The Standing Committee on Vaccination at the Robert Koch Institute, or STIKO, is a scientific committee comprising 18 members at the Robert Koch Institute in Berlin, Germany that provides official recommendations for the vaccination schedules used by the individual German states. The committee meets twice yearly to review the latest research regarding vaccination against infectious diseases. Although the STIKO makes recommendations, immunization in Germany is voluntary and there are no official government recommendations. German Federal States typically follow the STIKO's recommendations minimally, although each state can make recommendations for their geographic jurisdiction that extends beyond the recommended list. In addition to the proposed immunization schedule for children and adults, the STIKO recommends vaccinations for occupational groups, police, travelers, and other at risk groups.
History
The STIKO was established in 1972 as a department of the German Federal Health Agency in Berlin. During a reorganization of the Federal Health Agency in 1994, the STIKO was attached to the Robert Koch Institute in Berlin which was now an independent Upper-level federal agency under the purview of the Federal Ministry of Health. RKI compiles data of immunization status upon the entry of children at school, and measures vaccine coverage of Germany at a national level. The legal basis for the STIKO is §20 of the Infection Protection Act. Members of the expert body are appointed by the Federal Ministry of Health in coordination with the state ministries of health. Additional expert representatives from the Paul Ehrlich Institute, Robert Koch Institute Federal and state ministries of health attend the meetings in an advisory capacity.
Responsibility
The commission's responsibility is to provide scientifically based recommendations regarding the necessary vaccinations in Germany. Due to the importance of the recommendations, these have been codified in the Infection Protection Act since 2001. In accordance with the goals of the Infection Protection Act, the recommendations are focused on vaccinations that are most relevant to the protection of public health. The law does not require the commission to perform cost–benefit analysis on individual vaccinations. The commission's recommendations are based on a vaccine's risk–benefit ratio, evaluating the effectiveness of a vaccine versus any risks posed. The commission has developed criteria to minimize vaccine injuries caused by side effects. German health insurance companies are obligated to cover the cost of any immunizations recommended by the STIKO after they have been reviewed the Federal Joint Committee. The G-BA generally adopts the commission's recommendations, although minor differences do exist.
Membership
The members of the STIKO are appointed by the Federal Ministry for Health for 3-year terms. The members serve pro bono publico. Members include experts from many scientific disciplines and public health fields and professionals with extensive experience on vaccination. For the period of 2017 through 2020, the commission has the following members:
Rüdiger von Kries, Director of the Epidemiology Department and Leiter der Abteilung Epidemiologie und acting head of the Institute for Social Pediatrics at the Ludwig Maximilian University of Munich
Martina Littmann, Director of the Department for Infection Prevention at the State Office for Health and Social Affairs of Mecklenburg-Vorpommern, Rostock
