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HEALTH

Who can get the monkeypox vaccine in Germany – and how?

The monkeypox virus continues to spread in Germany and the vaccines panel is recommending that three groups of people get a jab. Here's who can get one - and how.

Monkeypox vaccine doses
A pharmacist sorts doses of the monkeypox vaccine in the US. Photo: picture alliance/dpa/San Francisco Chronicle/AP | Lea Suzuki

What’s the current monkeypox situation in Germany? 

The monkeypox virus is still spreading in Germany, with 2,982 confirmed cases of the disease recorded by the Robert Koch Institute (RKI) as of Tuesday.

The virus, which causes small lesions on the skin alongside flu-like symptoms, is primarily transmitted through close physical and sexual contact. The vast majority of cases have so far been found in gay men, though five women have also had the virus in Germany to date. 

On Tuesday, the RKI reported that a four-year old girl in Baden-Württemberg had contracted monkeypox from two adults in her household but was asymptomatic. Before that, two teenage boys aged 15 and 17 were also found to have picked up an infection. 

READ ALSO: Monkeypox in Germany: Two teens ‘among new infections’

With the number of cases rising globally, the World Health Organisation (WHO) has declared the situation an “emergency of international scope” – the highest alert level possible.

This is a sign for members of the WHO like Germany to implement containment and preparation measures, such as rolling out vaccination campaigns. For its part, the Robert Koch Institute (RKI) is tracking the cases and has put out an information sheet about the best practices for avoiding the measures and what to do in the case of an infection.

What should people do if they contract the virus?

If people think they have a monkeypox infection, the first thing they should do is seek the advice of a healthcare practitioner such as a GP or sexual health advice clinic. However, the RKI advises people to phone the clinic beforehand to let them know they believe they may have the virus.

In confirmed cases of monkeypox, people should self-isolate at home until the lesions on their skin scab over and peel over, but for a minimum of 21 days. They should avoid physical contact and sharing items like hand towels or bed sheets with others and should wear condoms during sex for at least eight weeks.

Healthy people with no pre-existing conditions are generally fine to remain at home with someone who has contracted monkeypox, but those with weakened immune systems, pregnant women, elderly people and children under the age of 12 should move out for the duration of the isolation. 

READ ALSO: EXPLAINED: How Germany wants to contain the monkeypox

What monkeypox vaccines are available? 

The smallpox vaccine Imvanex, which has been available in the EU since 2013, was approved for use against the monkeypox virus on July 22nd, 2022. 

People are generally protected against monkeypox for at least two years after their first dose of Imvanex, but doctors recommend a second dose after a four-week interval in order to make this protection permanent. 

The vaccine is generally seen as a preventative measure but can also be used up as a so-called post-exposure measure to lower the risk of getting ill after contracting the virus. In this case, the vaccination is most effective up to four days after exposure. 

Who are monkeypox vaccinations recommended for? 

So far, the Standing Vaccines Commission (STIKO) has recommended that two primary groups of people get a monkeypox jab: men who have multiple male sexual partners and people who work in infectious disease laboratories. 

As mentioned, the vaccine can also be used to ward off illness or prevent a severe course shortly after someone has been exposed to the virus. 

READ ALSO: German vaccine panel recommends monkeypox jab for risk groups

Nurse laboratory monkeypox PCR

A nurse sorts monkeypox test samples in a lab. Photo: picture alliance/dpa/EUROPA PRESS | Carlos Luján

Is there enough vaccine to go around?

Not currently.

In May, the German Health Ministry preemptively ordered 240,000 doses of the vaccine – but so far just 40,000 of these have been delivered. 

This is far too little to cater for the estimated 130,000 people who fall into one of the target groups for a jab.

The remaining doses are due to be delivered in August and September, though some pressure groups are already calling for more to be ordered. 

On Friday, the German Aids Federation (DAH) called on the government to secure at least one million doses of the monkeypox vaccine in order to help stamp out the virus in Germany. 

“The goal must be to reduce the number of infections as quickly as possible and to get the epidemic permanently under control,” explained Ulf Kristal of the DAH board.

This can only be done if as many people in risk groups as possible are vaccinated, he added. 

How can people book a jab?  

At the moment, this varies quite a bit from state to state, with some issuing the jabs via the local health authorities and others supplying the doses to specialist HIV clinics and hospitals.

In Saxony-Anhalt, Bremen and Hesse, vaccinations are primarily organised through the local health authorities, so this should be your first point of contact to enquire about a jab if you live in these states. In Frankfurt am Main, however, a handful of specialised HIV clinics are also carrying out vaccinations, according the FAZ newspaper. 

In Saarland, too, appointments should be booked through the health authorities, though they are carried out at Saarbrücken University Clinic. In Hamburg, jabs are being administered solely at infectious disease clinics.

UKE university clinic Hamburg

The main entrance to the University Clinic in Hamburg, where monkeypox patients have been treated for the disease. Photo: picture alliance/dpa | Axel Heimken

Berlin offers the most diverse range of vaccinations and, with 8,000, has the largest number of vaccine doses available. Vaccinations are given in HIV specialist practices, counselling centres for sexual health as well as in several hospitals. A list of vaccination centres has been compiled by the German Association of Outpatient Doctors for HIV Treatment. Neighbouring Brandenburg organises vaccinations through the local health authorities as well as through GP’s practices.

In three federal states, only hospitals are responsible for monkeypox vaccinations. In Saxony, hospitals in Chemnitz, Leipzig and Dresden have been vaccinating since the end of June. In northern Schleswig-Holstein, outpatient clinics in Kiel and Lübeck are responsible. Neighbouring Mecklenburg-Western Pomerania is administering its doses exclusively through the University Medical Centre Rostock.

Several federal states have opted to roll out monkeypox vaccinations through both HIV clinics and hospitals. These include Bavaria, which has more than 3,500 vaccination doses available, as well as Rhineland-Palatinate, Lower Saxony and North Rhine-Westphalia, for which a list of all vaccination centres was recently published.

What else should people know? 

The monkeypox vaccine is perfectly safe, but people can experience a few side effects for a day or two afterwards, including soreness on the vaccination arm, fever and headaches. 

People with HIV should talk to a specialist before getting the vaccine, because the effectiveness may vary depending on your Helper T cell count. 

For more information on the clinics offering jabs, the German Aids Federation has published a helpful Q&A along with a list of clinics in each of the federal states, which can be found here (in German).

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HEALTH

What to know about Germany’s plans to raise health insurance fees

Germany is struggling to fill huge gaps in its health funds following the pandemic and is planning to raise health insurance fees next year. Here's who it could affect and how much more people could have to pay.

What to know about Germany's plans to raise health insurance fees

What’s going on?

In the aftermath of the Covid pandemic, Germany is struggling to fill a large gap in its healthcare reserves.

According to Health Minister Karl Lauterbach (SPD), the statutory health insurance funds are facing a deficit of €17 billion next year, placing Germany’s healthcare finances under severe strain.

Lauterbach says this is largely due to the generous spending policies of the previous government both before and during the Covid crisis. As well as pouring billions of euros into free tests, the healthcare system was overwhelmed by patients during the most severe waves of the pandemic. 

To tackle this shortfall, the Health Ministry has drafted a set of proposals for raising additional funds. 

One of these proposals is to increase the level of health insurance contributions that people have to pay each month. The funds raised from this would account for around 10 percent of the total rescue package. 

READ ALSO: How to make the most of reward schemes on your German health insurance

How much more could people have to pay?

Lauterbach has pitched a 0.3 percent rise in monthly contributions. This would be added to the so-called additional contribution, which is currently set at a maximum of 1.3 percent, on top of the 14.6 percent general contribution that is paid as standard. 

For people in employment, contributions are divided equally between the employer and the employee. That means the extra 0.3 percent would translate to 0.15 percent extra per month in reality. 

In concrete terms, that’s an extra €1.50 for someone with a gross income of €1,000 per month, or €4.50 extra for someone with a gross income of €3,000 per month. 

Self-employed people – who generally have to bear the full brunt of the health insurance costs themselves – will fare a little worse under the plans. They’ll be expected to shell out €3 extra per month for every €1,000 of gross profit. 

Would everyone have to pay this much? 

No. Firstly, the changes would only affect those who are registered with one of the statutory health insurance companies such as TK or AOK. People who are privately insured will continue to pay the contribution set by their insurer.  

Secondly, unlike the general contribution of 14.6 percent, statutory insurance funds have the option to decide how much of the additional contribution they want to charge. 

That means that, while 1.6 percent could become the new maximum, there’s no guarantee that companies will choose to charge this. Depending on their financial situation, they may decide to keep the additional fees lower to remain competitive, or alternatively hike the fees to the maximum in order to shore up their reserves or offer better services. 

In other words, people will still pay a minimum contribution of 14.6 percent of their income but could pay a maximum of 16.2 percent (assuming that their health insurance company chooses to charge the full additional contribution). Most will pay something in the middle. 

READ ALSO: Reader question: How can I change my German health insurance provider?

Health insurance cards from AOK.

Health insurance cards from AOK. Photo: picture alliance/dpa | Karl-Josef Hildenbrand

What other plans are on the table?

As we mentioned, raising health insurance contributions is likely to cover just a small fraction of the deficit. To cover the rest, Lauterbach is proposing a range of other measures, including:

More state funding

In 2023, the federal government will step in with increased funding for the health insurance funds. Instead of the usual spending of €14.5 billion per year, the traffic-light coalition will shell out €16.5 billion on topping up the healthcare funds next year and will also provide a further €1 billion in the form of an interest-free loan.

Money from healthcare reserves

Statutory health insurance companies will have to dig into their savings to the tune of €4 billion to help cover the deficit. At the same time, €2.4 billion will be taken out of a pool of money known as the ‘Health Fund’ (Gesundheitsfond), which is built up through a combination of health insurance contributions, taxpayer funding and other forms of insurance such as pensions insurance. 

Increased discounts on medicines

Under German law, pharmaceutical companies are required to provide statutory health insurance companies with a discount of at least seven percent on certain types of medicine. This will be hiked to 12 percent for one year. 

A pharmacist scans a prescription

A pharmacist scans a prescription. Photo: picture alliance/dpa | David Inderlied

Furthermore, pharmacies will be required to provide the insurance funds with a discount of €2 (rather than the previous €1.77) per packet of prescription drugs. This will last for at least two years. Meanwhile, a moratorium on raising the price of medicines will be extended to 2026. 

Restrictions on bonuses for doctors

Doctors’ surgeries will no longer be given financial incentives for taking on new patients. 

Is this all set in stone?

Not yet, although it is likely to be passed in a parliamentary vote. So far, the cabinet has already waved through the changes, and on Friday they were debated for the first time in the Bundestag. 

READ ALSO: Why large families are set to pay less for German care insurance

What are people saying?

In a seething speech in the Bundestag on Friday, Bavaria’s state health minister Klaus Holetschek (CSU) criticised Lauterbach’s plans to raise health insurance contributions, arguing that it would “send the wrong signal” to patients. 

He also laid into the proposals to cut doctors’ bonuses for taking on new patients, arguing that this would lead to a cut in services.

However, the FDP health expert Andrew Ullmann said Lauterbach’s plans could help to avoid a hike in contributions that could cost people hundreds of euros per months. “That would not be responsible in times of inflation and energy crisis,” he said.

Health Minister Karl Lauterbach (SPD)

Health Minister Karl Lauterbach (SPD) speaks at a debate in the Bundestag on the measures to bail out the health insurance funds. Photo: picture alliance/dpa | Annette Riedl

In his speech in the Bundestag, Lauterbach said the rise in health insurance contributions was ultimately fair since employers would be expected to pay half. He also defended his plans to dig into the health insurance funds’ reserves. At some of the health insurance funds, board members “earn significantly more than the Federal Chancellor”, he claimed. 

Pointing to his proposals to shift some of the financial burden onto pharmaceutical companies, the SPD politician said he would “stand up to lobby pressure” and refuse to change course. 

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