Compulsory measles vaccination
Information on the compulsory measles vaccination
In Germany, there is a statutory requirement for certain groups of people to be vaccinated against measles. On this page, you can find out who is required to be vaccinated, how proof of vaccination can be provided and the background to the compulsory measles vaccination.
What is measles?
Measles viruses are highly contagious and are transmitted from person to person via respiratory droplets. A measles infection begins with flu-like symptoms such as fever, a cough and a runny nose, followed later by a characteristic rash. Although measles is considered a childhood illness, the disease can lead to serious complications such as pneumonia or encephalitis.
How can you protect yourself against measles?
The best protection against measles is vaccination, which is carried out in childhood with two doses of a combined vaccine. It is important to note that anyone born after 1970 who does not have adequate vaccination cover should catch up with a single dose.
To avoid contracting the disease, contact with infected people should be avoided.
Who is the measles vaccination suitable for?
Proof of immunity required – groups of people affected
In future, the persons concerned must provide proof of immunity to measles, either by means of a certificate confirming that they have been vaccinated against measles or by means of a medical certificate stating, for example, that they have sufficient immunity as a result of a previous measles infection. The regulation applies to two groups of people:
These include, for example, children in after-school clubs, nurseries, kindergartens, schools and other educational establishments, residential homes or refugee accommodation. As the STIKO generally recommends the measles vaccination only from 11 months of age, affected children under 1 year of age are not yet required to provide proof. Affected children who are at least 1 year old must provide proof of at least one vaccination or of immunity. Affected children who are at least 2 years old must be able to provide proof of full immunisation (two vaccinations) or of immunity.
This includes, for example, staff in after-school clubs, nurseries, kindergartens, schools, residential homes, refugee accommodation, hospitals, doctors’ practices, outpatient surgery centres, in the emergency services or in the care sector. Volunteers and trainees may also be affected by the regulation, provided they work regularly (not just for a few days) and for a longer period of time, rather than just a few minutes, within the facility.
If you are unsure whether you or your child is affected by the regulation, it is best to speak to your employer or the management of the childcare facility.
Incidentally, anyone who cannot provide proof of a complete vaccination status is, in case of doubt, considered unvaccinated. Serological tests to determine immune status (measuring antibody titres in the blood) should be treated with caution. Incorrect laboratory results may lead to unprotected individuals being mistakenly classified as protected.
Which vaccines are available?
In Germany, the only vaccines currently available for protection against measles are combination vaccines against measles, mumps and rubella (MMR) or measles, mumps, rubella and varicella/chickenpox (MMRV). These are also generally recommended by the STIKO. The compulsory measles vaccination requirement applies even if only the MMR vaccine can be administered.
What side effects may occur?
Swelling, pain and redness at the injection site are common after vaccination. Fever, irritability and a rash are other common symptoms following vaccination. Occasionally, enlarged lymph nodes, loss of appetite, a runny nose, crying, restlessness, insomnia, enlarged parotid glands, diarrhoea, vomiting, lethargy, malaise and tiredness may occur. Febrile convulsions, middle ear infections, coughs and bronchitis occur rarely. As there are various combination vaccines available, the frequency of side effects may vary, or some possible side effects may be missing from this list. You should therefore ask your GP about the risks and side effects.
Please note: Pregnant women and people with severely compromised immune systems must not be vaccinated against measles.
What costs does SBK cover?
SBK reimburses the costs of the measles vaccination for unvaccinated individuals born before 1970 as an additional benefit. In this case, please submit the private invoice from your GP practice, the vaccination prescription and the pharmacy invoice to us: upload these via the Meine SBK app or, alternatively, send them by post. You can find our
Where can I get myself or my child vaccinated?
If you have not yet been vaccinated against measles, you can get vaccinated at your GP practice, paediatrician’s practice or gynaecologist’s practice. For anyone within the STIKO’s recommended group, the practice can bill the vaccination via the SBK Healthcare Card. You will not have to pay any costs directly.
Frequently asked questions
Those affected must provide proof to the management of the relevant institution or to their employer that they have been fully vaccinated, have already had measles and are therefore immune, or that they cannot be vaccinated due to a medical contraindication. Proof must be provided in the following form:
Failure to comply with the obligation to provide proof must be reported by the heads of the relevant facilities to the competent health authority. A breach of the provisions of the Measles Protection Act is regarded as an administrative offence and may be punishable by fines of up to €2,500. This applies equally to those in care and to staff who fail to fulfil their obligation to provide proof as well as to facility managers and organisations that employ unvaccinated staff or admit unvaccinated individuals in their care. In extreme cases, this may also lead to exclusion from facilities (provided there is no obligation to provide training or accommodation) and to bans on carrying out certain activities.
Measles is a highly contagious disease. Consequently, almost any contact between an infected person and an unvaccinated person can lead to infection – even at a distance of several metres. However, in addition to typical symptoms such as fever and a rash, the infection can have far more serious consequences. Many people are unaware that, in one in 1,000 cases, measles infections can lead to encephalitis, which in turn can result in mental disabilities, paralysis and even death. In rare cases, subacute sclerosing panencephalitis (a progressive inflammation of the brain and nervous system) can also occur several years after infection, and this condition is always fatal.
Despite this risk, and although the measles vaccine is the only effective and lifelong form of protection, many people refuse to be vaccinated against the virus or simply forget to do so. Furthermore, unvaccinated people also put at risk those who cannot be vaccinated due to their age (particularly infants under 1 year old), pregnancy or health reasons (for example, severe immunodeficiency).
Insufficient vaccination coverage has led to the measles virus making a resurgence across Europe, with cases on the rise compared to previous years. However, to completely eradicate measles, 95% of the population must be fully vaccinated (i.e. with two doses of the vaccine). The aim of compulsory vaccination is now to close existing gaps in vaccination coverage.
Questions about the pathogen and the vaccination
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