Role, working methods and recommendations of the Standing Committee on Vaccinations (STIKO) in the context of the COVID-19 pandemic

Abstract

The Standing Committee on Vaccination (STIKO) is a voluntary body whose 18 experts are appointed by the Federal Ministry of Health. The scientific work of STIKO is supported by a scientific secretariat at the Robert Koch Institute. The STIKO develops independent vaccination recommendations for Germany using the methodology of evidence-based medicine (EBM). During the COVID-19 pandemic, STIKO faced major challenges. Several COVID-19 vaccines based on new technologies were approved within a very short time. The benefit–risk assessment had to be carried out according to the current state of knowledge. The vaccination recommendations had to be continuously adapted to the constantly changing epidemiology of SARS-CoV‑2, increasing vaccine availability, new approvals, extensions of indications, and safety signals of vaccines. STIKO has adapted its way of working to the situation; the experts showed an impressive commitment during the pandemic. Even under time pressure, STIKO adhered to the principles of EBM and developed evidence-based vaccination recommendations. Before the final decision was made, STIKO submitted every vaccination recommendation to a commenting procedure with the stakeholders (e.g., medical societies and health authorities). Despite the short deadlines, the stakeholders made extensive and constructive comments and gave STIKO the opportunity to discuss and adapt their recommendations, consider the feedback, and thus build on a broad consensus. The past few months have shown that it is possible and rational to developing vaccination recommendations based on the principles of EBM even during a pandemic. Sufficient human resources in the STIKO office are essential.