Standing Committee on Vaccination

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The Standing Vaccination Commission (abbreviated to STIKO, full name: Standing Vaccination Commission at the Robert Koch Institute ) is a voluntary, currently 18-person expert group in the Federal Republic of Germany, which is located at the Robert Koch Institute (RKI) in Berlin and meets twice a year in order to deal with the important health-political questions about protective vaccinations and infectious diseases in research and practice and to issue corresponding recommendations (including the current vaccination calendar ). The recommendations of the STIKO, which are usually published annually in the epidemiological bulletin of the RKI, serve the federal states as a template for their public vaccination recommendations .

History, organization and legal basis

The STIKO was set up in 1972 at what was then the Federal Health Office (BGA) in Berlin. After reunification , the Federal Disease Act of that time became valid in the new federal states, and the STIKO was expanded to include experts from the new federal states. In 1991, the Conference of Health Ministers decided that the STIKO's recommendations should officially serve as a basis in all federal states. After the dissolution of the BGA in 1994, the STIKO was affiliated to the Robert Koch Institute (RKI) in Berlin. It therefore belongs to the business area of ​​the Federal Ministry of Health (BMG).

The legal basis for the establishment of the STIKO is the Infection Protection Act ( § 20 Paragraph 2 IfSG), which was anchored there in 2001. Accordingly, the members of the STIKO are appointed by the Federal Ministry of Health in consultation with the state health ministries. In addition to the members of the STIKO, experts from the Federal and State Health Ministries, the Robert Koch Institute and the Paul Ehrlich Institute are also allowed to participate in the meetings of the commission in an advisory capacity.

In 2017, the Federal Court of Justice ruled (AZ XII ZB 157/16) that the STIKO can assess the benefits and risks of vaccinations, the vaccination recommendations are considered the "medical standard".

tasks

The task of the commission is to prepare recommendations for the necessary vaccinations in Germany on a scientific basis. In 1972 she published the first recommendation that certain intervals should be observed between different vaccinations. In the following years, the STIKO published the first vaccination recommendations for measles (1974), rabies (1974) and whooping cough (1975), until it finally created the first vaccination calendar in 1976 . Due to the importance of its vaccination recommendations, the STIKO was anchored in law with the Infection Protection Act from 2001. In accordance with the objectives of the Infection Protection Act, vaccinations in particular are relevant for public health protection.

Economic cost-benefit assessments are not part of the STIKO's legal mandate and are not the primary basis for making vaccination recommendations. The recommendations are made in particular on the basis of efficacy data and information on possible vaccination risks, as well as taking into account the epidemiological risk-benefit assessment (Section 1 of the STIKO's rules of procedure). In addition, the STIKO develops criteria for the delimitation of a usual vaccination reaction and damage to health that goes beyond the usual extent .

Vaccinations recommended by the STIKO have to be paid for by the health insurance companies after confirmation by the Federal Joint Committee (G-BA) since the health reform was passed on April 1, 2007 . Although the recommendations of the STIKO have so far been largely adopted by the G-BA, there are in part slightly different formulations and differences in the recommendations.

occupation

The members of the STIKO are appointed to their voluntary work for three years by the Federal Minister of Health .

As of June 4, 2020, the STIKO includes the following experts for the 2020 to 2023 appointment period:

Other members:

criticism

With the introduction of the assumption of costs for the vaccinations recommended by the STIKO in the health reform on April 1, 2007, the recommendations of the STIKO have an impact on the costs of the health system and on the sales of pharmaceutical products.

For some time now, critics have been calling for the members of the STIKO to be fully financially independent from vaccine manufacturers, although this is not required by law. In this context, a lack of transparency in the way members work and sideline activities is criticized. 12 of 16 members of the STIKO were offered such secondary activities for pharmaceutical companies or organizations supported by them. For example, the organization Transparency International had established in March 2009 with the swine flu vaccination "that the majority of the current 16 members have more or less intensive contacts, including paid jobs, with the most important manufacturers of vaccines."

This debate got a boost when Heinz-Josef Schmitt stepped down from his chairmanship of STIKO in autumn 2007 and accepted a position in the pharmaceutical industry at Novartis Vaccines and Diagnostics . Schmitt stated that at the beginning of 2007 he wished to be involved in clinical trials with vaccines; as this was only possible in close cooperation with vaccine manufacturers, he saw a conflict of interest and gave up his membership in the STIKO. The parliamentary group of Bündnis 90 / Die Grünen put a small question (16/6718) to the federal government about these events in October 2007 , in which a catalog of questions about the working methods of the STIKO was presented. The Federal Government saw no criticisms of the work of the vaccination commission in its response - the STIKO decisions since 2004 are "scientifically well founded", and STIKO members have committed to point out possible bias before their appointment. Nevertheless, the federal government announced that “the procedures to ensure impartiality and transparency of work. . . be further expanded ”, and promised to publish potential conflicts of interest of the commission members in the future. These are now listed on the STIKO website.

At the end of October 2008 the Rules of Procedure were changed to remove doubts about impartiality; In addition, it should be prevented that “personal views, conflicts of interest or lobbyists of the vaccine manufacturers can influence the decisions”. STIKO members now have to fully disclose all possible connections to pharmaceutical companies before each meeting. If in doubt, STIKO members may not take part in the consultation:

"A member who has any other reason that is suitable to justify mistrust of the impartial exercise of office ( fear of bias ) is not allowed to participate in the consultation and resolution of the commission."

- STIKO's rules of procedure dated October 16, 2008 as amended on June 20, 2014

StIKo Vet.

Since 2008 there has been a Standing Vaccination Commission for Veterinary Medicine (StIKo Vet.) In the professional field of veterinary medicine , which is part of the Federal Association of Practicing Veterinarians e. V. is located and develops vaccination recommendations for horses, dogs, cats, rabbits, ferrets, etc.

In Germany, the German Equestrian Association (FN) stipulates intervals of six months against equine influenza and two years against tetanus for revaccination for competition horses. In Switzerland, the Swiss Equestrian Association (SVPS) stipulates that sport horses should be re-vaccinated against equine influenza and tetanus every year.

In 2007 there were critical voices in the Baden-Württemberg state parliament regarding the vaccination regulations for competition horses. Specialist authors also question the short vaccination intervals using horses as an example. Herpes vaccination for horses is also controversial among medical experts.

Web links

Individual evidence

  1. ↑ a b c S. Klein et al .: From compulsory smallpox vaccination to the national vaccination plan . In: Federal Health Gazette . tape 55 , no. 11 , November 1, 2012, p. 1512-1523 , doi : 10.1007 / s00103-012-1539-7 .
  2. ↑ § 20 IfSG - single standard. Retrieved July 15, 2017 .
  3. ↑ Dr Thomas Schmitz and Sven Siebert: Plain text: Vaccination! - An educational book to protect our health . 1st edition. HarperCollins, 2019, ISBN 978-3-95967-884-1 , pp. 40-41 .
  4. ↑ STIKO: STIKO recommendations 1972 . Robert Koch Institute, August 1, 1972 ( rki.de [accessed April 4, 2020]).
  5. ↑ STIKO: STIKO recommendation for measles vaccination . Robert Koch Institute, Infection Epidemiology, September 20, 1974 ( rki.de [accessed April 4, 2020]).
  6. ↑ STIKO: Recommendations of the STIKO for the rabies vaccination of humans . Robert Koch Institute, Infection Epidemiology, June 14, 1974 ( rki.de [accessed April 4, 2020]).
  7. ^ Commission Environmental Medicine: STIKO recommendation on whooping cough vaccination . Robert Koch Institute, Epidemiology and Health Reporting, May 2, 1975 ( rki.de [accessed April 4, 2020]).
  8. ↑ STIKO: STIKO recommendations 1976 . Robert Koch Institute, August 1, 1976 ( rki.de [accessed April 4, 2020]).
  9. ^ RKI - Commissioners. Retrieved June 4, 2020 .
  10. ^ AOK Bundesverband: The Standing Vaccination Commission (STIKO). ( Memento of September 28, 2007 in the Internet Archive ) from: Health Press Service, Politics No. 4 of April 11, 2007
  11. ^ Arznei-telegram: Standing Vaccination Commission: Transparency is necessary. 2007; 38: 33-4
  12. ↑ Harald Schumann: Swine flu: Highest warning level. In: Der Tagesspiegel. November 1, 2009, accessed May 5, 2015 .
  13. ↑ Süddeutsche Zeitung: Standing Vaccination Commission - Experts with the wrong friends. January 25, 2008.
  14. ↑ "Swine flu vaccination: Transparency criticizes potential conflicts of interest and non-transparent decision-making processes at the standing STIKO vaccination commission"
  15. ↑ a b Sabine Rieser: Standing Vaccination Commission: Under application observation . Deutsches Ärzteblatt 104, issue 49 of December 7, 2007, page A-3361
  16. ↑ a b "A child should not be allowed to attend a public school without vaccinations". Doctors newspaper , September 20, 2007, accessed January 5, 2020 .
  17. ↑ a b German Bundestag: Answer of the Federal Government to the small question 16/6718 . (PDF; 109 kB)
  18. ↑ a b Dr Thomas Schmitz and Sven Siebert: Plain text: Vaccination! - An educational book to protect our health . 1st edition. HarperCollins, 2019, ISBN 978-3-95967-884-1 , pp. 41-42 .
  19. ^ Rules of Procedure of the STIKO
  20. ↑ Members of the Standing Vet. Vaccination Commission (StIKo Vet.) At the Federal Association of Practicing Veterinarians e. V. ( Memento of October 13, 2012 in the Internet Archive )
  21. ↑ Implementation provisions for mandatory vaccination based on the Performance Examination Regulations (LPO), 2013
  22. ↑ Small inquiry , Landtag of Baden-Württemberg, 2007  ( page no longer available , search in web archives )  Info: The link was automatically marked as defective. Please check the link according to the instructions and then remove this notice. (PDF; 43 kB)@1@ 2Template: Toter Link / www.landtag-bw.de  
  23. ↑ Vaccinations for horses - good or bad , Sabine Müller, 2009 (PDF; 48 kB)
  24. ↑ Controversial: Herpes vaccination for horses? Internet presentation of the specialist magazine "Cavallo", accessed on July 25, 2013.