American President Donald Trump recommends in a decree that the number of standard vaccinations for children be reduced from 18 to eleven. He also advises greater intervals between vaccinations and the distribution of combination preparations such as those against measles, mumps and rubella. Reinhard Berner, chairman of the Standing Vaccination Commission STIKO since 2024, assesses what this can mean, including for Germany. As director of the Clinic for Pediatric and Adolescent Medicine at the University Hospital of Dresden, the 62-year-old native of Karlsruhe is particularly knowledgeable about the topic.
Professor Berner, US President Trump wants to reduce the number of child vaccinations. How useful is that?
Trump doesn't specifically mandate that fewer vaccinations be given, but he does stir up uncertainty. Doubts are being sown about the safety and effectiveness of vaccinations; they are being portrayed as something dangerous and dubious. Pediatricians can continue to vaccinate and parents can choose to do so. But in fact this will no longer happen as often as before, when vaccinations were recommended equally for everyone. The risk lies in undermining an extremely successful vaccination program for all in America and ultimately endangering the population.
Health Secretary Kennedy links measles vaccinations to autism.
Kennedy says he would vaccinate his own children, but vaccines can cause mental health conditions such as autism or attention deficit disorder. Accompanying substances may also be harmful to children. These are double messages that sow doubt. None of these connections have been proven, on the contrary: everything that can be found scientifically proves the opposite of what Trump and Kennedy say.
Trump points to other industrialized countries such as Germany and Denmark, where fewer vaccinations are being done.
This is a perfidious strategy. Let's take hepatitis B. We actually vaccinate a smaller proportion of newborns in Germany than in the USA. Namely only those whose mothers had the virus actively detected. The status is tested for all women during prenatal care. Not in America because health insurance is often lacking. Many infections are therefore not even recognized. If this is supposedly purely formally based on Germany, this is associated with considerable risks for the newborns. This doesn't affect the grandchildren of Kennedy or Trump, but rather families who have no insurance and no money for pregnancy screenings.
Trump recommends separating vaccination appointments and splitting up the combined measles-mumps-rubella vaccination.
There is also no scientific justification for why the poor children should receive three pricks instead of one. Years ago in England there was a campaign by a doctor that combination vaccines were harmful. The case has been examined very carefully, there is no evidence whatsoever. On the contrary: If I have three appointments, the risk of not attending one or more of them and jeopardizing vaccination protection increases.
Will the US debate spill over to us?
Certainly. Maybe not specifically, but the associated uncertainty, because the USA in particular has always been exemplary when it comes to vaccinations. Uncertainty is already a problem in Germany, and it could get worse. We have to say it very clearly: Doubts are poison for vaccination, whether in America or here. Our pharmaceutical industry and therefore indirectly we as consumers could also feel this; the USA is the most important market. Prices may rise and research may decrease. What is also bad is that the USA has frozen its funding for many international vaccination programs such as the Gavi vaccination alliance, which supports developing countries. The responsible authority, USAID, was simply dissolved in 2025. This has deadly consequences for the countries affected.
What is the vaccination situation in this country?
It's basically good, but it could be much better. The vaccination rates for children are reached too late. In a way it's crazy: Germany developed a beneficial corona vaccine and brought it onto the market incredibly quickly, which saved many of our lives. One could have expected that after this success the willingness to vaccinate would increase, for example against the equally dangerous flu. But that didn't happen.
Rather?
Rather the opposite. The group that categorically rejects vaccinations has not grown significantly. These already existed in the Bismarck era against smallpox vaccinations. But the number of undecided and uncertain people has increased. We have to achieve them. They need more conversations, education and advice about how essential immunization is, especially for children, the elderly and the sick.
Where is there a particular fire?
The big problem in Germany is that many vaccinations and follow-up vaccinations are not carried out on time. We've already talked about this: If a vaccination is split unnecessarily or an appointment is postponed, the next one may be missed. This leads to dangerously low immunization rates in particularly vulnerable age groups against dangerous diseases such as polio.
Is there any evidence for this?
Yes. A few years ago, vaccine-derived polioviruses were found in wastewater and an investigation was carried out to determine how high the vaccination rate was in the highest risk group of three and four year olds. The frightening result: Depending on the region, 25 to 40 percent did not have sufficient immunization. There are currently no cases of polio in Germany. But if the virus came back, it would be extremely dangerous.
Does this only apply to polio?
No. Protection against polio is part of the six-fold vaccination. The example shows that the immunization was started, but not completely completed. So we also have to worry about whooping cough, diphtheria, tetanus or pneumococcal infections. Three doses are required at the ages of two, four and eleven months, although the correct interval is important. The delay until a later age creates a group of unprotected children, even though their parents are not anti-vaccination people and their doctors are not vaccination refusers.
Would compulsory vaccination be the right way?
I am not a fan of compulsory vaccination. It can remind people with a certain emphasis that a vaccination is due. But there must be another way to achieve this. It is important to invest more in education and also to address harder-to-reach target groups using all available media. Doctors need to be made more aware of the importance of timely vaccination. Health education should start in schools.
Is the measles vaccination requirement unnecessary since 2020?
Personally, I am not convinced by the results of compulsory measles vaccination. The vaccination rate has increased slightly, but no one knows whether this is really due to the obligation. Opponents of vaccination cannot be convinced of the protection anyway; if in doubt, they are more likely to forge vaccination certificates. We have to rely on voluntary action and at the same time provide adults and children with much better information and offer them more low-threshold options.
In a separate school subject?
Not necessarily in a separate school subject, what is crucial is reliable concepts for teaching in class, perhaps also in different subjects. Girls and boys must receive an HPV vaccination against the cause of cervical cancer before first sexual contact. Sixteen-year-old students are the expectant mothers of tomorrow and should therefore know about preventative care and infant vaccinations in good time. The classroom reaches children regardless of their level of education and social status. This represents a great opportunity for vaccination education.
What does the corona pandemic teach?
There was a lot that went right when it came to vaccination, but also a lot of things went wrong. Mandatory vaccinations in healthcare and other professions were not helpful. The myths that persist to this day should also have been countered more strongly and with more unity. The mRNA vaccine is associated with vaccination deaths and genetic damage over several generations. There has never been any evidence of this. But that is up in the air and unsettling. In addition, many people no longer know what diphtheria, measles or polio are and what devastating consequences these diseases have. Vaccinations prevent diseases that are no longer known. This makes it so difficult to convey their importance.
How independent is the new STIKO from the Ministry of Health?
We enjoy the grace of late birth, so to speak, because we were called when the pandemic was over and public interest had waned. This also reduced the temptation for politicians to exert influence. For myself and for our STIKO, I can say that we are a completely independent commission. But that's what STIKO has always been. We feel no influence from the ministry and are also independent of industry and other interest groups. Our work is entirely voluntary and I don't receive a penny for it. It may not be nice, but it makes you independent. If we go out to eat together on the evening of a STIKO meeting, each of us pays ourselves. That may not be nice, but it's completely right.
