Germany's vaccine system divides into two categories: Standardimpfungen (standard vaccines, covered for everyone) and Indikationsimpfungen (indication vaccines, covered for people in specific risk groups). Gay and bisexual men with multiple partners fall into those risk groups for several important vaccines — but you may need to know to ask.
Mpox (Monkeypox) Vaccine
Free on GKV for gay and bisexual men with multiple partners.
The STIKO (Germany's vaccination committee) recommends Mpox vaccination for gay and bisexual men with multiple or changing partners. Your Schwerpunktarzt or GP can prescribe this as an Indikationsimpfung — covered by GKV with no cost to you.
The vaccine is Imvanex/Jynneos (two doses, 28 days apart). If you haven't had it yet, ask at your next appointment. During outbreak periods, Gesundheitsämter and community health centres may also offer vaccination sessions.
Hepatitis A
Free on GKV as an Indikationsimpfung for gay and bisexual men.
Hepatitis A spreads via the faecal-oral route and is more common in men who have sex with men during certain types of sexual contact. STIKO recommends vaccination for gay and bisexual men with multiple partners. Ask your GP or Schwerpunktarzt — two doses, six months apart.
Hepatitis B
Free on GKV as an Indikationsimpfung for gay and bisexual men.
If you weren't vaccinated as a child (routine since the 1990s in Germany), you can get the full Hepatitis B course as an adult under GKV. A combined Hep A/B vaccine (Twinrix) is often used to cover both in one series — three injections over six months.
Your Schwerpunktarzt will check your Hepatitis B status as part of PrEP onboarding; if you're not immune, they'll prescribe the vaccine.
HPV Vaccine — The Cost Trap
This is where things get expensive for adult gay and bisexual men.
Under 18: HPV vaccine is free on GKV (Standardimpfung for all children).
18–26: GKV covers HPV vaccination if not previously vaccinated. Check your records — if you missed it in childhood, you may still be eligible.
Over 26: GKV does not cover HPV vaccination. You pay privately — the full Gardasil 9 course (2–3 injections) costs approximately €550–600 out of pocket.
This is a significant gap in coverage. HPV causes anal, penile, throat, and mouth cancers, as well as genital warts, and gay and bisexual men who have receptive anal sex are at higher risk of HPV-related anal cancer.
Your options if over 26:
- Pay privately. Ask your Schwerpunktarzt to prescribe — they'll know the route. Costs around €180–200 per injection (Gardasil 9).
- Some PKV policies cover HPV vaccination regardless of age — check your policy.
- Clinical trials and public health vaccination campaigns occasionally offer free HPV vaccination to adult gay and bisexual men. Check with your local Aidshilfe.
How to Access Vaccines
| Vaccine | Who prescribes | Cost on GKV |
|---|---|---|
| Mpox | GP or Schwerpunktarzt | Free |
| Hepatitis A | GP or Schwerpunktarzt | Free |
| Hepatitis B | GP or Schwerpunktarzt | Free |
| Hep A+B combined | GP or Schwerpunktarzt | Free |
| HPV (under 26, unvaccinated) | GP | Free |
| HPV (over 26) | GP or Schwerpunktarzt | ~€550–600 private |
What to Say
To ask for your Indikationsimpfungen:
"Ich bin schwul und habe wechselnde Sexualpartner. Stehe ich für Impfungen gegen Hepatitis A, Hepatitis B und Mpox als Indikationsimpfungen zu?" ("I'm gay and have multiple sexual partners. Am I entitled to hepatitis A, hepatitis B, and Mpox vaccines as indicated vaccines?")
This is a recognised clinical category — any GP or Schwerpunktarzt will understand.
Your Impfpass (Vaccination Booklet)
Germany uses a paper Impfpass (vaccination record booklet). Keep yours — doctors need to see it to check what you've already had and to record new vaccines. If you've lost yours, ask your GP for a new one and try to reconstruct your vaccination history.