Vaccination advice and proof of vaccination

Two provisions of the Infection Protection Act (Infektionsschutzgesetz, IfSG) look confusingly alike — both demand “proof relating to vaccination before a child joins a facility” — and yet they order the opposite of each other. § 34 Abs. 10a IfSG merely requires written proof, before admission to a child daycare centre, that medical advice on vaccination protection has taken place shortly beforehand. It does not require a single vaccination, and no regulatory fine is attached to it: if the proof is missing, the facility notifies the Gesundheitsamt, which may invite the parents to a discussion. § 20 Abs. 8 IfSG demands something altogether different: proof of sufficient protection against measles or of immunity — and this proof is an obligation, for children and staff alike, but only for those born after 31 December 1970. Its absence can cost up to €2,500 under § 73. Anyone who pins the warning on the wrong one of the two provisions needlessly alarms some people and wrongly reassures others.

An exception under § 20 Abs. 8 IfSG is almost never mentioned, although it is decisive for parents: the ban on entering premises does not apply to children subject to compulsory schooling. A child subject to compulsory schooling must not be refused lessons because of a missing measles proof — compulsory schooling prevails. The proof remains required, the Gesundheitsamt is notified and a regulatory fine is possible; but the school door stays open. For the Kita (child daycare centre), which is not subject to compulsory schooling, the exact opposite applies: there, the missing proof leads to refusal of admission.

What applies outside the measles rule is likewise more precise than its reputation suggests. The recommendations of the Standing Committee on Vaccination (Ständige Impfkommission, STIKO) are not an obligation — they are the professional benchmark. They become legally significant via a second step: under § 20 Abs. 3 IfSG the federal states issue public recommendations. This public recommendation is more than advice, and the next paragraph shows why.

Where a vaccination exceptionally causes lasting harm, there is state compensation — and the provision governing it has moved to a different Act. Until 31 December 2023 it was in § 60 IfSG; since 1 January 2024, § 24 SGB XIV has applied. Which vaccinations are covered is almost everywhere stated too narrowly: § 24 names four groups of cases, not one. Covered are vaccinations that the competent Land authority publicly recommended under § 20 Abs. 3 IfSG and that were given within its area — the most common case — but also vaccinations to which there is an entitlement under a statutory instrument issued under § 20i Abs. 3 SGB V, vaccinations a public health authority carried out free of charge, and vaccinations that were ordered or are prescribed by law. Anyone who measures their case only against the first alternative gives up too soon. In any case, the decision is not taken by the Gesundheitsamt: the application goes to the Versorgungsamt (office for social care provision) of the federal state in which the vaccination was given — not that of the place of residence.