FAQ - Frequently Asked Questions
Vaccination and Vaccines
I have got some questions regarding vaccinations against the measles. Where can I find the answers?
The Measles Protection Act (Masernschutzgesetz) has been applicable since 1 March 2020. The aim of the "Act governing the protection from the measles and the reinforcement of infection prevention by vaccination" (Gesetz für den Schutz vor Masern und zur Stärkung der Impfprävention) is to provide a better protection from measles infections, especially for children. More detailed information on vaccinations against the measles have been elaborated jointly by the Federal Ministry of Health, the Federal Office for Health Information (Bundeszentrale für gesundheitliche Aufklärung, BzgA), the Robert Koch-Institut and the Paul-Ehrlich-Institut. This information also contains answers with regards to the composition of vaccinations, the question of why a multiple component vaccine should be used, etc.
Why are Cell Cultures from Human Foetal Tissue Used for the Manufacture of some Vaccines?
Since viruses always require a live cell to replicate, a cell line (cell culture) from animals or humans is required to produce vaccine viruses. Depending on the virus type, various cell types or cell lines have proved to be particularly suitable for this purpose. For influenza vaccines, for instance, up to now, these have been primarily embryonised hen’s eggs; measles viruses and mumps viruses are replicated on chicken fibroblasts, rubella viruses and chicken pox viruses on human diploid cells (MRC-5).
There are currently two cell lines from human lung tissue for the production of marketable vaccines in Germany. In 1961, the scientist L. Hayflick developed the cell line WI-38, and in 1966, the scientist J. P. Jacobs developed the cell line MRC-5 (Medical Research Council). These cell lines are described as human diploid cells (HDC).
With the development and authorisation of vector vaccines to prevent COVID-19 disease caused by the SARS-CoV-2 virus, two additional cell lines have been added.
These vector vaccines require an attenuated virus as a means of transport (vector) for a harmless portion of the genetic information of SARS-CoV-2 into a small number of somatic cells. AstraZeneca's Vaxzevria and Johnson&Johnson's COVID-19 Vaccine Janssen use adenoviruses for this purpose.
In the case of Vaxzevria, these viruses are propagated on the cell line 293 HEK (Human Embryonic Kidney), in the case of Johnson&Johnson's vaccine on the cell line PER.C6 (from human fetal retinal cells).
The cell line 293 HEK was developed in 1973 by Frank. L. Graham, a doctoral student of Alex J. van der Eb.
The PER-C6 cell line was generated in 1998 by Frits J. Fallaux, also in the laboratory of van der Eb, by an immortalisation of embryonic retinal cells. These came from a fetus aborted in 1985.
The term "cell line" means that this line has been created as a unique line, and has since then been replicated and frozen. The cells are cultured. No new foetuses are required, as can be frequently read. No foetus was aborted in any case to serve as starting material for the establishment of cell cultures.
Who should Receive a Vaccination against Pneumococci?
The German Standing Committee on Vaccination (Ständige Impfkommission, STIKO) has adjusted their recommendations regarding the pneumococcal vaccination during the current pandemic. Seniors of 70 years and older as well as persons with particular underlying diseases have been requested to have themselves vaccinated against pneumococci, since persons in this age group have an increased risk of SARS-CoV-2 infection. Besides, the vaccination of infants and young children up to the age of 2 years is recommended.
Are Pneumococcal Vaccines Available or are there Supply Shortages?
The demand for pneumococcal vaccines has increased in 2020 due to the Corona crisis, since many more people chose to have themselves compared to the previous year. The Paul-Ehrlich-Institut has improved the supply situation by taking various measures. You can find the current situation in our overview of supply shortages.
Can I Receive a Vaccination if I Am Allergic to Chicken Egg White?
Most vaccines, for example individual vaccines against hepatitis A and hepatitis B as well as combination vaccines for the primary immunisation of infants and young children (against diphtheria, pertussis, tetanus, hepatitis B, polio, haemophilus influenzae type B) do not contain any chicken egg white and do therefore not present any problems for people with egg white allergy.
MMR vaccines (measles, mumps, rubella), MMRV (measles, mumps, rubella, varicella (chickenpox)), yellow fever, tick-borne encephalitis (TBE) and influenza may contain traces of egg white. If you are allergic to chicken egg white, please contact your doctor, who will carry out an individual benefit-risk assessment for you before performing a vaccination, and who can take precautionary measures during a vaccination (for example, follow-up of the vaccinee in the doctor’s office). You will find further information and answers to this question on the web pages of the Robert Koch Institute:
Where Can I Find out about the Composition of Vaccines?
The Paul-Ehrlich-Institut offers a lot of information about vaccination on its website, e.g. a list of all vaccines approved in Germany: www.pei.de/vaccines.
In the last column of each table, we offer links to the pages on which the so-called technical and usage information is linked. This includes all information e.g. on the use, the contraindications and the composition of vaccines.
What Is the Difference between an SmPC (Summary of Product Characteristics) and a Package Leaflet?
The package leaflet is enclosed with the drug packages and contains the most important information and instructions for patients.
The SmPC is specific to physicians and is more detailed. You can find the links to the specialist information on our vaccine list in the last column of the table by following this link: www.pei.de/vaccines.
Do Vaccines Contain Aluminium?
Vaccines do not contain any pure aluminium, but certain vaccines contain aluminium compounds as an adjuvant.
Attenuated live vaccines do not require an enhancer. These include, for example, vaccines against measles, mumps, rubella and chicken pox (varicella).
Inactivated vaccines, however, such as vaccines against whooping cough, TBE (tick-borne encephalitis), meningococci, tetanus and diphtheria vaccines contain aluminium compounds as enhancers. This is necessary because such vaccines contain only killed pathogens or parts thereof that do not sufficiently stimulate the immune system without an enhancer. Here, the enhancer helps the immune system to build an effective immune protection.
The content of aluminium compounds of all vaccines authorised in Germany and Europe is well below the permitted limit specified in the European Pharmacopoeia.
Every day, every human being absorbs aluminium in the form of a chemical compound from the air, drinking water, and food. In comparison to that, the additional uptake of aluminium compounds via vaccinations in a person's life is minimal.
Do Vaccines Contain Mercury?
Today's vaccines approved in Germany are thiomersal-free, which means they are free from mercury compounds, as they are supplied in pre-filled syringes. The only exceptions are pandemic and prepandemic inactivated influenza vaccines in multi-dose containers. The latter may contain thiomersal, in the form of an organic mercury compound, as a preservative.
The Vaccine Was Not Stored as Prescribed. Can I Use it Anyway, i.e. Can I Still Be Vaccinated with It?
The quality, efficacy and safety of a vaccine are only guaranteed if the vaccine has been stored correctly. The respective summary of product characteristics (SmPC) provides information on the required storage conditions, which are documented by extensive studies. You can find the links to the SmPC on our vaccine list in the last column of the table by clicking on this link: www.pei.de/vaccines.
Why Is There a Trivalent and a Tetravalent Vaccine against Influenza?
For many years, trivalent (3-fold) influenza vaccines were common. They contained pathogen components (components) of two virus strains of type A and of one virus strain of type B. Since 2016, tetravalent (quadrivalent or quadruple) vaccines are also available. They contain an additional type B virus strain. This provides a broader protection against circulating influenza viruses.
From the 2018/2019 season, the recommendation of the Ständige Impfkommission (STIKO, Standing Vaccination Commission) for tetravalent vaccines applies.
Background: In the last few years it has become apparent that during the flu season both lines of the B-strain circulated to an ever increasing extent. Therefore, the World Health Organization (WHO) recommends two A-type strains and two B-type strains for the composition of strains for influenza vaccines:
Recommended composition of influenza virus vaccines for use in the 2018-2019 northern hemisphere influenza season.
Why Can Vaccine Shortages Occur?
The manufacture of vaccines is complex and time-consuming. For instance, manufacturing combination vaccines with 5 or 6 components for the vaccination of infants up to the age of 2 years can take up to 2 years.
Vaccines are complex biomedical products. They are based on biological starting materials. Before a vaccine is ready to use, it undergoes hundreds of quality controls. Delays can occur in the event of problems during the production of a component, e.g. if the pathogens do not replicate as planned.
I Need a Vaccination, but the Vaccine is Not Available. How Do I Proceed?
The Paul-Ehrlich-Institut provides an overview of supply shortages of vaccines on its internet pages.
In each last column, you will find information on an alternative vaccine or a link to the notes for action provided by the Ständige Impfkommission (STIKO, Standing Vaccination Committee) at the Robert Koch-Institut (RKI).
I Need Advice on a Vaccination. Who Can I Contact?
For medical advice please contact your treating doctor. The Paul-Ehrlich-Institut is not a medical care provider like a hospital or a clinic and is not entitled to provide advice on vaccinations to individuals.
I Suspect That I Am Suffering from Vaccination Damage. How Should I Proceed?
If you suspect that you are suffering from vaccination damage, you will have to make an application for recognition of your vaccination damage at the responsible Versorgungsamt (public support institution) in your federal state.
Overview of support institutions (Versorgungsämter)
How Safe Are Vaccines?
Before a vaccine is marketed, it must undergo an extensive marketing authorisation procedure, either in Germany (national marketing authorisation procedure) or at the European Medicines Agency (EMA) (centralised procedure by the EU Commission).
Even after the vaccine has been authorised, each individual vaccine batch undergoes control procedures. In Germany, this is done at the Paul-Ehrlich-Institut. To achieve this, medical professionals at the Paul-Ehrlich-Institut test the safety and tolerability of the vaccines.