Germany recommends mRNA Covid vaccine after AstraZeneca

Germany's Standing Vaccine Commission (STIKO) has issued updated Covid vaccination advice in light of the spread of Delta, stating that the second dose after AstraZeneca should be an mRNA vaccine, regardless of the patient's age.

Germany recommends mRNA Covid vaccine after AstraZeneca
A sign marks the entrance to a Covid vaccination centre. Photo: picture alliance/dpa/dpa-Zentralbild | Sebastian Kahnert

With the rapid spread of the highly contagious Delta variant in Germany, the Standing Vaccination Commission (STIKO) is adapting its vaccination recommendations.

Under the latest advice, people who have received a first dose of AstraZeneca should in future receive an mRNA vaccine such as BioNTech or Moderna as their second injection, regardless of their age, the committee announced on Thursday.

The interval between the first and second dose should then be at least four weeks. The recommendation will apply “subject to the feedback from the comment procedure,” it said.

The advice is justified by recent studies that have shown that the immune response after two doses of different types of vaccine – first vector, then mRNA vaccine – is “clearly superior” to the immune response after two doses of AstraZeneca.

Chancellor Angela Merkel had received a Moderna second jab after getting an AstraZeneca injection for her first.

READ ALSO: Covid vaccine mix-and-match: Why is it so common in Germany – and is it safe?

STIKO had previously only recommended this to younger people who had already received an initial vaccination with AstraZeneca.

In their latest recommendation, the commission emphasised that in view of the significantly more contagious Delta variant, it was important to “take the second vaccine dose on time”.

After just one vaccine dose, the protection against Delta seems to be “significantly reduced”.

READ ALSO: Should Germany shorten Covid vaccine intervals to combat Delta?

For fully vaccinated people, the protection offered against severe courses of the disease is similar for Delta as it is for other variants, the experts said, citing recent data from the United Kingdom.

STIKO now recommends the following intervals between the two required vaccine doses: three to six weeks for Biontech/Pfizer, four to six weeks for Moderna, nine to 12 weeks for AstraZeneca (if the patient receives two doses of the same vaccine) and “from four weeks” for the combination of AstraZeneca and mRNA vaccine.

The German government usually follows STIKO’s recommendations.

Germany expects the Delta variant to take over as the dominant strain of the coronavirus in the country in the coming days.

Member comments

  1. Now if only it were possible to book your second dose with another vaccine online, if you got AstraZeneca for the initial dose…

    1. As of Today (Monday 5th July) our local Impfzentrum is Taking appointments for mRNA shots as your 2nd dose if you had AstraZeneca as your first, regardless of where you got the first shot. Hopefully your local Impfzenrum will do the same

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Are people who’ve had the single J&J jab no longer fully vaccinated in Germany?

Germany's federal vaccine agency says that people who've had one dose of the Johnson & Johnson (J&J) vaccine should no longer be classed as being fully vaccinated.

People queue for a vaccination in Quedlinburg, Saxony-Anhalt.
People queue for a vaccination in Quedlinburg, Saxony-Anhalt. Photo: picture alliance/dpa/dpa-Zentralbild | Matthias Bein

People who’ve had J&J, sometimes known as Janssen, used to have full vaccination status after a single dose of the vaccine. 

Since January 15th, however, a single dose of J&J should no longer count as full vaccination, according to the Paul Ehrlich Institute (PEI), the country’s vaccine authority. 

In autumn last year the German government began recommending a second mRNA jab for people who’d had J&J – which many people thought was the booster vaccination. 

However, according to the PEI’s update on proof of vaccination within the Covid Protective Measures Exemption Ordinance and the Coronavirus Entry Ordinance, the second shot is needed to complete ‘basic immunisation’.

It is unclear at this stage if it means that people returning or coming to Germany from abroad with only one shot of J&J will be counted as partially vaccinated and therefore need to present tests or face other forms of barriers to entry. 

We are also looking into what this means for the various health pass rules in states, such as the 3G rules for transport. 

The Deutsches Ärzteblatt, a German-language medical magazine, said: “Special rules according to which one dose was recognised as a complete vaccination with the Johnson & Johnson vaccine are no longer applicable.”

The Local has contacted the German Health Ministry for clarification on what this means for those affected. 

According to the latest government figures, 5.3 million doses of Johnson & Johnson have been given out in Germany so far in the vaccination campaign. 

The news will come as a shock to those who don’t know that they need another jab, or haven’t got round to getting their second vaccine yet. 

All other jabs – such as BioNTech/Pfizer, Moderna and AstraZeneca – already require two jabs. 

People in Germany are seen as fully vaccinated two weeks after their second dose. 

What about boosters?

As The Local Germany has been reporting, the German government said in December that people who’ve had J&J need a third shot three months after their second dose to be considered boosted.

A German Health Ministry spokesman told us last week that due to more vaccination breakthrough infections affecting people who’ve had the J&J vaccine, extra protection was needed.

“Therefore, after completion of the basic immunisation as recommended by STIKO, i.e. after administration of two vaccine doses (preferably 1x J&J + 1x mRNA), following the current recommendation of the STIKO, a further booster vaccination can subsequently be administered with a minimum interval of a further three months, as with the other approved Covid-19 vaccines,” the Health Ministry spokesman said. 

However, there has been much confusion on this front because some states have been accepting J&J and another shot as being boosted, while others haven’t.


It is unclear if the new regulation will mean that states will all have to only accept J&J and two shots as being boosted. 

North Rhine-Westphalia, for instance, updated its regulations on January 16th and now requires that people who’ve had J&J and one shot have another jab to be boosted. 

Having a booster shot in Germany means that you do not have to take a Covid-19 test if you’re entering a venue, such as a restaurant or cafe, under the 2G-plus rules.

The Paul Ehrlich Institute said that proof of complete vaccination protection against Covid takes into account “the current state of medical science”.