Vaccinations for the baby – these are the vaccinations the baby really needs

In addition to the check-ups, vaccinations for the baby are an essential part of health care. Parents have to decide at an early stage whether and how they want their children to be vaccinated.

In this article we give an overview of all standard vaccinations recommended by the Standing Vaccination Commission (STIKO) for newborns, infants and toddlers up to the age of two. All recommended vaccinations are considered very well researched, safe and highly effective.

If you are still worried about one or more vaccinations, you should always discuss this with the midwife or the treating pediatrician. Only trained medical professionals are able to make a meaningful decision on the subject of vaccinations for each baby.

The baby should be vaccinated against these diseases and pathogens

Vaccinations for babies are already an important part of counseling and health care for the first time during the U2 preventive medical check-up. The baby’s first vaccination is scheduled for 6 weeks of age.

The large number of different diseases against which the baby should be vaccinated unsettles many parents. Up to an age of two years, the baby is ideally immunized against 13 different diseases and receives a basic immunization and / or booster vaccination on a total of 6-7 different dates.

Combination vaccines are available for many types of pathogen so that an injection does not have to be given for each vaccination. Because there should be a certain period of time between the administration of individual active ingredients, the manufacturer’s instructions must be carefully observed, especially with combination vaccines.

This is of course the task of the pediatrician. However, the parents can help him by carefully keeping the vaccination book and presenting it for entry with every vaccination.

Parents receive the vaccination appointments and corresponding advice again and again during the preventive medical check-ups. You can also consult your pediatrician about vaccinations at any time.

Rotaviruses

The primary vaccination against rotavirus is the very first vaccination the infant receives. The first basic immunization takes place at the age of 6 weeks. Depending on the vaccine used, the vaccination must be repeated three to four times in order to develop its full protective effect.

The live vaccine is given as an oral vaccine so the baby does not need to be injected for the vaccination. Rotaviruses can cause severe gastrointestinal infections (gastroenteritis), which can be severe in babies. 

The disease is highly contagious and notifiable. Infants and toddlers get infected particularly quickly. In 2013, immunization against rotaviruses was included in the standard vaccination cycle for infants by the Standing Vaccination Commission. 

tetanus

Tetanus, also called tetanus, is an infectious bacterial disease that enters the body through open wounds. The disease is often fatal, even with medical treatment. 

For children, vaccination against tetanus is an absolute must. Even minor injuries such as abrasions or a knocked knee while riding a bicycle open the door to the child’s organism for the bacterium Clostridium tetani.

Babies are therefore given the first basic immunization at the age of two months. The disease caused by this pathogen is so dangerous that vaccination protection is strongly recommended even for adults and should be refreshed every 10 years.

The basic immunization against tetanus takes place as a so-called 6-fold vaccination together with diphtheria, whooping cough, Hib, polio and hepatitis B. Vaccination against six different diseases can be built up against these six diseases with a combination agent.

Alternatively, vaccines are also available that can be used without hepatitis B or Hib, for example.  The immunization must be repeated several times to ensure adequate protection.

diphtheria

Diphtheria is an infectious disease caused by bacteria. The pathogen mainly affects the upper respiratory tract. The bacterium can also enter the body through wounds and cause skin diphtheria.

In addition to a sore throat, infected people are also at risk of serious complications that can affect the heart, kidneys, nervous system or liver. Because the disease mainly affects babies and small children, the Standing Vaccination Commission recommends vaccination across the board from the age of two months.

The diphtheria vaccine is considered particularly well researched and is on the list of essential drugs of the World Health Organization (WHO). 

Four basic immunizations are required for complete protection against diphtheria. At school age, children then receive two further booster vaccinations. As with tetanus, adults should be vaccinated against diphtheria every 5 to 10 years to maintain protection. 

whooping cough

Just like diphtheria, whooping cough is transmitted by bacteria and is highly contagious. Children get infected particularly easily and show significantly more severe courses than adults.

The disease can quickly become life-threatening for newborns. Because babies do not receive their first basic immunization until they are two months old, only herd immunity can protect newborns against whooping cough.

Parents and family members should therefore have their own vaccination against whooping cough checked in order to prevent infection of the newborn. A whooping cough vaccination is recommended for pregnant women in the third trimester. 

The vaccination against whooping cough is included in the 6-fold vaccine, so that four basic immunizations initially build up full protection against the disease.

Further booster vaccinations are given between the ages of 5 and 6 and between 9 and 17 years of age. After an infection, there is immunity, but it does not last for life. Vaccinated people also have to have their protection renewed every 10 years. 

Hib

The abbreviation Hib is the abbreviation for the bacterium Haemophilus influenzae type b. The most common infections caused by the pathogen include meningitis and numerous ear, nose and throat diseases.

Originally, these infections could be treated well with antibiotics. However, since 1990 the Standing Vaccination Commission has recommended vaccination against the pathogen because many strains of the bacterium are resistant to common antibiosis and cannot be treated well.

Since the introduction in the STIKO vaccination calendar, infections with Hib have decreased so much that many parents are no longer aware of this infectious disease. 

The Hib vaccination is part of the six-fold vaccination and is carried out a total of 4 times. In contrast to tetanus or diphtheria, a booster is no longer necessary from the age of five, because infections with Hib are only widespread in small children.

Polio (poliomyelitis)

Polio is triggered by the polio virus and occurs mainly in childhood. As of 2003, apart from very few individual cases, Europe is considered a polio-free zone. Vaccination is nevertheless important for herd immunity and, in addition to protecting against infection, aims to completely eradicate the disease. 

The vaccine is considered very safe and well researched. Polio vaccinations have been used with success since the 1950s and have led to a sharp decline in the number of new infections.

Immunization in Germany has been routine with an inactivated vaccine since 1998. This no longer contains any living components and is therefore particularly well tolerated. In rare cases, side effects are limited to a slight reddening of the injection site.

Protection against polioviruses is carried out as part of the four basic immunizations. As part of the 6-fold vaccine, the vaccination takes place as an injection into a muscle and has completely replaced previous oral vaccination with the live vaccine. 

Hepatitis B.

The vaccination against hepatitis B is also included in the 6-fold combination vaccine. The basic immunization takes place here also four times up to the completion of the second year of life.

Infection with the hepatitis B virus causes severe inflammation of the liver and can lead to some life-changing complications, such as cirrhosis of the liver or a malignant tumor of the liver.

Hepatitis B is considered an infectious disease that primarily affects medical staff and people with risky lifestyles. The vaccination has been recommended to infants by the STIKO since 1995.

Although the risk of infection for infants and young children is very low, the Standing Vaccination Commission justifies its recommendation with the fact that the course for infants and young children can often become chronic. While only 10% of adults show a chronic form, it is up to 90% for infants and toddlers. 

The WHO has also recommended vaccination for infants since 1993 in order to reduce the globally active, widespread disease. Contrary to what is required by the WHO, newborns are first vaccinated against hepatitis B at the age of two months.

Immediately after birth, however, vaccination is recommended for all newborns whose mothers have hepatitis B. If an infection is likely or at least possible, the newborn should also receive basic immunization immediately after birth.

After completing the four vaccination appointments for basic vaccination, no booster vaccination against hepatitis B is required. In adulthood, further vaccination is only recommended for those people who belong to risk groups or who are more frequently exposed to the pathogen for professional reasons.

Pneumococci

In 2015, the STIKO revised its recommendations for pneumococcal vaccination for infants. The number of basic immunizations has been reduced from four to three. Only premature babies (before the 37th week of pregnancy) continue to receive four doses of the vaccine. 

Pneumococci mainly affect children up to the age of two and cause infections of the nasopharynx. This results in inflammation of the lungs, middle ear and sinuses, among other things.

Pneumococci are also problematic because they can settle in body fluids such as blood or cerebrospinal fluid and cause severe infections of the blood (blood poisoning) and the brain (meningitis).  The eye can also be attacked by pneumococci (inflammation of the cornea).

Meningococci

Various vaccines are available for vaccinating against meningococci. Because the pathogen appears with numerous subtypes, a so-called serogroup must be selected when choosing the right vaccine.

In the context of this subgroup, the selected vaccine then offers very reliable protection. Infants are immunized against serogroup C meningococci.

In an updated statement from 2018, the STIKO points out that infections with meningococci from serogroup B are so rare in Germany that a recommendation for the standard vaccination of infants can currently be dispensed with. 

Since 2006, infants in the second year of life have been vaccinated against serogroup C meningococci as standard. Like pneumococci, meningococci colonize the nasopharynx and can cause serious infections.

The bacteria cause, among other things, severe meningitis (meningitis) and blood poisoning (sepsis). The diseases can be treated with antibiotics, but they are often severe and are often associated with complications and long-term damage (e.g. blindness, paralysis, seizures). Meningococcal infection is fatal in around 5-16% of cases. 

measles

The measles vaccination has recently become the subject of numerous discussions about vaccination. While many parents dismiss measles as a harmless childhood disease, it is actually a serious infection with highly contagious viruses.

In 10% of the cases, the infection has severe complications. Measles is therefore not a typical childhood disease.  Adults can also become infected with the pathogen. The fact that the disease is notifiable within the meaning of the Infection Protection Act underscores once again that this is not a harmless childhood disease.

The decline in willingness to vaccinate against measles has led to the disease becoming more and more widespread in recent years. If measles was once considered on the safe path to eradication, more infections were reported by the Robert Koch Institute in the first quarter of 2017 than in the entire previous year combined. 

A highly effective combination agent is available against measles, which simultaneously enables immunization against mumps, rubella and, optionally, chickenpox. A single vaccine is also available.

With two vaccinations (one in the first and one in the second year of life), a reliable protection against measles, mumps, rubella and possibly chickenpox can be built up with the MMR or MMRV vaccine.

On November 14, 2019, the Bundestag passed a nationwide vaccination against measles. Children and people who are employed in health and community facilities (e.g. hospitals, day-care centers, schools, etc.) must be vaccinated. The mandatory vaccination came into effect on March 1st, 2020 and is covered by Section 20 (8) of the Infection Protection Act. 

mumps

As already mentioned, immunization against mumps is carried out with the MMR combination vaccine. With two vaccination appointments, a basic immunization against the mumps virus is achieved. Individual vaccines against mumps are currently no longer produced in Germany. 

Because the disease has spread in recent years, the STIKO recommends the mumps vaccination in the first and a follow-up vaccination in the second year of life. People who work in the health and care sector should also get vaccinated against mumps.

The infectious disease mainly affects children and is therefore a classic childhood disease. Many parents forget that a mumps infection can lead to serious complications such as meningitis and numbness.

Because the likelihood of complications increases with age, basic immunization is recommended as early as infancy in order to reduce the risk of complications and consequential damage in the case of infections at an advanced age.

rubella

Triggered by the rubella virus, this highly contagious infectious disease is also a classic childhood disease. A passed infection promises lifelong protection (immunity) against the disease, so many parents still believe that children are best protected after they have gone through the disease.

90% of all rubella infections affect children. For adults, the infection may be more likely to develop complications. Rubella infections are particularly problematic during pregnancy.

Because rubella infection during pregnancy greatly increases the risk of miscarriages and malformations , girls in particular should be vaccinated against rubella as standard. Vaccination during pregnancy is not possible. It is therefore imperative that women of childbearing age get the rubella vaccination if they were not vaccinated in childhood.

With the combination active ingredient available in Germany, rubella infection can be safely prevented. With the first vaccination, there is a 95% probability that full protection will be built up. To be on the safe side, the basic immunization is repeated before the second birthday.

chickenpox

Since 2006, the STIKO has been recommending an MMR vaccination with an additional component to protect against chickenpox. The quadruple vaccine (MMRV) protects against measles, rubella, mumps and chickenpox and is given in the first and second year of life.

Children who were vaccinated only once when they were young can receive a safe catch-up vaccination with the MMRV.  A chickenpox vaccination is therefore recommended even in infancy, because this childhood disease, which is considered harmless, can lead to serious complications.

In addition to an increased risk for pregnant women, a chickenpox infection increases the likelihood of developing shingles later in life.

The reason for this is that after the disease, varicella zoster viruses remain in the body and can trigger the disease in times of a weakened immune system. [25] Another problem is that people with shingles can transmit the virus and infect those who have not been vaccinated with chickenpox. 

Vaccines against measles, mumps, rubella and chickenpox (MMR and MMRV vaccines) are repeatedly criticized for promoting or triggering diseases such as autism, diabetes or allergies.

Even if there is no scientific evidence for this, some parents still tend not to have their children vaccinated and instead – mostly unconsciously – take the risk of serious complications that the supposedly harmless teething problems can bring with them.

However, numerous studies have shown that the MMRV vaccination is highly effective and has contributed significantly to a reduction in the four infectious diseases. It was not until 2019 that a Danish study also proved again that vaccinations do not increase the risk of autism. 

Differences in the various vaccinations

Vaccinations are divided into different types depending on the dosage form. Depending on whether it is the first vaccination against a pathogen or a revaccination, different vaccines are used.

Live and dead vaccination

Some vaccines contain live components. For the vaccine, the pathogens are weakened so much in the laboratory that they can no longer trigger the respective disease in healthy people. Live vaccines therefore contain a small amount of live bacteria or viruses that can multiply but pose no threat to the person being vaccinated.
Live vaccines are used to immunize against the following diseases

  • mumps
  • measles
  • rubella
  • chickenpox
  • Rotaviruses

Inactivated vaccines, on the other hand, contain inactivated forms of the pathogen. They are broken down by the body much faster, so that several booster vaccinations have to be given in order to achieve a complete immunization.

Inactivated vaccines are used to immunize against the following diseases

  • Polio
  • whooping cough
  • Hepatitis B.
  • Pneumococci
  • Meningococci
  • tetanus
  • diphtheria
  • Hib

Basic immunization

As the first vaccination against a certain pathogen, infants receive a so-called basic immunization. It lays the foundation for future vaccination protection and must – depending on the pathogen – be repeated at least once.

The basic immunization ideally takes place in infancy or toddler age. The vaccines provided are tailored to the needs of this age group.

Booster vaccination

The booster vaccination ensures that the basic immunization carried out in infancy is maintained for life. Booster vaccinations are only suitable for people who have already received basic immunization.

Because vaccinations with dead vaccines do not offer lifelong protection against the respective disease, the booster against all diseases against which vaccine is vaccinated with dead vaccine is particularly recommended.

In contrast to the basic vaccination course, vaccines contain a lower dose for booster vaccines. This is sufficient to remind the immune system of the pathogen and to stimulate it to produce sufficient antibodies against the bacterium or virus.

Catch-up vaccination

Children who did not receive basic immunization against certain diseases in infancy receive a so-called catch-up vaccination. Even if the recommended time for a booster vaccination is missed, the catch-up vaccination is used.

The permanent vaccination commission points out that every vaccination against every pathogen counts and the interrupted series of vaccinations can easily be completed by a catch-up vaccination. 

Standard vaccination

Standard vaccinations are all those vaccinations against which the STIKO recommends immunization as standard. You will be faced with further vaccinations, which are recommended or even mandatory for risk groups, travelers or followers of certain professional groups (e.g. medical staff).

Standard vaccinations include all of the above vaccinations for infants and young children.

The pediatrician will advise you on further vaccinations that may be important for the baby. This applies in particular to the flu vaccination, which is currently not recommended by the STIKO as a standard vaccination for infants. Further vaccinations for the baby may also be recommended when traveling to risk areas.

Recommended vaccinations according to age

In order for vaccinations to develop their full effectiveness, certain periods of time must be observed between the individual vaccination appointments for basic vaccination and booster vaccination. When the baby should receive which vaccination, the Standing Vaccination Commission determines in the so-called vaccination calendar. This contains all periods in which the vaccination should ideally be carried out.

The pediatrician ultimately decides, in consultation with the parents, which vaccinations the baby should receive. The measles vaccination is mandatory; all other vaccinations are on a voluntary basis.

To avoid invasive procedures such as B. To keep injections and visits to the pediatrician as low as possible, many vaccinations can be carried out as part of the preventive examinations. A consultation also takes place regularly as part of the U-examination, so that parents can make appointments here or make up for them. Your worries and fears also find space here.

Immediately after birth

Newborns are only vaccinated immediately after birth if it is medically necessary. For example, if the mother has transmitted hepatitis B infection to the baby, the baby will be vaccinated against the virus within 24 hours of birth.

6 weeks

The first vaccination for the infant is the primary vaccination against rotaviruses. It takes place 6 weeks after the birth.

2 months

With a 6-fold vaccine, babies can receive basic immunization against the following diseases at the age of two months:

  • tetanus
  • diphtheria
  • whooping cough
  • Hib
  • Polio
  • Hepatitis B.

In addition, the first vaccination against pneumococci is recommended. The protection against the rotaviruses is also refreshed at the age of two months.

3 months

Because tetanus, diphtheria, whooping cough, polio, Hib and hepatitis B have to be refreshed several times in order to be fully effective, the baby is given another appointment for the booster vaccination at the age of three months.

The third vaccination against rotaviruses is also recommended at the age of three months, but can be postponed for a few weeks if necessary.

4 months

If the baby has already received the third vaccination against rotavirus at the age of three months, it is now fully protected against this pathogen. Otherwise this vaccination appointment must be made up at the age of 4 months. In addition, the baby needs the third vaccination with the 6-fold vaccine. It is also vaccinated against pneumococci for the second time.

11-14 months

The fourth basic vaccination against diphtheria, tetanus, whooping cough, polio, Hib and hepatitis B takes place between the ages of 11 and 14 months. Protection against pneumococci is also completed.

In addition, a vaccination against meningococci is recommended, which protects against dangerous meningitis.

Basic immunization against typical childhood diseases such as measles, chickenpox, mumps and rubella is also started when the baby is around one year old.

15-23 months

Before the baby turns two years old, further vaccinations are on the program. The 6-fold vaccination protection should now be completed at the latest. The meningococcal vaccination is also being refreshed.

The toddler also receives a booster vaccination against measles, mumps and rubella, which is available as a triple vaccine. The second basic vaccination against chickenpox is also due at this age.

Important note and disclaimer:

This article is about a health issue. All information is given to the best of our knowledge and belief and has been carefully researched and substantiated with well-founded sources. The information provided is as objective as possible and is – as far as possible – free of evaluation and recommendation.

However, no guarantee is given for the correctness, currency and completeness. This article is not intended for self-diagnosis or medical advice, but is of a purely informative nature. It cannot and should not replace advice from a doctor or midwife.

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