Vaccines in Germany — What You're Entitled To

Germany's vaccine system divides into two main categories: Standardimpfungen (standard vaccines, covered for everyone) and Indikationsimpfungen (indicated vaccines, covered for people in specific risk groups).

Gay and bisexual men with multiple sexual partners fall into these risk groups for several crucial vaccines. While these are fully covered, you often have to actively ask for them.

✅ Fully Covered: The Indikationsimpfungen

The STIKO (Germany's standing committee on vaccination) officially recommends the following vaccines for gay and bisexual men with multiple or changing partners. Your GP (Hausarzt) or specialised HIV/STI doctor (Schwerpunktarzt) can prescribe these at no cost to you under standard public health insurance (GKV).

🦠 Mpox (Monkeypox) Vaccine

• The Schedule: Two doses of Imvanex/Jynneos, administered 28 days apart.
• How to get it: Ask at your next appointment. During outbreak periods, local health authorities (Gesundheitsämter) and community health centres may also host dedicated, free vaccination drives.

💉 Hepatitis A

Hepatitis A spreads via the faecal-oral route and STIKO strongly recommends vaccination for men who have sex with men.

• The Schedule: Two doses, administered six months apart.

💉 Hepatitis B

If you were not vaccinated against Hepatitis B as a child (which became routine in Germany during the 1990s), you are entitled to the full adult course.

• The Schedule: Often administered as Twinrix, a combined Hepatitis A/B vaccine. This requires three injections (typically at 0, 1, and 6 months).
• Note: Your Schwerpunktarzt will automatically check your Hepatitis B immunity status as part of your PrEP onboarding. If you are not immune, they will prescribe the vaccine.

⚠️ The HPV Vaccine — The Cost Trap

HPV causes anal, penile, throat, and mouth cancers, alongside genital warts. Gay and bisexual men who engage in receptive anal sex are at a substantially higher risk for HPV-related anal cancer.

Unfortunately, this is where adult vaccination in Germany gets expensive. Coverage depends entirely on your age:

• Under 18: Fully free on GKV. It is a Standardimpfung for all children and adolescents.
• 18 to 26: It depends on your insurer. While STIKO catch-up recommendations end at 18, many major public insurers (like TK, Barmer, and AOK) voluntarily cover the vaccine up to age 26 as a bonus benefit (Satzungsleistung). Check directly with your Krankenkasse.
• Over 26: GKV does not cover it. You must pay privately. The full Gardasil 9 course (usually 3 injections) costs approximately €180–€200 per dose, totaling roughly €550–€600 out of pocket.

Your options if you are over 26:

1. Pay privately: Ask your GP or Schwerpunktarzt for a private prescription.
2. Check Private Insurance (PKV): If you are privately insured, some premium tariffs cover HPV regardless of age.
3. Look for campaigns: Occasionally, clinical trials or local Aidshilfe campaigns offer free or subsidised HPV vaccinations for adult gay and bisexual men.

🏥 Access & Costs at a Glance

🗣️ The Script: What to Say to Your Doctor

To request your Indikationsimpfungen, you can use this precise German phrasing. This is a recognised clinical category, and your doctor will immediately understand the billing protocol:

"Ich bin schwul und habe wechselnde Sexualpartner. Habe ich Anspruch auf die Impfungen gegen Hepatitis A, Hepatitis B und Mpox als Indikationsimpfungen?"

(I am gay and have multiple sexual partners. Am I entitled to the Hepatitis A, Hepatitis B, and Mpox vaccines as indicated vaccines?)

📒 Your Impfpass (Vaccination Booklet)

Germany runs on a yellow, paper vaccination booklet called the Impfpass. Keep this safe and bring it to every doctor's appointment. They need it to verify your history and log new doses. If you have lost yours, ask your GP to issue a new one and help reconstruct your history.

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