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July 2003


Vaccinations-unpleasant but necessary

“Now this won’t hurt at all,” must be listed in the handbook of meaningless reassuring phrases issued to physicians worldwide and used whenever an injection needs to be administered. Have you ever had an injection that didn’t hurt, unless you were unconscious at the time? I know that coming down with black-water fever or malaria can be uncomfortable, not to say fatal, and I’m truly grateful for the advances in medicine that have brought us vaccines for so many gruesome diseases, but I hate injections whatever they happen to be for. So, if you don’t mind I’ll write this month’s Red Tape on, yes, you guessed it, vaccinations, with my eyes and ears shut.

For purposes of clarity the vaccinations (Impfungen) discussed here will be divided into two categories: those needed for going abroad and those that are given for local diseases here in Bavaria. If you are traveling to an exotic location, you should be aware that there are mandatory injections (Pflichtimpfungen) and non-mandatory injections (freiwillige Impfungen). In fact there is only one vaccination worldwide that the World Health Organization (WHO) currently classifies as obligatory, and that is for yellow fever (Gelbfieber). However, individual countries can demand that travelers be vaccinated against certain diseases (Krankheiten) if they pose a threat in that country. If, for example, cholera (Cholera) flares up in a particular region, proof of a vaccination may be demanded on entering (Einreise) an affected country.

In order to find out which non-mandatory vaccinations are recommended for individual countries, go to and click on the relevant destination. You will be given not only a list of jabs, but details on which regions of a country are affected by which diseases. To ensure a smooth journey, it is best to carry your own copy of the International Certificate of Vaccinations (Impfpass) with you. This booklet is issued by the WHO and is available from doctors. It is useful not only for registering mandatory vaccinations, but also for keeping track of how long, say, a precautionary injection (prophylaktische Impfung) such as tetanus (Tetanus) is valid (Dauer des Impfschutzes) and when it needs to be renewed (aufgefrischt). Vaccinations can be given by most general practitioners (Hausärzte).

It is essential that no matter what vaccine is deemed necessary that you visit your doctor well in advance—four weeks is a good rule of thumb. Some injections can be combined (kombinierbar), others must be given at intervals to one another (Zeitabstände). In addition, age and chronic or acute illnesses (chronische oder akute Erkrankungen) must be taken into consideration.

Here in Germany there are a number of vaccinations worth considering, such as the inoculation for spring-summer encephalitis (Früh-Sommer-Meningo-Enzephalitis, FSME), which can be passed on by ticks (Zecken). Although Munich is not a danger zone, you may want to play it safe nonetheless. The Website provides a map of FSME affected regions. Vaccinations against tetanus, which can develop from an untreated wound (Wunde)—it need be nothing more serious than a small, superficial cut (Schnittwunde), say, from a piece of broken glass—are usually given to infants and it is recommended that a booster is given every 10 years. If you have never been immunized, it is possible to have the injection at any time provided you are in good health. Finally, although for most of us the risk of contracting Hepatitis B (Hepatitis B) is very small, certain people are at risk through their profession or lifestyle. For a list of risk factors go to

Of course not all vaccines come in syringes; thank goodness, some can be swallowed (Schluckimpfungen). Now there’s an area of medical research that deserves our support.

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