Immunization is a topic that all parents must sometime face in the lives of their children. Until moving to Germany, the question of whether to immunize or not was never an issue with me - it was just an accepted part of life. Nevertheless, living in Germany, parents will be faced with the issue of which immunizations to give their children when and why, if at all. My advice is to seek out information on both sides of the issue (whether to immunize or not), not only from compentent medical authorities, but also from other sources such as scientific publications, friends with experience and some deep soul-searching with your partner. Once you have made your decision, be sure your pediatrician supports your choice and if not, it might be time to find a new one.

Below is a listing of the officially recommended immunizations of the German Immunization Commission (Empfehlungen der Ständigen Impfkommission--STIKO), January 2000, and when to administer them:

• Age 3 months: Diphtherie (Diptheria - D), Tetanus (T), Pertussis (Keuchhusten/Whooping Cough - K), Haemophilus influenza Type B (Hib), Poliomyelitis (P), Hepatitis B (HB). First Immunization.



• Age 4 months: D, T, K. Second Immunization.



• Age 5 months: D, T, K. Third Immunization. Hib, P, HB. Second Immunization.



• Age 12-15 months: D, T, K. Fourth Immunization. Hib, P, HB. Third Immunization. Masern (Measles), Mumps, Röteln (German Measels) - MMR. First Immunization.



• Age 5-6 years: MMR. Second Immunization. (However, the second MMR immunization can be administered as soon as 4 weeks after the first MMR immunization.) D, T. First Booster.



• Age 11-18 years: K, P. First Booster. HB, MMR. Both immunizations should be completed at this time, if not previously completed. D, T. Second Booster.

To keep the number of shots at a minimum, check with your pediatrician regarding combination immunizations. You and your pediatrician, however, should sit down together to come up with a personalized immunization schedule for your child. Some things that might influence changes in this standard program are if and how long you are breast feeding, how soon you plan on traveling with your baby, environmental factors and personal preferences.

You should receive a World Health Organization Immunization booklet from your pediatrician, where all your child's immunizations will be recorded, including dates, batch numbers and manufacturers (which are helpful in case of problems with the immunization).

For more detailed information regarding this topic, please visit the following websites:

• For more detailed information on individual immunizations and the latest developments, I suggest contacting the Robert-Koch-Institut, Nordufer 20, 13353 Berlin, Tel. 018887540. They also have a website at www.rki.de (click on Gesundheit und Krankheiten, then on Impfen, then on Empfehlungen der STIKO, then on Impfkalender).



• A detailed article regarding immunizations can be found in the Öko-Test Ratgeber Kleinkinder 1/2000 (Öko-Test Council on Small Children) publication. Their website is Öko-Test. To get to the information on immunizations you have to go to the Suche page and type in Impfstoffe.