Vaccination

On May 14, 1796, Jenner injects 8-year-old James, son of his gardener Phipps, with material he had obtained from fresh cowpox lesions of a milker (Sarah Nelmes). To Jenner's relief, the boy subsequently develops only a mild fever. Six weeks later, he exposes the boy to smallpox material. Smallpox disease does not develop. Jenner's merit is that he proved the correctness of his hypothesis "cowpox protects against smallpox" (proof of concept). His investigations on other persons culminated in 1798 in the publication "An Inquiry Into the Causes and Effects of the Variolae Vaccinae" (1). There were vaccination skeptics even in his time, coupled with reports that after vaccination people grew cow heads, among other things. As a late recognition of his achievements, the country doctor Jenner was appointed personal physician to King George IV in 1821. On October 26, 1979, the WHO declares smallpox eradicated. Only in high-security laboratories does the smallpox virus live on.

The term vaccination is derived from the Latin word "vacca" (cow). In Germany, the independent Standing Commission on Vaccination (STIKO) at the Robert Koch Institute (RKI) issues annually updated vaccination recommendations, which are published in the Epidemiological Bulletin.

According to the measles protection law of March 1, 2020, confirmed by the highest court, measles vaccination is the only one required by law for a certain group of people and its non-compliance is subject to sanctions. In contrast to compulsory vaccination, people retain the freedom to choose not to be vaccinated. In addition, the law stipulates that physicians may perform any vaccination regardless of their specialty.

The recommendations issued by the STIKO only become legally binding nationwide through the protective vaccination guideline (SI-RL) issued by the Federal Joint Committee (G-BA), on the basis of which the highest authorities of the various federal states recommend the vaccinations that meet the medical standard and are then offered by the statutory health insurance funds to their members as free mandatory services.

Despite this extensive range of vaccinations, vaccination rates are low. The booster vaccinations in adolescence and adulthood are not infrequently forgotten. Therefore, physicians have a responsibility to keep track of their patients in this regard, e.g., by checking the vaccination card annually and by actively addressing vaccination gaps to close them.

Adult vaccination rates: Uptake of standard vaccinations recommended for adults varies. All recommended vaccinations have had uptake rates that can be classified as low to moderate. In particular, vaccination against herpes zoster stands out with particularly low vaccination rates in the age group of ≥ 60 years. Only 3.3% in this age group are fully immunized: For pneumococcus, the following figures apply:

• Pneumococcus: 22.5%