023. Members are expected to listen only to their own conscience and are obliged to "fulfill their tasks in an impartial manner."

STIKO recommendations are just that: recommendations. They are not legally binding. Even so, STIKO advice is taken seriously by all German public health officials in each state. One reason is to help ensure each region has a consistent approach to vaccines. The body's expertise is also taken into consideration by the Federal Joint Committee, which convenes to issue directives regarding Germany's statutory health insurers and their medical services.

Infection protection act

In 2001, Germany adopted the Infection Protection Act. Among other things, it sets out that the STIKO must provide recommendations on administering vaccinations as well as advise on the tolerability of vaccines. The law says such advice must make clear criteria that differentiate between a vaccine that causes an unusual reaction, or leads to unusually severe health complications.

Politicians have amended the act since the advent of the coronavirus crisis. The law now stipulates that the advisory body must issue recommendations to help reduce the number of severe COVID-19 cases, curb infections, and protect vulnerable groups — alongside ensuring key state bodies remain functional.

This article was translated from German

August 4, 2021: The headline and introduction to this article have been corrected, to show that STIKO has not yet endorsed the vaccine for teenagers, not that they are opposed to it. DW regrets the error.