COVID-19 carries some level of risk for everyone. However, various different factors can increase the risk of severe illness.
People with weakened immune defense and very obese people (with BMI over 30) are at particular risk of severe illness.
The high-risk groups also include people aged over 60 years old and people with certain pre-existing conditions. Those with diabetes are particularly endangered while those with cancer and diseases of the cardiovascular system, lungs or liver also constitute high-risk groups.
In addition, people with some disabilities, certain genetic rare diseases or severe mental illness can be at increased risk of severe illness with COVID-19.
The section COVID-19: An ABC lists the risk factors for severe illness.
Information is available in different languages from the World Health Organization (WHO).Written by the HELPFÜRMICH editors and updated on 23.05.22
The different ways in which the illness is expressed in children and adults suggest that children's immune systems are better able to fend off SARS-CoV-2 infection than are those of adults.
Currently, the exact reasons for the different immune responses are still being investigated. According to a study carried out by researchers at Berlin’s Charité hospital, one of the explanations is that the immune cells in the airways are generally more active in children than in adults and are therefore better able to recognize and combat invading viruses.
Further information about the illness in children is available on the websites Zusammen gegen Corona and kindergesundheit.info which are run by the Federal Health Ministry and BzGA (Federal Centre for Health Education) respectively.Written by the HELPFÜRMICH editors and updated on 23.05.22
Vaccines are placed in different categories depending on how they are made and how they act.
mRNA vaccines against COVID-19 contain parts of the hereditary material of the SARS-CoV-2 virus in the form of messenger-RNA (mRNA for short). In this form, the vaccines carry the instructions for making the so-called spike protein, one of the proteins on the surface of the SARS-CoV-2 virus. When someone is vaccinated, the cells in their body start to make this protein which then stimulates an immune response. The mRNA in the vaccine does not enter the cell nucleus, the place where our own hereditary information is kept, and is quickly degraded by the body. It therefore has no effect on the person’s own genetic material.
Vector vaccines (from the Latin “vector” meaning “bearer”) are based on viruses that are harmless for humans (such as adenoviruses). These are genetically engineered so that their genetic material contains the building instructions for parts of another virus. In COVID-19 vaccines, the vector viruses contain the gene for making the spike protein on the surface of the SARS-CoV-2 virus. When someone is vaccinated, the cells in their body start to make this protein which then stimulates an immune response.
The adenoviruses used as vectors cannot reproduce in the body and are destroyed by the body within a short time.
Inactivated vaccines are also known as killed vaccines. They contain either killed pathogens or parts of pathogens. These are recognized by the immune system as foreign material and can thus stimulate an immune response without causing the illness itself.
As intensive research continues it is likely that more types of vaccine against COVID-19 will also become available. The World Health Organization (WHO) provides an overview of the current state of vaccine development.
The Share to Care initiative provides evidence-based information about infection risks and the characteristics of the illness in vaccinated and unvaccinated people.Written by the HELPFÜRMICH editors and updated on 23.05.22
The aim of vaccination is to achieve or maintain basic immunity.
For some diseases, a single vaccination is enough to give basic immunity. With COVID-19, more than one vaccination is necessary.
The effectiveness of a vaccination can decrease after a period of time. A booster vaccination can increase and renew the protection given by the vaccine when its effectiveness is wearing off.
The frequency at which the various booster vaccinations should be given, and the interval that should be left between them, both vary depending on the disease and the vaccine.
An additional factor in the case of the SARS-CoV-2 vaccination is that the virus can mutate and the resulting virus variants can react to the vaccines in different ways.
For coronavirus vaccinations, STIKO (Germany’s Standing Committee on Vaccination) at the Robert Koch Institute (RKI) continually monitors the available data on the efficacy of the vaccines and adjusts its recommendations accordingly.
The Share to Care initiative provides evidence-based information about infection risks and the characteristics of the illness in vaccinated and unvaccinated people.
Further information about booster vaccinations is available from the federal government.Written by the HELPFÜRMICH editors and updated on 23.05.22
The likelihood that you will transmit the SARS-CoV-2 virus and infect other people is lower if you have been fully vaccinated than if you have not been vaccinated. When vaccinated people become infected with SARS-CoV-2, they shed viruses for a shorter period of time than unvaccinated people.
Transmission of the virus after vaccination is therefore less likely but not completely impossible. It is not possible to quantify to what extent vaccination can reduce transmission of the virus. For this reason, vaccinated people also need to follow the current hygiene rules and recommendations in order to avoid infecting others.
The Robert Koch Institute (RKI) provides further information about the effectiveness of Coronavirus vaccinations.Written by the HELPFÜRMICH editors and updated on 23.05.22
You should expect that your body will react after the coronavirus vaccination and you may notice this reaction. Various different symptoms can occur such as tiredness, headache, aching limbs, fever, cold-like symptoms and pain similar to muscle stiffness in the vaccinated arm.
It is important to remember that these are not unwanted side effects. Rather, they are signs that the vaccine has triggered an immune reaction in your body – just as it should - and are nothing to worry about. A strong immune reaction can be unpleasant but it usually only lasts for a few days.
It is not possible to predict how any one individual will react. Some people experience stronger reactions while others don’t react at all.
In rare cases, there can also be side effects and complications after vaccination. These can include symptoms such as headache, respiratory distress, swelling and paralysis of arms or legs, chest pain, skin bleeding and paralysis of the chest or face. Symptoms such as respiratory distress, pronounced heartbeat and chest pain can be signs of myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the pericardial sac surrounding the heart). These primarily affect younger males – young men, adolescents and boys. Anyone who experiences these or other side effects 4 to 16 days after being vaccinated should consult a doctor.
Further information about the side effects of coronavirus vaccinations is available on the Federal Health Ministry’s websites Zusammen gegen Corona and gesund.bund.de, on the BzGA (Federal Centre for Health Education) website infektionsschutz.de and from the Paul Ehrlich Institute.
The Share to Care initiative provides evidence-based information about infection risks and the characteristics of the illness in vaccinated and unvaccinated people.Written by the HELPFÜRMICH editors and updated on 23.05.22
According to the Paul Ehrlich Institute, the risk of serious side effects after a coronavirus vaccination is about 0.02%. On average, one in 5000 people experiences a serious adverse reaction.
The Paul Ehrlich Institute is responsible for monitoring the safety of vaccines in Germany. The institute collects and evaluates the notifications of suspected side effects in Germany and publishes safety reports on all the cases in which potential side effects or complications occurred soon after vaccination against COVID-19.
Further information and current safety reports on COVID-19 vaccinations are available from the Paul Ehrlich Institute.Written by the HELPFÜRMICH editors and updated on 23.05.22
Vaccinations have been used successfully in medicine for a long time. When unwanted side effects occur, experience has shown that they usually become apparent a few days or weeks after vaccination. Up to now, no vaccination has been found to have side effects that only appear months or years later on. Such long-term consequences are not to be expected after a COVID-19 vaccination either.
Further information about the side effects of coronavirus vaccinations is available on the Federal Health Ministry’s websites Zusammen gegen Corona and gesund.bund.de, on the BzGA (Federal Centre for Health Education) website infektionsschutz.de and from the Paul Ehrlich Institute.Written by the HELPFÜRMICH editors and updated on 23.05.22
Yes. STIKO (Germany’s Standing Committee on Vaccinations) recommends the coronavirus vaccination for children and young people aged 12 years and over.
STIKO also recommends the coronavirus vaccination for children aged 5 years and over when they have certain pre-existing conditions or when they have close contact with people at high risk of becoming severely ill with COVID-19.
To date, STIKO has not issued a general recommendation to vaccinate children under 12 years of age. However, STIKO states that children aged between 5 and 11 years without pre-existing conditions can also be vaccinated if that is the wish of both the parents and the child after a doctor has explained the situation to them.
The Robert Koch Institute (RKI) provides further information about the vaccination of children including a list of relevant pre-existing conditions (the list is to be found below the question “Welchen Kindern und Jugendlichen wird die COVID-19-Schutzimpfung besonders empfohlen?”)Written by the HELPFÜRMICH editors and updated on 23.05.22
Yes. STIKO (Germany’s Standing Committee on Vaccinations) recommends a coronavirus vaccination in the second trimester of pregnancy. Women who received the first vaccination before they became pregnant should have their second vaccination in the second trimester of pregnancy.
STIKO particularly recommends the coronavirus vaccination for women of child-bearing age who are hoping to conceive and for women who are breast-feeding.
Further information on vaccinations for women who are pregnant, breast-feeding or hoping to conceive is available from the Robert Koch Institute (RKI).Written by the HELPFÜRMICH editors and updated on 23.05.22
The coronavirus vaccination is usually particularly recommended for people with pre-existing conditions because they are at increased risk of becoming seriously ill with COVID-19.
However, there are also exceptions such as people with acute severe illness. In their case, it may be sensible to delay vaccination until the acute symptoms have died down. Also, some pre-existing conditions and particular medications mean that certain vaccines cannot be used, but such cases are rare.
Consult your doctor if you think a coronavirus vaccination might be a problem for you for medical reasons.
Patient organizations are also good to contact if you have questions. Patient organizations are usually well informed about the current state of research and can inform you on this basis.
A statement on COVID-19 booster vaccinations for cancer patients issued by the cancer organization Deutsche Krebshilfe can be found here.
Recommendations from the German MS society (DMSG) on COVID-19 vaccinations for people with MS can be found here.Written by the HELPFÜRMICH editors and updated on 23.05.22
It is not possible to say how much the effectiveness of the vaccination will be reduced if new mutations and SARS-CoV-2 variants occur. This will depend on several factors: on the vaccine used, on the number of doses that have already been administered, on the combination of vaccines used so far and above all on the type of mutation.
According to the Robert Koch Institute (RKI), the COVID-19 vaccination was 75% effective against symptomatic infection and 90% effective against severe illness in fully (doubly) vaccinated people before the omicron variant appeared.
It is nevertheless important to remember that the effectiveness of the vaccination decreases with time. This applies particularly in relation to the omicron variant of the virus which has spread worldwide since November 2021. RKI reports that the effectiveness of vaccination is lower against the omicron variant than against delta and decreases more quickly. This means that from about 15 weeks after the second vaccination there is no adequate protection against illness. However, the study data do show that a booster vaccination can provide good protection against the omicron variant.
The Robert Koch Institute (RKI) provides current information about the effectiveness of coronavirus vaccinations.Written by the HELPFÜRMICH editors and updated on 23.05.22
Vaccine breakthrough is said to have occurred when a fully vaccinated person becomes infected with SARS-CoV-2 as confirmed by a PCR test and this person also experiences symptoms.
But it’s important to remember that vaccine breakthrough does not mean the vaccine has failed. Even when vaccine breakthrough does occur, the vaccination still prevents severe illness with COVID-19 in the vast majority of cases.
Further information about vaccine breakthrough is available from the Robert Koch Institute (RKI).Written by the HELPFÜRMICH editors and updated on 23.05.22
STIKO is a group of independent experts attached to the Robert Koch Institute (RKI). They have to be clear and transparent with regard to any conflict of interests. STIKO has had a working group on coronavirus vaccinations since mid-May 2020.
STIKO's recommendations about vaccination are based on weighing up the benefit of the vaccination and the potential risks or uncertainties that may arise because information is lacking or incomplete. STIKO’s experts also use mathematical models to assess the potential consequences of their recommendations.
It is often necessary to change the recommendations or issue new ones because the epidemiological situation and the current state of research keep on changing. When making recommendations about vaccination, new knowledge about the SARS-CoV-2 virus and COVID-19 illness needs to be taken into account, as do the authorization and availability of vaccines and the usefulness of vaccination to the vaccinated individual and to the population as a whole.
Further information about STIKO and COVID-19 vaccination recommendations are available from the Robert Koch Institute (RKI) under the headings “Kommissionen” and “Wie werden die Impfempfehlungen erarbeitet?”Written by the HELPFÜRMICH editors and updated on 23.05.22
Adjuvants are substances that are used to enhance the effects of some vaccines. They are used in inactivated vaccines, such as the influenza vaccine, because the immune system would not give a sufficiently strong reaction to the components of the pathogen in the vaccine on their own.
Adjuvants make the immune response stronger. They can cause side effects, e.g. pain and hardness at the injection site, but these are usually not serious.
The mRNA and vector vaccines do not contain adjuvants. Other vaccines, such as the so-called inactivated vaccines, can contain different adjuvants.
Further information on the use of adjuvants in vaccine development is available from vfa (Germany's association of research based pharmaceutical companies) and in an article in the journal Pharmazeutische Zeitung.Written by the HELPFÜRMICH editors and updated on 23.05.22
For information about coronavirus vaccinations we recommend the following sources:
- zusammen gegen Corona, the Federal Health Ministry’s website providing information about coronavirus SARS-CoV-2 / COVID-19
- gesund.bund.de, the Federal Health Ministry’s website providing information on a variety of health topics
- infektionsschutz.de, the information website of BZgA (the Federal Centre for Health Education)
- Robert Koch Institute (RKI) for information about infectious diseases and vaccination
- Paul Ehrlich Institute for information and safety reports on drugs and vaccines
- World Health Organization (WHO) for information about coronavirus vaccinations in different languages
Please remember that the information available about the coronavirus can change rapidly. Make sure the information sources you consult are up to date. The sources listed above offer sound scientific information and are continually updated.Written by the HELPFÜRMICH editors and updated on 23.05.22
Everyday preventive measures
It is not usually necessary to use disinfectant for normal household cleaning. Cleaning surfaces and objects with hot water and your usual household cleaner is enough to reduce the pathogens to an acceptable level.
Surfaces that are touched frequently, like door handles, light switches, mobile phones and landline telephone receivers, have a particularly high pathogen load. These should therefore be wiped more often.
In exceptional situations it can be useful to use disinfectant at home – when someone is ill and infectious, for instance, or when a member of the family has a weakened immune system.Written by the HELPFÜRMICH editors and updated on 23.05.22
BZgA (the Federal Centre for Health Education) recommends sticking to the rule known in Germany as “AHA+L+A”, in the UK as “Hands-Face-Space-Fresh air”, and in the USA as “the 3Ws”.
The main elements of this rule in all three cases – given here as the 3 Ws – are:
Watch your distance: be sure to keep 1.5 meters away from other people (such as when you go shopping or in the office when you're at work).
Wash your hands: thorough hand washing is important. When you cough or sneeze, do it into the crook of your arm and not into your hand.
Wear a mask: wear a covering over your nose and mouth when you can’t be sure of keeping far enough away from other people in public spaces. Also, be aware of the current rules and recommendations on wearing specific types of mask such as surgical masks or FFP-2 (equivalent to N95 or KN95) masks on public transport.
Additional preventive measures to protect yourself against the coronavirus SARS-CoV-2 are:
Keep indoor spaces well aired. In enclosed indoor spaces, regular and thorough airing is important to prevent infection. Air your home regularly; in your workplace, open the windows regularly (for a few minutes each time, several times a day).
Stay at home if you experience symptoms. If you have symptoms such as coughing, sneezing and other signs of a cold, you should stay at home and avoid social contact completely if at all possible.
Using the German Corona Warn App: The German app is available in various languages including English. (The language it uses after installation depends on the language your phone uses.) It can show you if you had contact with someone in the past 14 days who could have passed on the SARS-CoV-2 virus to you and it can calculate your individual risk of infection. This makes it easier to understand chains of infection. The Corona Warn App is issued by the Robert Koch Institute and can be downloaded from the usual app stores.
As well as the advice given here, there may also be regional rules and regulations to be aware of.
The rules and recommendations relating to SARS-CoV-2 and COVID-19 can change rapidly. Keep up to date and stay thoroughly informed.
The website infektionsschutz.de run by BZgA (Federal Centre for Health Education) provides comprehensive information that is regularly updated.
A brochure produced by the patient safety alliance APS provides more tips about ways to prevent infection.
English-language tips and recommendations on infection prevention are provided by the World Health Organization (WHO).
Important: Some people avoid attending hospital or doctor’s appointments for fear of catching COVID-19. From a medical point of view, though, it is wrong to postpone or cancel necessary appointments or check-ups for fear of infection. In emergencies it can be essential to get help as quickly as possible. Check-ups should not be delayed either.
If in doubt, you should call the hospital or doctor’s office and ask whether an appointment is possible and how you can best protect yourself from infection while there.Written by the HELPFÜRMICH editors and updated on 23.05.22
To prevent infection you should wash your hands thoroughly several times a day: before and after preparing food, before eating, after using the toilet, before and after contact with sick people, after touching animals and after contact with contaminated material.
When you come home, the first thing you should do is wash your hands. In everyday life we constantly touch objects such as bannisters, door handles, support rails on public transport, banknotes, coins, displays, computer keyboards, etc. All these things could have pathogens on them.
Wash your hands with plenty of hot water and soap. Don't forget your finger nails and the area between your fingers. A 30-second hand-wash is enough to clean your hands thoroughly. If you don’t want to count the seconds you can sing “Happy Birthday” twice over instead. Or Beethoven’s “Ode to Joy” once over if you prefer.
After washing your hands, dry them thoroughly with a clean towel. At work or in restaurants you should dry them with a paper towel if possible. A short video about hand hygiene from BZgA (the Federal Centre for Health Education) is available here. A brochure produced by the patient safety alliance APS provides more tips about ways to prevent infection.Written by the HELPFÜRMICH editors and updated on 23.05.22
The word “quarantine” means the isolation of people, animals or plants for a limited period of time when there is a chance that they may be infected with certain diseases or could transmit pathogens. This includes people who have had contact with someone infected with SARS-CoV-2. In Germany, the infection protection law (IfSG) provides the legal basis for quarantine. Where the infected people themselves are concerned, the world is “isolation” and not “quarantine”.
Quarantine is intended to prevent the spread of infectious diseases. In Germany, local health authorities decide whether to prescribe quarantine in accordance with this law.
Quarantine means that the person in question must stay at home for a certain period of time and cannot receive any visitors during that time. They are not allowed to have any form of contact with other people.
The length of time that infected people have to spend isolating and the time that close contacts have to spend in quarantine can be different in different parts of Germany and have been changed several times during the pandemic. Please check on the current rules in your particular federal state.
More information about isolation and quarantine can be found at infektionsschutz.de (website of BZgA, the Federal Centre for Health Education), and at the Federal Health Ministry’s website Zusammen gegen Corona.
You can download the free leaflet “Self-isolation at home with confirmed COVID-19” from the Robert Koch Institute (RKI). It is also available in German and other languages.
Further information about the law on infection protection is available from the Robert Koch Institute (RKI).Written by the HELPFÜRMICH editors and updated on 23.05.22