Table 1. Recommended vaccinations for adult patients with chronic inflammatory diseases^*.

Vaccination	Recommendation of the STIKO** (as of July 2010)	Recommendation of the SIKO*** (as of 1 January 2011)
Tetanus/diphtheria	Booster every 10 yr., catch-up vaccination(s) as needed1	Booster every 10 yr., catch-up vaccination(s) as needed1
Poliomyelitis	Catch-up vaccination(s) as needed2	Booster every 10 yr., catch-up vaccination(s) as needed1
Pertussis	The next due Td vaccination should be given once as a Tdap or Tdap-IPV combined vaccination3	Booster every 10 yr., catch-up vaccination(s) as needed3, 4
Hepatitis A	In hepatic involvement: vaccination as directed by the manufacturer, preliminary serological testing based on epidemiologic and historical considerations5, 6	Vaccination as directed by the manufacturer, preliminary serological testing based on epidemiologic and historical considerations6
Hepatitis B	In hepatic involvement: vaccination as directed by the manufacturer after serological testing5, 6,7	Vaccination as directed by the manufacturer after serological testing 6,7
Influenza	Annually	Annually
Pneumococci	Single vaccination with 23-valent polysaccharide vaccine8	Vaccination with 23-valent polysaccharide vaccine, booster 6 years later
Measles	Single vaccination for unvaccinated patients born after 1970, patients vaccinated only once in childhood, and patients whose vaccination status is unclear9, 10	For susceptible patients: 2 vaccinations at least 4 weeks apart, or else a single vaccination and demonstration of immunity9, 10, 11
Mumps	No recommendation to vaccinate	For susceptible patients: 2 vaccinations at least 4 weeks apart, or else a single vaccination and demonstration of immunity9, 10, 12
Rubella	For women who were never vaccinated or whose vaccination status is unclear, or who were vacinnated once and are of childbearing age: 2 vaccinations or single vaccination9,10	For susceptible patients: 2 vaccinations at least 4 weeks apart, or else a single vaccination and demonstration of immunity9, 10, 13
Varicella	For seronegative patients before the initiation of immunosuppressive treatment: 2 vaccinations at least 6 weeks apart9	For seronegative patients, whether or not immunosuppressive therapy is planned: 2 vaccinations at least 6 weeks apart9
Herpes zoster	No recommendation to vaccinate (yet?)	Patients over age 509
Additional recommendations (of both STIKO and SIKO) for patients taking immunosuppressive medication
Meningococci	Single vaccination with tetravalent conjugate vaccine14
Haemophilus influenzae type b (Hib)	Single vaccination14

^*Not including vaccinations that are indicated for occupational reasons, travel vaccinations, or vaccinations that are medically indicated for reasons other than chronic inflammatory disease.

^**Standing Committee on Vaccination of the Robert Koch Institute;

^***Vaccination Committee of the State of Saxony: in accordance with § 20 Para. 3 of the German Law on Protection against Infectious Disease, the SIKO makes expert recommendations based on those of the STIKO, considering the particular epidemiologic and historical characteristics of the State of Saxony;

¹catch-up vaccination(s) if baseline immunization is incomplete or absent;

²catch-up vaccination(s) if baseline immunization is incomplete or absent, or if a recommended single booster has not been given after complete baseline immunization;

³a vaccine against pertussis alone is not currently available;

⁴catch-up vaccination(s) if baseline immunization is incomplete or absent, or if a booster has not been given: one vaccination with Tdap or a Tdap-IPV combined vaccine;

⁵chronic inflammatory disease alone is not considered a medical imdication;

⁶a combined HAV/HBV vaccine can be used as indicated

⁷Immunity (anti-HBs) must be tested 4–8 weeks after completion of baseline immunization, and repeated vaccination(s) should be administered as necessary;

⁸consider repeating vaccination in 5 years in patients with congenital or acquired immune system defects with residual T- and/or B-cell function, or with chronic renal disease or nephrotic syndrome;

⁹Live vaccine: contraindicated in patients with functionally relevant immunosuppression, should not be given from 14 days before immunosuppressive treatment is initiated until 3 months after it has been terminated (or one month after the termination of high-dose cortisone therapy);

¹⁰MMR vaccine is preferred;

¹¹susceptible persons are unvaccinated persons born after 1958 without immunological evidence of a prior measles infection;

¹²susceptible persons are persons born after 1970 who have never had the mumps or been vaccinated against it, or who lack immunological proof of immunity;

¹³susceptible persons are those who were never vaccinated or lack proof of immunity;

¹⁴in analogy to antipneumococcal vaccine; cf. the article (in German) „Hinweise für Patienten mit Immundefizienz“ [Information for Patients with Immune Deficiency], Epidemiologisches Bulletin des Robert-Koch-Institutes, 10 November 2005.