Flu vaccination 2025: Who should get vaccinated and when is the best time?

A runny nose, cough, fever – many people are currently struggling with these symptoms. As is well known, the influenza viruses, the cause of the "real" flu, are also at their peak during the cold months.

These viruses are not harmless: "In a particularly severe flu season, tens of thousands of people die from this disease," warns Markus Beier, chairman of the German Association of General Practitioners. He therefore advises getting vaccinated against the flu. But who is eligible for the vaccination? And how effective is the vaccine?

Influenza is an infectious disease caused by the influenza virus. Common symptoms include high fever, severe headache and body aches, a dry cough, and a sore throat. "In uncomplicated cases, the symptoms subside after five to seven days," explains the Federal Institute for Public Health (BIÖG) . However, the course of the illness and the severity of symptoms can vary considerably from person to person.

It's impossible to make precise predictions. Seasonal flu outbreaks in Germany typically occur during the winter months, usually after the New Year . Their severity and spread can vary from season to season. COVID-19 safety measures prevented the widespread transmission of influenza viruses in recent winters. As these measures continue to decline, this could also affect the flu season.

So far, no high level of flu activity has been observed in Germany. However, the number of cases has increased significantly in recent weeks, as the Robert Koch Institute (RKI) notes in its latest weekly report on acute respiratory illnesses.

In the last week of September, the public health departments reported 176 influenza virus infections to the RKI (Robert Koch Institute), most of which were caused by influenza A viruses. Forty of these patients required hospitalization.

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The Standing Committee on Vaccination (STIKO) recommends influenza vaccination for all population groups at high risk of severe illness. These risk groups include:

• all persons aged 60 and over
• Pregnant women from the fourth month of pregnancy (if chronic underlying diseases are known, then already in the first trimester)
• People with chronic underlying conditions such as cardiovascular disease, diabetes, or liver and kidney disease
• Residents of retirement and nursing homes
• medical staff and staff in care facilities
• Contact persons of high-risk patients
• People in facilities with high public traffic (for example, staff in public transport)

In July of this year, the Standing Committee on Vaccination (STIKO) expanded its vaccination recommendation to include additional groups of people . This is due to an increased occurrence of the animal influenza viruses H5Nx viruses among poultry and H5N1 viruses among mammals, primarily dairy cows and pigs in agriculture. Therefore, the following groups should also be vaccinated:

• People who have frequent, regular and direct contact with potentially infected animals (such as pigs, poultry, wild birds or seals) in a private or professional capacity and who work in, for example, livestock farms, zoos, animal parks, animal shelters, rescue centers, veterinary practices and slaughterhouses.

This is not primarily for the benefit of any individual, as the Standing Committee on Vaccination (STIKO) explains, but rather aims to reduce the risk of coinfections. This is because the human influenza virus can also be transmitted to pigs. Vaccine resistance is intended to prevent the mixing of animal and human virus strains, which could lead to genetically modified influenza viruses (reassortants) with potentially improved human-to-human transmissibility. This is meant to counteract the development of an influenza epidemic or pandemic.

It is generally advisable to be free of feverish infections before receiving vaccinations, in order to avoid placing additional strain on the body. This also applies to the flu vaccine. Once the infection has cleared up, the vaccination can be administered.

People who are allergic to components of the vaccine, such as egg proteins, also need to be careful. They should definitely inform their doctor before vaccination.

The Standing Committee on Vaccination (STIKO) generally recommends flu vaccination for children only if they suffer from underlying chronic illnesses . They receive the same dose as adults. In addition to the inactivated vaccine, which is injected into the upper arm, a live attenuated vaccine is also available. This is administered as a nasal spray and can be used as an alternative for children and adolescents aged two to 17 years who suffer from, for example, a fear of needles.

The Standing Committee on Vaccination (STIKO) does not recommend vaccinating healthy children against the flu. Influenza infections in children generally run their course without serious complications. However, STIKO's recommendation of influenza vaccination only for certain groups of people does not mean that it advises against it for others. "If necessary, it should be clarified whether the health insurance company covers the costs," writes the Robert Koch Institute (RKI) on its website .

The Standing Committee on Vaccination (STIKO) recommends that at-risk individuals get vaccinated against the flu every year , ideally in the fall. This is due to the high mutability of influenza viruses. Different strains of the pathogen can emerge from year to year, and even within a single season, against which previous vaccines may be ineffective. However, it is sufficient for at-risk individuals to get vaccinated against the flu once per season .

Flu vaccinations can be administered by all licensed physicians. The primary points of contact are general practitioners, internists, pediatricians, and gynecologists .

Vaccination is also possible in pharmacies . To make vaccinations easily accessible and thus achieve a higher vaccination rate, pharmacists are permitted to administer vaccinations against flu and coronavirus on site.

This requires prior medical training of the staff, and only persons over 18 years of age may receive a vaccination.

The costs of a flu vaccination are generally covered by statutory health insurance for all insured individuals for whom the vaccination is recommended. For healthy people under 60 for whom there is no vaccination recommendation, the health insurance company may also reimburse the costs. Those wishing to be vaccinated should clarify this with their health insurance provider before getting the flu shot.

Even privately insured patients do not have to bear the costs themselves.

Getting vaccinated against the flu doesn't automatically provide protection. It takes between ten and fourteen days for sufficient immunity to develop. A flu shot is recommended in October or November . If you miss getting vaccinated during these months, you can still get vaccinated later in the flu season. The peak of the flu season is usually after the New Year.

The duration of immunity is estimated at six to twelve months . Therefore, a booster vaccination is not required within a single season. Studies have also shown that repeated vaccinations can provide better protection against severe cases.

The level of protection can vary considerably from season to season. It also depends on the composition of the vaccine and the currently circulating influenza variant. "When there is a very good match between the circulating influenza viruses and the vaccine, a protective effect of up to 80 percent has been observed in young adults," writes the BIÖG (Federal Institute for Public Health).

In older people, however, the flu vaccine may be less effective because they often have a weakened immune system. To increase the protective effect, the Standing Committee on Vaccination (STIKO) now recommends high-dose vaccines for everyone aged 60 and over.

No vaccine offers 100% protection – not even the flu vaccine. This means that even after vaccination, it is still possible for vaccinated individuals to become infected with influenza viruses and develop the illness. However, the course of the illness is usually milder.

No. Getting vaccinated against the flu does not provide protection against the coronavirus. A flu vaccination can only reduce the risk of contracting the flu.

But it is possible to get vaccinated against both the flu and Covid-19 at the same time . Doctors even recommend it. "Left arm: flu, right arm: corona," Andreas Gassen, Chairman of the Board of the National Association of Statutory Health Insurance Physicians, told the "Wams" and the "Neue Osnabrücker Zeitung".

"The seasonal influenza vaccine is generally well tolerated ," explains the RKI (Robert Koch Institute). Severe and irreversible side effects are very rare. However, as with other vaccinations, mild pain, redness, and swelling at the injection site may occur temporarily. These symptoms usually subside without any lasting effects after a few days.

Furthermore, it is not possible for inactivated vaccines, like the influenza vaccine, to cause infections. This is because they do not contain any replicating viruses that could cause illness. In other words, the flu vaccine does not cause the flu .

The situation is somewhat different with the live vaccine for children and adolescents, which is administered as a nasal spray. According to the BIÖG (Federal Institute for Public Health), there is a risk, albeit a very low one, of transmitting vaccine viruses, for example to severely immunocompromised individuals. Therefore, it is not recommended in cases of immunodeficiency.

RND/with dpa

We last comprehensively updated this article on October 2, 2025.