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Travel Advisory July 26, 2023

Germany - level 2: exercise increased caution.

Reissued with obsolete COVID-19 page links removed.

Exercise increased caution in Germany due to  terrorism .

Country Summary: Terrorist groups continue plotting possible attacks in Germany. Terrorists may attack with little or no warning, targeting tourist locations, transportation hubs, markets/shopping malls, local government facilities, hotels, clubs, restaurants, places of worship, parks, major sporting and cultural events, educational institutions, airports, and other public areas.

Read the  country information page for additional information on travel to Germany.

If you decide to travel to Germany:

• Be aware of your surroundings when traveling to tourist locations and crowded public venues.
• Follow the instructions of local authorities.
• Monitor local media for breaking events and adjust your plans based on new information.
• Enroll in the  Smart Traveler Enrollment Program  ( STEP ) to receive Alerts and make it easier to locate you in an emergency.
• Follow the Department of State on  Facebook  and  Twitter . 
• Review the  Country Security Report  for Germany.
• Visit the CDC page for the latest Travel Health Information related to your travel.
• Prepare a contingency plan for emergency situations. Review the  Traveler’s Checklist .

Embassy Messages

View Alerts and Messages Archive

Quick Facts

Three months beyond planned date of departure from the Schengen area including transit (strictly enforced) .

Not required for stays under 90 days.

 10,000€ (euros or equivalent).

Embassies and Consulates

U.S. EMBASSY BERLIN  Clayallee 170 14191 Berlin Federal Republic of Germany Telephone: +(49) (30) 8305-0 Email: [email protected]

U.S. CONSULATE GENERAL FRANKFURT  Giessener Str. 30 60435 Frankfurt am Main Federal Republic of Germany Telephone: +(49) (69) 7535-0 Fax: +(49) (69) 7535-2252 Passport, Consular Report of Birth Abroad, and Citizenship:  [email protected]  All other questions:  [email protected]

U.S. CONSULATE GENERAL MUNICH   Koeniginstrasse 5 80539 Munich Federal Republic of Germany Telephone: +(49) (89) 2888-575  Emergency After-Hours Telephone: +(49) 89-2888-0 Fax: If you need to send a fax, please email first to obtain a one-time use fax number.  Email:  [email protected]

U.S. CONSULATE GENERAL DUSSELDORF Willi-Becker-Allee 10 40227 Duesseldorf Federal Republic of Germany Telephone: +(49) (211) 788-8927 Emergency After-Hours Telephone: +(49) (30) 8305-0 Fax: +(49) (211) 788 - 8938 Consular services are provided through the U.S. Consulate in Frankfurt. 

U.S. Consulate General Hamburg Alsterufer 27/28 20354 Hamburg Federal Republic of Germany Telephone: +(49) (40) 411-71-100 Emergency After-Hours Telephone: Contact the U.S. Embassy in Berlin: +(49) (30) 8305-0 Fax: +(49) (40) 411-71-222 Consular services are provided through the U.S. Embassy in Berlin.

U.S. Consulate General Leipzig Wilhelm-Seyfferth-Str. 4 04107 Leipzig Federal Republic of Germany Telephone: +(49) (341) 213-84-0 Emergency After-Hours Telephone: Contact the U.S. Embassy in Berlin: +(49) (30) 8305-0 Fax: +(49) (341) 213-84-75 Consular services are provided through the U.S. Embassy in Berlin.

Destination Description

See the Department of State’s Fact Sheet on Germany for information on U.S. - Germany relations.

Entry, Exit and Visa Requirements

Traveling Through Europe :  If you are planning to visit or travel through European countries, you should be familiar with the requirements of the Schengen Agreement.   

• Your passport should be valid for  at least three months beyond the period of stay  if you plan on transiting a Schengen country review our  U.S. Travelers in Europe page .     
• You will need s ufficient proof of funds  and a  return plane ticket .   
• For additional information about visas for the Schengen area, see the  Schengen Visa page.   
• For transit through Germany to another Schengen country, passports must be valid for three months beyond the length of your visit to Europe.

Credit cards are not as widely accepted in Germany as they are in the United States; however, ATMs are widely available throughout Germany. 

Carry identification with you at all times.

The U.S. Department of State is unaware of any HIV/AIDS entry restrictions for visitors to or foreign residents of Germany.

Find information on  dual nationality ,  prevention of international child abduction  and  customs regulations  on our websites.

Safety and Security

Terrorism:  

Credible information indicates terrorist groups continue plotting possible attacks in Europe. European governments are taking action to guard against terrorist attacks; however, all European countries remain potentially vulnerable to attacks from transnational terrorist organizations.  

Terrorist groups and those inspired by such organizations are intent on attacking U.S. citizens abroad.  Terrorists are increasingly using less sophisticated methods of attack –including knives, firearms, and vehicles – to more effectively target crowds.  Frequently, their aim is unprotected or vulnerable targets, such as:  

• High-profile public events (sporting contests, political rallies, demonstrations, holiday events, celebratory gatherings, etc.)  
• Hotels, clubs, and restaurants frequented by tourists  
• Places of worship  
• Schools  
• Shopping malls and markets  
• Public transportation systems (including subways, buses, trains, and scheduled commercial flights)  

For more information, see our  Terrorism  page.   

Demonstrations:

Demonstrations occur regularly in Germany.  Large, public demonstrations take place for a variety of political and economic issues.  Demonstrations tend to take place on politically significant holidays like German Labor Day (May 1) and during international summits hosted in Germany.  Demonstration organizers must obtain prior police approval, and police routinely oversee participants.     

• Even demonstrations intended to be peaceful can turn confrontational and possibly become violent.   
• Avoid areas around protests and demonstrations.   
• Check local media for updates and traffic advisories.   

International Financial Scams:

Internet romance and financial scams are prevalent in Germany.  Scams are often initiated through Internet postings/profiles or by unsolicited emails and letters.  Scammers almost always pose as U.S. citizens who have no one else to turn to for help.  Common scams include:    

• Romance/Online dating  
• Transit flight issues related to romance scams 
• Immigration, and Detention issues related to romance scams

See the  Department of State  and the  FBI   pages for information.  

Violent crime is rare in Germany, but can occur, especially in larger cities or high-risk areas such as on large metropolitan subway systems and in train stations, primarily during late night or early morning hours. Most incidents of street crime involve the theft of unattended items and pickpocketing.  Theft and pickpocketing primarily take place at train stations, on public transportation, at tourist attractions, and at large public events.  Always pay close attention to your valuables! 

Be cautious and aware of your surroundings. 

U.S. citizens should exercise caution when congregating in known expatriate hangouts. 

Hooligans, most often drunken “skinheads,” have harassed and attacked perceived foreigners or members of rival groups. Seemingly racially motivated assaults (because of a “foreign” appearance) against U.S. citizens have occurred. 

Don’t buy counterfeit and pirated goods, even if they are widely available. They are illegal to bring back into the United States, and you could also be breaking local law. 

Victims of Crime:

Report crimes to the local police: in an emergency dial 112 for ambulance and 110 for the police and contact the U.S Embassy or nearest U.S. Consulate (see contact details above) . 

Remember that local authorities are responsible for investigating and prosecuting crimes. 

See our webpage on  help for U.S. victims of crime overseas . 

We can: 

• Help you find appropriate medical care 
• Assist you in reporting a crime to the police 
• Contact relatives or friends with your written consent 
• Provide general information regarding the victim’s role during the local investigation  and following its conclusion
• Provide a list of local attorneys 
• Provide information on  victim’s compensation programs in the U.S.  
• Provide information on  victim’s compensation and support in Germay
• Provide an emergency loan for repatriation to the United States and/or limited medical support in cases of destitution 
• Help you find accommodation and arrange flights home 
• Replace a stolen or lost passport 

We also maintain information on our website on how to report  child abuse situations to the local authorities.

Domestic Violence: 

U.S. citizen victims of domestic violence may contact the Embassy or the Consulates in Frankfurt or Munich for assistance.  Call 110 if you are in immediate danger.  

The tourism industry is generally regulated and rules are regularly enforced. Hazardous areas/activities are identified with appropriate signage and professional staff is typically on hand in support of organized activities.  

Germany sometimes experiences extreme weather conditions including floods, long periods of drought, and unusually harsh winters with vast amounts of snow even in urban areas. Numerous injuries and deaths occur every year in Germany’s Alpine and coastal regions. Most of the emergencies relate to the following sports:  skiing, hiking, snowboarding, mountain biking, sledding, rock and mountain climbing, paragliding, and swimming. Those engaging in Alpine sports are strongly encouraged to register with  German “Alpen Verein”  .

In the event of an injury, appropriate medical treatment is widely available throughout the country. Outside of a major metropolitan center, it may take more time for first responders and medical professionals to stabilize a patient and provide life-saving assistance.

U.S. citizens are encouraged to purchase medical evacuation insurance . 

Local Laws & Special Circumstances

Criminal Penalties:  You are subject to local laws.  If you violate local laws, even unknowingly, you may be expelled, arrested, or imprisoned. Individuals establishing a business or practicing a profession that requires additional permits or licensing should seek information from the competent local authorities, prior to practicing or operating a business.   

Furthermore, some laws are also prosecutable in the U.S., regardless of local law. For examples, see our website on  crimes against minors abroad  and the  Department of Justice  website.

Arrest Notification:  If you are arrested or detained, ask police or prison officials to notify the U.S. Embassy or nearest U.S. Consulate immediately. See our  webpage  for further information.

Special Circumstances:  Germany has strict customs regulations concerning:

• Temporary importation or exportation of firearms
• Military artifacts (particularly those of World War II)
• Medications/pharmaceuticals
• Business equipment

Under German law it is also illegal to bring into or take out of Germany any literature, music, or paraphernalia that glorifies fascism, the Nazi past, or the “Third Reich.”

Contact the German Embassy in Washington or one of the German consulates in the United States for specific information regarding customs requirements.

Faith-Based Travelers : See our following webpages for details:

• Faith-Based Travel Information
• International Religious Freedom Report  – see country reports
• Human Rights Report  – see country reports
• Hajj Fact Sheet for Travelers
• Best Practices for Volunteering Abroad

LGBTI Travelers :  There are no legal restrictions on same-sex sexual relations or the organization of LGBTI events in Germany. Same-sex marriage is available in Germany. The LGBTI community is protected by federal anti-discrimination laws and LGBTI Pride events are officially encouraged by most large city governments, including those in Berlin, Cologne, Hamburg, Frankfurt, and Munich. 

See   our  LGBTI Travel Information  page and section 6 of our   Human Rights report  for further details.

Travelers with Disabilities:

The law in Germany prohibits discrimination against persons with disabilities, and the law is enforced.  Social acceptance of persons with disabilities in public is as prevalent as in the United States.  The law in Germany prohibits discrimination against persons with disabilities, and the law is enforced.  Social acceptance of persons with disabilities in public is as prevalent as in the United States.  Expect accessibility to be limited in some older public transportation, lodging, and general infrastructure especially outside major cities, but common in most urban infrastructure. Some older buildings and public transportation systems are less adapted to individuals with disabilities.

Check your hotel or destination to learn more about options to accommodate disabled traveler needs before visiting Germany.

The German National Tourist Board maintains information about accessibility and disability-friendly travel .

All German airports and  Lufthansa  offer services for disabled travelers.

The German National Railway,  Deutsche Bahn , maintains a mobility resource webpage.

Students:  See our  Students Abroad  page and  FBI travel tips .

Women Travelers:  See our travel tips for  Women Travelers .

COVID-19 Vaccines:   The German government has authorized  several vaccines  , including the Pfizer/BioNTech, Moderna, Astra Zeneca, Janssen/Johnson & Johnson, and Novavax vaccines.  Visit the FDA's website to   learn more about FDA-approved vaccines  in the United States.  

Germany has generally high-quality medical care and facilities. Prescript ion and over-the-counter medicines are widely available although brands and drug names differ from those available in the United States.

For emergency services in Germany, dial 112.  

Ambulance services are widely available.  

Payment for medical services in Germany:

We do not pay medical bills. Be aware that U.S. Medicare does not apply overseas.   Most hospitals and doctors overseas do not accept U.S. health insurance.  If you are not a resident of Germany, doctors and hospitals may expect immediate payment in cash. Credit card payment is not always available.

Medical Insurance:  Make sure your health insurance plan provides coverage overseas or purchase travel insurance for this purpose.  Most care providers overseas only accept cash payments.  See our webpage for more information on insurance coverage overseas.  Visit the  U.S. Centers for Disease Control and Prevention  for more information on type of insurance you should consider before you travel overseas.  We strongly recommend supplemental insurance to cover medical evacuation. 

The U.S. Embassy and Consulates maintain lists of doctors and medical services in Germany .  We do not endorse or recommend any specific medical provider or clinic. 

Medical Tourism and Elective Surgery 

• Medical tourism is a rapidly growing industry. People seeking health care overseas should understand that medical systems operate differently from those in the United States and are not subject to the same rules and regulations.  Anyone interested in traveling for medical purposes should consult with their local physician before traveling and visit the  U.S. Centers for Disease Control and Prevention  website for more information on Medical Tourism.   
• Visit the  U.S. Centers for Disease Control and Prevention  website for information on Medical Tourism, the risks of medical tourism, and what you can do to prepare before traveling to Germany.  
• We strongly recommend  supplemental insurance  to cover medical evacuation in the event of unforeseen medical complications.   

Pharmaceuticals 

• If traveling with prescription medication, visit the  German customs website  to ensure the medication is legal in Germany. For medications that Germany classifies as narcotics, you may only carry a 30-day supply.  A comprehensive list of these medications can be found   here.   If your medication is on that list, there is an additional requirement for your doctor to complete a certification form .  You will see part E asks for the endorsement of an “issuing authority.”  As there is no such authority in the United States, travelers may have the doctor self-certify the form and enter the information of his or her practice in part E, ideally with a stamp or seal from their office. Due to Germany’s strict customs regulations, you are not allowed to receive prescription medication by mail without special permission.  Always, carry your prescription
• Exercise caution when purchasing medication overseas.   Medication should be purchased in consultation with a medical professional and from reputable establishments.   
• U.S. Customs and Border Protection and the Food and Drug Administration are responsible for rules governing the transport of medication back to the United States.  Medication purchased abroad must meet their requirements to be legally brought back into the United States.  Medication should be for personal use and must be approved for usage in the United States.  Please visit the  U.S. Customs and Border Protection  and the  Food and Drug Administration  websites for more information.    

Assisted Reproductive Technology and Surrogacy   

If you are considering traveling overseas to have a child through use of assisted reproductive technology (ART) or surrogacy, please see our  ART and Surrogacy Abroad page .  

• All surrogacy arrangements, as well as IVF procedures involving the use of donated eggs, are illegal in Germany.  For additional information, see this webpage of the German Foreign Ministry (German language only).

Vaccinations:  Be up-to-date on all  vaccinations  recommended by the U.S. Centers for Disease Control and Prevention. 

Further health information:

• World Health Organization
• U.S. Centers for Disease Control and Prevention  (CDC) 

Adventure Travel: Visit the U.S. Centers for Disease Control and Prevention website for more information about  Adventure Travel .  

Travel and Transportation

Road Conditions and Safety:  Road conditions in general are excellent but can differ from those in the United States, but driver error is a leading cause of accidents involving U.S. citizen motorists in Germany.  

If you hold a valid U.S. driver’s license you can drive in  Germany for up to six months  without acquiring a German driver’s license.  Many German traffic laws and traffic signs differ significantly from those in the United States. For more information, please visit the U.S. embassy’s webpage on  driving in Germany .

Speed limits are posted on large stretches of the highway, on the Autobahn in urban areas and when the road has many curves. While high speeds are permitted on the Autobahn, adverse weather conditions and unfamiliar road markings pose significant hazards.  Speed limits are strictly enforced. Use of seat belts is mandatory in front and back seats. Do not park on bike paths or sidewalks. Your vehicle registration, insurance policy, a first-aid kit, a reflective vest and a reflective triangle must be in your vehicle at all times. In snowy or icy conditions, your vehicle must have snow tires or all-season tires (indicated by M+S marking) or you will be subject to a fine.

Bicycles: German streets and sidewalks have dedicated bike lanes. Bicycles have priority use of bike lanes over pedestrians and automobiles. Bicyclists also have priority over cars when turning onto side streets. If you are driving, check whether a bicyclist is approaching from either direction before attempting to enter side streets, even when the light is in your favor. You will be held responsible for any injury or damage caused if you turn into a side street and hit a bicyclist using a marked bike lane. If you are walking, watch for bicyclists before crossing or stepping into bike lanes. 

Traffic Laws:  If you are involved in a traffic accident in Germany, even a minor fender-bender, you MUST stay with your vehicle and do not leave the scene until police arrive to take a report.  It is illegal to use your cell phone while driving in Germany. Except on priority roads, vehicles coming from the right have the right-of-way. It is generally illegal in Germany to pass vehicles on the right. Germans strictly observe the ‘slower traffic keep right’ rule. It is illegal to operate a vehicle if your blood alcohol level is 0.05% or higher. You may be fined and your driver’s license may be suspended for specified periods of time depending upon the gravity of each violation. 

Public Transportation:  Germany has an extensive and safe public transportation network consisting of buses, streetcars, trains, and subways. Metered taxis are also prevalent throughout Germany, although some taxis do not accept credit cards. Uber and other rideshare companies are available in most cities in Germany. Use common sense safety practices such as guarding valuables and remaining aware of your surroundings on all public transportation. 

See our  Road Safety page  for more information. Visit the website of Germany’s  Federal Ministry for Digital and Transport (BMVI) , the national authority responsible for road safety.

Aviation Safety Oversight:   The U.S. Federal Aviation Administration (FAA) has assessed the government of Germany’s Civil Aviation Authority as compliant with International Civil Aviation Organization (ICAO) aviation safety standards for oversight of Germany’s air carrier operations. Further information may be found on the  FAA’s safety assessment page . 

Maritime Travel:  Mariners planning travel to Germany should also check for U.S. maritime advisories and alerts .  Information may also be posted to the  U.S. Coast Guard homeport website , and the NGA broadcast warnings .

For additional travel information

• Enroll in the  Smart Traveler Enrollment Program (STEP)  to receive security messages and make it easier to locate you in an emergency.
• Call us in Washington, D.C. at 1-888-407-4747 (toll-free in the United States and Canada) or 1-202-501-4444 (from all other countries) from 8:00 a.m. to 8:00 p.m., Eastern Standard Time, Monday through Friday (except U.S. federal holidays).
• See the  State Department’s travel website  for the  Worldwide Caution  and  Travel Advisories .
• Follow us on  Twitter  and  Facebook .
• See  traveling safely abroad  for useful travel tips.

Review information about International Parental Child Abduction in Germany . For additional IPCA-related information, please see the  International Child Abduction Prevention and Return Act ( ICAPRA )  report.”

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Germany Traveler View

Travel health notices, vaccines and medicines, non-vaccine-preventable diseases, stay healthy and safe.

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After Your Trip

There are no notices currently in effect for Germany.

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Check the vaccines and medicines list and visit your doctor at least a month before your trip to get vaccines or medicines you may need. If you or your doctor need help finding a location that provides certain vaccines or medicines, visit the Find a Clinic page.

Routine vaccines

Recommendations.

Make sure you are up-to-date on all routine vaccines before every trip. Some of these vaccines include

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Flu (influenza)
• Measles-Mumps-Rubella (MMR)

Immunization schedules

All eligible travelers should be up to date with their COVID-19 vaccines. Please see  Your COVID-19 Vaccination  for more information. 

COVID-19 vaccine

Hepatitis A

Consider hepatitis A vaccination for most travelers. It is recommended for travelers who will be doing higher risk activities, such as visiting smaller cities, villages, or rural areas where a traveler might get infected through food or water. It is recommended for travelers who plan on eating street food.

Hepatitis A - CDC Yellow Book

Dosing info - Hep A

Hepatitis B

Recommended for unvaccinated travelers younger than 60 years old traveling to Germany. Unvaccinated travelers 60 years and older may get vaccinated before traveling to Germany.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

Cases of measles are on the rise worldwide. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks prior to departure, or have not had measles in the past, and travel internationally to areas where measles is spreading.

All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, according to  CDC’s measles vaccination recommendations for international travel .

Measles (Rubeola) - CDC Yellow Book

Germany is free of dog rabies. However, rabies may still be present in wildlife species, particularly bats. CDC recommends rabies vaccination before travel only for people working directly with wildlife. These people may include veterinarians, animal handlers, field biologists, or laboratory workers working with specimens from mammalian species.

Rabies - CDC Yellow Book

Tick-borne Encephalitis

For travelers moving or traveling to TBE-endemic areas

TBE vaccine is recommended for persons who will have extensive exposure to ticks based on their planned outdoor activities and itinerary.

TBE vaccine may be considered for persons who might engage in outdoor activities in areas ticks are likely to be found. 

Tick-borne Encephalitis - CDC Yellow Book

Avoid contaminated water

Leptospirosis

How most people get sick (most common modes of transmission)

• Touching urine or other body fluids from an animal infected with leptospirosis
• Swimming or wading in urine-contaminated fresh water, or contact with urine-contaminated mud
• Drinking water or eating food contaminated with animal urine
• Avoid contaminated water and soil

Clinical Guidance

Airborne & droplet.

• Breathing in air or accidentally eating food contaminated with the urine, droppings, or saliva of infected rodents
• Bite from an infected rodent
• Less commonly, being around someone sick with hantavirus (only occurs with Andes virus)
• Avoid rodents and areas where they live
• Avoid sick people

Tuberculosis (TB)

• Breathe in TB bacteria that is in the air from an infected and contagious person coughing, speaking, or singing.

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in Germany, so your behaviors are important.

Eat and drink safely

Food and water standards around the world vary based on the destination. Standards may also differ within a country and risk may change depending on activity type (e.g., hiking versus business trip). You can learn more about safe food and drink choices when traveling by accessing the resources below.

• Choose Safe Food and Drinks When Traveling
• Water Treatment Options When Hiking, Camping or Traveling
• Global Water, Sanitation and Hygiene | Healthy Water
• Avoid Contaminated Water During Travel

You can also visit the  Department of State Country Information Pages  for additional information about food and water safety.

Prevent bug bites

Although Germany is an industrialized country, bug bites here can still spread diseases. Just as you would in the United States, try to avoid bug bites while spending time outside or in wooded areas.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Consider using permethrin-treated clothing and gear if spending a lot of time outside. Do not use permethrin directly on skin.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
• Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
• 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs .

For more detailed information on avoiding bug bites, see Avoid Bug Bites .

Stay safe outdoors

If your travel plans in Germany include outdoor activities, take these steps to stay safe and healthy during your trip:

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• If you are outside for many hours in the heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation : use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Do not dive into shallow water.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if you are driving a boat, and always wear a life jacket.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately.  Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance for things your regular insurance will not cover.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medicines you take.
• Bring copies of your prescriptions for medicine and for eye glasses and contact lenses.
• Some prescription drugs may be illegal in other countries. Call Germany’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website ( www.jointcommissioninternational.org ).

Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Make sure there are seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in Germany, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.
• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

Maintain personal security

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel advisories and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP) .
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate .
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

Healthy Travel Packing List

Use the Healthy Travel Packing List for Germany for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.

Why does CDC recommend packing these health-related items?

It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.

If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic . Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.

For more information on what to do if you are sick after your trip, see Getting Sick after Travel .

Map Disclaimer - The boundaries and names shown and the designations used on maps do not imply the expression of any opinion whatsoever on the part of the Centers for Disease Control and Prevention concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Approximate border lines for which there may not yet be full agreement are generally marked.

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Information on coronavirus vaccination

COVID-19 vaccines contributed significantly toward the SARS-CoV-2 pandemic running a comparatively mild course in Germany.

Basic knowledge

Covid certificates, side effects and vaccine injury law.

The development of highly effective vaccines against COVID-19 and the large-scale vaccination campaign above all helped reduce the number of severe cases and protect highly vulnerable groups. However, no vaccine is free of side effects. In very rare cases, it is possible for such serious vaccination side effects and/or complications to occur that individuals suffer long-term health impairments. Against this backdrop, the Federal Ministry of Health provides answers to the most important questions concerning COVID-19 vaccination, side effects of COVID-19 vaccines and vaccine injury law.

Who is recommended a vaccination?

Since the beginning of the COVID-19 pandemic, infection trends have changed greatly. At this point in time, it can be assumed that it is transitioning to that of endemic waves. This means that while the virus continues to be transmitted among the population, the milder infections seen with Omicron virus variants and the high immunity within the population on account of vaccination and past infection have resulted in there now being significantly fewer instances of severe illness.In contrast with earlier virus variants, infections with the Omicron variant also appear to result in fewer instances of long COVID.

Nevertheless, SARS-CoV-2 infection does pose a risk of severe illness for those who have gone unvaccinated or, for example, are over 60 or have underlying conditions. Furthermore, various studies indicate that vaccination may provide a certain level of protection against Long COVID ( Useful information for patients and interested parties ).

The Standing Committee on Vaccination (STIKO) recommends the following persons have basic immunity against the SARS-CoV-2 coronavirus:

• All persons aged ≥ 18 years
• Residents of long-term care facilities
• Children and adolescents aged between six months and 17 years with an underlying condition that confers a higher risk of severe illness
• Persons of any age with a higher occupational infection risk on account of their work in health or long-term care that brings them into direct contact with patients or residents
• Family members and close contacts from the age of six months of persons for whom the COVID-19 vaccination is unlikely to produce a protective immune response
• Women of reproductive age and pregnant women

Basic immunity exists once the immune system has been exposed to pathogen components (through vaccination) or the pathogen itself (through infection) three times. At least one of these exposures should be through vaccination. The vaccine should be a current variant-adapted vaccine that is recommended by the World Health Organization (WHO).

Groups of people who are at increased risk are recommended an additional booster in the autumn of each year .

This applies to:

• All people aged 60 or over
• Anyone over the age of six months with relevant underlying conditions
• People of all ages with an increased infection risk on account of their occupation in healthcare or long-term care that involves direct contact with patients or residents
• Family members and close contacts of people for whom the COVID-19 vaccination is unlikely to produce a protective immune response

Persons in this group whose immune system is not compromised and who already had a SARS-COV-2 infection in the current year do not usually need to get an annual COVID-19 booster in autumn.

For people with an immune deficiency and a relevant limited immune response, additional vaccine doses at shorter intervals may be beneficial. Whether additional vaccine doses are needed is determined by the attending physician.

Who is eligible for COVID-19 vaccination?

Since 7 April 2023, entitlement to COVID-19 vaccinations for people with statutory health insurance is subject to the provisions of the vaccination directive passed by the Joint Federal Committee of Physicians and Health Insurance Funds (G-BA) on the basis of the Standing Committee on Vaccination’s recommendation. According to the COVID-19 Prevention Ordinance, aside from the provisions of the vaccination directive (German) , those insured are entitled to COVID-19 vaccinations should a doctor deem it medically necessary.

Furthermore, health insurance funds can make provisions for additional protective vaccinations within their by-laws.

People with private health insurance are subject to their individual contractual terms.

Where can you get vaccinated?

A large proportion of COVID-19 vaccinations are carried out by local GPs, which includes vaccinations administered by doctors at nursing care facilities. Company doctors and local pharmacies also administer COVID-19 vaccines.

Is the COVID-19 vaccine recommended for healthy children and adolescents?

The Standing Committee on Vaccination (STIKO) currently recommends that babies, (young) children and adolescents without underlying conditions do not require vaccination against COVID-19 on account of the mostly mild courses of disease with a very low likelihood of needing hospitalisation.

Children and adolescents with relevant underlying conditions are to continue to receive vaccinations according to the recommendations.

Is the COVID-19 vaccine recommended for pregnant people?

Like other healthy adults between the ages of 18 and 59, it is recommended that pregnant people have a basic immunity. For the basic immunity, it is important that the immune system is exposed to pathogen components (through vaccination) or the pathogen itself (through infection) three times. At least one of these exposures should have occurred through vaccination. In addition to the basic immunity, pregnant people with an existing underlying illness are recommended to get a booster from the second trimester in autumn.

Pregnant people should only be vaccinated from the second trimester, and the vaccine should be Comirnaty by BioNTech/Pfizer.

What vaccines are administered in Germany?

The following COVID-19 vaccines are currently available in Germany ( short overview of authorised COVID-19 vaccine products, accessible via the Paul Ehrlich Institute website ):

• Comirnaty by BioNTech/Pfizer [including vaccines adapted to Omicron variants (monovalent: Comirnaty XBB.1.5; bivalent: Comirnaty Original/Omicron BA.1 and Comirnaty Original/Omicron BA.4-5)]
• Spikevax by Moderna [bivalent vaccines adapted to Omicron variants (Spikevax bivalent Original/Omicron BA.1 and Spikevax bivalent Original/Omicron BA.4-5)]
• Jcovden (old name: COVID-19 Vaccine Janssen) by Janssen-Cilag (Johnson & Johnson)
• Nuvaxovid by Novavax
• COVID-19 Vaccine (inactivated, adjuvanted) by Valneva
• VidPrevtyn Beta by Sanofi Pasteur

Information regarding use can be found in the expert information and instructions for use for each vaccine that are provided electronically by the pharmaceutical companies. Moreover, the approved product information texts can be accessed via the website of the Paul Ehrlich Institute (PEI) . Details describing which vaccine should preferentially be administered to each age group can be found in STIKO’s vaccination recommendations.

A short overview of authorised COVID-19 vaccine products can be found on the website of the Paul Ehrlich Institute. It does not state whether the preparations are available on the market.

How will the vaccine be procured in the future?

No further central procurement of COVID-19 vaccines by the Federal Government is planned. Once the Federation’s respective stocks have been distributed or used up, the pharmaceutical companies will be able to introduce their COVID-19 vaccines into the distribution chains themselves. As with other medicinal products and vaccines, ordering will then be carried out by the doctor from pharmaceutical wholesalers through pharmacies. COVID-19 vaccines brought to market by the pharmaceutical companies themselves are subject to the legal provisions that apply to the distribution of medicinal products in Germany.

Are digital vaccination certificates still issued upon request?

It was only possible to issue COVID-19 vaccination certificates until the end of 2023.

Issue of COVID-19 vaccination certificates is only possible until the end of 2023.

Are digital COVID-19 vaccination certificates still needed for specific journeys abroad?

Meanwhile, there are no requirements to present a vaccination certificate when travelling within Germany or upon entry. In the other EU member states and in the large majority of third countries, SARS-CoV-2-related entry restrictions no longer apply. For furnishing proof when travelling, we recommend taking the “yellow vaccination booklet”.

It is also recommended to find out about the local provisions in place at your destination before travelling (e.g. travel and safety advisories by the Federal Foreign Office, German ).

The quality, efficacy and safety of the COVID-19 vaccines were tested as part of the approval process, and the vaccines were certified as having a positive benefit-risk ratio. The benefit-risk ratio of licensed COVID-19 vaccines is subject to continuous monitoring by the competent authorities. In coordination with the European Medicines Agency (EMA), in Germany this is carried out by the Paul Ehrlich Institute (PEI).

The approved vaccines against COVID-19 protect effectively against severe progression of the disease. Their benefits far outweigh the potential risks. Since the beginning of the vaccination campaign, over 192 million vaccine doses have been administered. Therefore, there is a large body of data on the safety of COVID-19 vaccine products.

Nevertheless, side effects, and in very rare cases serious side effects or vaccine complications, may occur.

Vaccine reactions

Vaccine reactions are typical symptoms following a vaccination, such as reddening, swelling and pain at the injection site, but also more general reactions such as fever, headache, aching limbs and malaise. These reactions are a sign of the desired activation of the immune system, emerge within 1-2 days of receiving the vaccine and usually subside again after a few days without any consequences.

Side effects

According to the Medicinal Products Act (Arzneimittelgesetz – AMG), side effects are defined as noxious and unintended reactions to a medicinal product. Serious side effects are side effects that are fatal or life-threatening, require hospitalisation or the prolonging of existing hospitalisation, or lead to persistent or significant disability, incapacity, congenital anomalies or birth defects. For information on the type and frequency of adverse drug reactions , please refer to the relevant vaccine's product information texts (expert information and instructions for use). 

Vaccine complications

Vaccine complications are adverse drug reactions (ADRs) following vaccination. For the reported frequency of adverse drug reactions (ADRs) observed in clinical trials, please refer to the product information of the respective vaccines. As a rule, adverse drug reactions are quite rare. This also applies to the vaccines against COVID-19.

The information leaflets on the various COVID-19 vaccines offered in Germany describe the frequently occurring vaccination reactions as well as the rarely and very rarely observed vaccination complications for which a causal relationship with the vaccination is deemed possible or is being investigated. “Rarely” means a reaction occurs in between one to ten cases per 10,000 vaccinated people. “Very rarely” means a specific reaction occurs in fewer than one person per 10,000 vaccinated people.

A vaccine injury exists if, as a result of vaccination pursuant to section 2 number 9 of the Protection against Infection Act (IfSG), a person has sustained damage to health that exceeds the extent of a normal vaccine reaction (cf. section 24 sentence 1 Social Code Book Fourteen – Social Compensation (SGB XIV). Whether in an individual case damage to health was caused by vaccination and an inherent claim to benefits therefore exists is determined by the competent Land authority.

The term “post-vac” does not constitute a medical definition of an illness. Based on the available evidence, the term is used to describe various prolonged complaints after COVID-19 vaccination, such as those associated with Long/Post COVID (e.g. chronic fatigue syndrome (Myalgic Encephalomyelitis /Chronic Fatigue Syndrome, ME/CFS), postural tachycardia syndrome (POTS), including the complaints known as postexertional malaise (PEM, malaise after exertion)). When assessing health complaints following COVID-19 vaccination, please note the information regarding the known side effects of COVID-19 vaccines that are listed in the product information (expert information and instructions for use) and are publicly available.

The Paul Ehrlich Institute (PEI) routinely collects and evaluates all suspected cases of side effects from COVID-19 vaccines. After evaluating the data available in Germany and abroad on reported suspected cases following COVID-19 vaccination, PEI has thus far been unable to confirm a causal relationship between persistent Long COVID-like symptoms and COVID-19 vaccination.

Additional information on the safety of COVID-19 vaccines is provided by the PEI on its website.

The first point of contact for health complaints after COVID-19 vaccination is the attending physician so that diagnostic and, if possible, appropriate therapeutic measures can be initiated. Depending on the symptoms, referral to a specialist may take place for further diagnosis and treatment.

According to section 6 (1) sentence 1 number 3 of the Protection against Infection Act (IfSG), the person responsible for carrying out the vaccination (in pharmacies, this is the manager of the pharmacy) are required to report suspected vaccination-related damage to health that exceeds the extent of a normal vaccine reaction to the competent public health office. In addition, reporting obligations under the codes of professional practice apply.

Moreover, some clinics have set up special outpatient clinics that specialise in the treatment of complaints following COVID 19 vaccination. The hospitals themselves decide whether or not to set up and run such specialised outpatient departments.

Decade-long experience has shown that most of the side effects of vaccines usually emerge within a few hours or days following a vaccine dose. In other words, these are in close temporal relation with the vaccination. In rare cases, side effects occur or are recognised only after weeks or a few months. The first COVID-19 vaccines available in Europe were already licensed late in 2020 or early in 2021. Since then, they have been administered millions or even billions of times. In the meantime, these vaccines and their side effects are well known – even side effects that occur very rarely. In individual cases, side effects may result in health impairments that can persist over a longer period of time.

The Federal Ministry of Health (BMG) will support patient-centered research into Long COVID within the context of a multi-year funding priority. The focus of this funding will be pilot projects in which innovative types of treatment for those affected by Long COVID are being developed and tested. This Long COVID funding priority will also benefit ME/CFS patients as well as those affected by lingering complaints consistent with Long COVID that emerged in a temporal relation with a COVID-19 vaccination.

In addition, further healthcare research projects on postviral syndromes such as Long COVID are supported via the Innovation Fund of the Federal Joint Committee (G-BA).

To ensure faster and more needs-appropriate care for patients suspected to have Long COVID, the Federal Joint Committee (G-BA) also drafted a new directive on 21 December 2023 defining requirements for patient care and specifying care pathways. The directive provides for one designated doctor. That person would be in charge of the specific coordination needed for diagnostics and therapy. For example, existing outpatient structures and offerings will be used and the correct health professions involved based on the patient’s needs as determined by the severity and complexity of the illness.

As a next step, the G-BA will submit its draft directive to the Federal Ministry of Health for legal assessment. If no objections are raised in this context, the directive can take effect. Subsequently, the Valuation Committee of doctors and health insurance funds examines if or to what extent the doctors' fee scale (EBM) needs to be adjusted. The Valuation Committee has a maximum of six months to do so.

COVID-19 vaccinations are subject to the general principles of the law of benefits on account of vaccine injuries and Social Compensation. Effective 1 January 2024, the law of benefits on account of vaccine injuries was transferred to Social Code Book XIV (SGB XIV). Pursuant to section 24 sentence 1 SGB XIV, damage to health exceeding the extent of a normal vaccine reaction must be present for a vaccine injury to exist. Vaccine injuries sustained in connection with immunisations given since 1 January 2024 especially on the basis of the COVID-19 Prevention Ordinance or, in the case of immunisations given to a person insured in the private health insurance as specified in the entitlement pursuant to the COVID-19 Prevention Ordinance, give rise to a claim to Social Compensation benefits (section 24 SGB XIV). A claim also exists if the immunisation was publicly recommended by the competent Land authority and implemented within its area.

It is for the relevant competent Land authorities to decide on applications for such benefits. For a vaccine injury to be recognised, an application has to be submitted to the competent authority. This is usually the pension office (Versorgungsamt). If the immunisation was carried out in Germany, this claim is made against the Federal Land in which the vaccine injury was caused.

Pursuant to section 141 sentence 1 SGB XIV, even persons injured before 1 January 2024 receive benefits under SGB XIV if the prerequisites set out in section 60 of the Protection against Infection Act (IfSG) in the version applicable until 31 December 2023 (old version) were met. Up until 31 December 2023, the IfSG stipulated that vaccine injuries sustained in connection with immunisations performed particularly on the basis of the Coronavirus Vaccination Ordinance since 27 December 2020 (the day of the first coronavirus vaccination in Germany) or, since 8 April 2023, on the basis of the COVID-19 Prevention Ordinance, give rise to a claim to benefits with the provisions of the Federal War Victims' Compensation Act (Bundesversorgungsgesetz - BVG) applying accordingly (section 60 (1) no. 1a IfSG old version). In the context of immunisations, this applied accordingly also to persons who have private health insurance cover. These benefit claims also existed if the immunisation was publicly recommended by a competent health authority and implemented within its area (section 60 (1) sentence 1 number 1 IfSG old version).

For COVID-19 vaccines approved by the European Commission (EU COM), the same liability rules apply as for all other medicinal products. People who have suffered harm as a result of vaccination are comprehensively protected in Germany on account of medicinal product-related absolute liability provisions and the benefit claim for vaccine injuries pursuant to the Protection against Infection Act (IfSG).

In order to promote the development of vaccines against COVID-19 and to reduce the financial risks assumed by the manufacturers, the agreements concluded by the EU Commission with the manufacturers provide for the Member States to shoulder financial obligations for the manufacturers in certain cases in the event of liability claims due to side effects. But no agreement exists with the vaccine manufacturers limiting the compensation claims of vaccinated people. The contracts for the purchase of vaccines against COVID-19 do not affect the provisions of the European Product Liability Directive or liability under the applicable Member State law.

In particular, the medicinal product-related absolute liability provision pursuant to section 84 of the Medicinal Products Act (AMG) has proven its relevance. To the benefit of the potentially injured party, in addition to a right to disclosure vis-à-vis the pharmaceutical company and the competent higher federal authority, the medicinal product-related absolute liability provision also provides for the presumption of a causal connection between the injury’s occurrence and the medicinal product. The civil court route is to be taken to assert these liability claims, since they constitute a private-law dispute between the vaccinated person and the vaccine manufacturer.

Administering a vaccine represents a medical treatment within the meaning of section 630a (1) of the German Civil Code (BGB). Doctor liability therefore only applies to vaccine injuries if, while administering the vaccine, a medical error occurred or the patient was not or only improperly informed.

For example, doctors are obliged to inform patients about all circumstances that are essential for consent prior to medical treatment. Here, the information concerning vaccination risks must be sufficient for the patient to possess the knowledge needed to provide valid consent. In principle, this is also possible using a factsheet. In any case, the patient must then have the opportunity to acquire additional information by way of a personal consultation with the doctor. If the factsheet downplays the risk in its explanations, then this impression must be corrected for the patient.

If this clarification was not or only improperly carried out, then the patient’s consent is rendered void. If a vaccine is still administered in spite of this, it constitutes a violation of medical duties for which doctors are liable for damages.

People who suspect they may have suffered a vaccine injury can submit their claim to the competent Land authority. Generally, these are the pension offices of the Federal Länder. But in some Federal Länder, these responsibilities may differ. That is why those affected will need to find out from their Federal Land where exactly to file their claim. Initially, the competent Land authority determines whether or not a vaccine injury is present. If the immunisation was carried out in Germany, this claim is made against the Federal Land in which the vaccine injury was caused.

This claim to benefits does not presume unlawfulness nor fault and is based primarily on the causal link between the vaccination and its effects. For the purposes of recognition of an injury that goes beyond the extent of a normal vaccine reaction, the burden of proof in demonstrating causation has been eased. For damage to health as a consequence of an injury to be recognised, the likelihood of a causal link suffices. When determining whether the conditions have been met in an individual case, medical science findings are to be applied. For the remaining claim conditions, full proof must be provided, meaning their existence must be proven with almost absolute certainty.

The so-called “Kann-Versorgung” (discretionary recognition of benefits) should be noted as a further easing of the burden of proof. In the event that uncertainty in medical science over the cause of the established condition is the only reason preventing this probability from being accepted, then the damage to health may nonetheless be recognised as the consequence of a vaccine injury subject to the approval of the highest Land authority responsible for the pension scheme for war victims. This approval may also be issued on a general basis. In case law, the condition is that according to at least one medical authority a causal link between a harmful event and a health impairment is not only possible but likely.

The Working Group of Senior Physicians of the Federal Länder and the Federal Armed Forces (AGLeitÄ) has compiled findings on potential vaccine injuries caused by COVID-19 vaccinations from the Federal Länder, bundled them and drawn up guidelines that serve as uniform national guidance for the assessment and evaluation of a causal connection between particular health disorders and a COVID-19 vaccination. These guidelines are developed further on an ongoing basis to keep abreast of current scientific findings.

No, a reversal of the burden of proof is not provided for in respect of the compensation claim. This means that, apart from the aforementioned easing of the burden of proof (question: “What do I have to consider if I want to assert a claim for compensation under the IfSG?”), full proof must be provided, i.e. the prerequisites of the compensation claim must be proven with a probability bordering on certainty. This applies, in particular, to the presence of a vaccine injury.

The public health office can offer assistance in initiating the investigations needed during the evidentiary process and offer support with initiating compensation claim proceedings.

The assessment of whether a health impairment in temporal relation to a vaccination was indeed caused by the vaccination initially falls under the jurisdiction of the competent Land authority in each Federal Land.

To challenge the assessment of the competent entity, administrative appeal proceedings filed with the competent authority must in principle precede the judicial clarification (sections 78, 83 et seqq. of the Social Courts Act (SGG)). Information regarding which authority an appeal must be filed with can be found in the instructions in the official letter from the competent Land authority (advice on legal remedies).

Should the appeal proceedings also prove unsuccessful, final clarification of whether the rejection of the application for benefits on account of a vaccine injury is lawful can be obtained in a social court.

Vaccine side effects can be reported directly by the person affected to the Paul Ehrlich Institute (PEI) as the competent higher federal authority for vaccines at www.nebenwirkungen.bund.de using an online form. You can report suspected cases on your own behalf or that of another person in your care, for instance on behalf of a child or family member. Reports of suspected side effects can be submitted by phone, by letter and of course electronically.

Additionally, pursuant to section 6 (1) sentence 1 number 3 of the Protection against Infection Act (IfSG), doctors, for instance, are required to report vaccination-related damage to health that exceeds the extent of a normal vaccine reaction. This report is sent to the public health office. The public health offices are required, pursuant to section 11 (4) of the IfSG, to transmit all reported suspected cases to the competent Land authority and the competent higher federal authority, the PEI.

The Paul Ehrlich Institute (PEI) records all suspected cases of vaccine side effects in Germany and transmits these to the European EudraVigilance database. The PEI regularly evaluates suspected cases of COVID-19 vaccine side effects and informs the public, e.g. in safety reports or the Pharmacovigilance Bulletin ( publications on medicines ). Moreover, in cooperation with the European Medicines Agency, the PEI implements further steps if required.

The safety of licensed COVID-19 vaccines is regularly reviewed and assessed by the pharmaceutical company itself as well as by the Paul Ehrlich Institute (PEI) and the committees responsible at the European Medicines Agency (EMA). If new findings indicate the occurrence of side effects, it is possible to respond very swiftly and, where required, take further measures.

As an independent body of experts, the Standing Committee on Vaccination (STIKO) develops evidence-based vaccination recommendations for Germany. In doing so, STIKO takes into account the benefit for the vaccinated individual and for the entire population. STIKO strictly follows the criteria of evidence-based medicine. While the efficacy, safety and pharmaceutical quality of a vaccine are relevant for its approval, STIKO then analyses the individual benefit-risk ratio, the epidemiology at the population level and the effects of a nationwide vaccination strategy for Germany so that vaccines can be optimally used. For this purpose, STIKO incorporates the assessments of PEI on the safety of vaccines.

PEI has the expertise to assess individually occurring adverse reactions after vaccinations. Following the approval of a vaccine, all reports of suspected side effects or vaccine complications are continuously recorded and evaluated. Information on side effects after vaccination with COVID-19 vaccines can be found in the safety reports of PEI and in the product information of the respective vaccines.

Reporting suspected cases of adverse drug reactions (ADRs) is a core component in the evaluation of medicinal product safety. It allows potential new warning signals to be detected swiftly and the benefit-risk profile of vaccines monitored continuously in the context of the marketing authorisation.

Since the rollout of COVID-19 vaccines, the Federal Government provides comprehensive information particularly on the efficacy, risks and side effects of the available vaccines.

This information is provided in addition to the European Commission’s and the European Medicines Agency’s publicly available product information for COVID-19 vaccines.

Information on the side effects and data on the frequency of occurrence are included in the current product information texts for the authorised vaccines. The PEI website provides current product information texts on the authorised COVID-19 vaccines . Furthermore, the pharmaceutical companies provide current expert information and instructions for use relating to the COVID-19 vaccines.

Information on the efficacy and safety of the recommended COVID-19 vaccines can also be found in the scientific justifications concerning the Standing Committee on Vaccination’s COVID-19 vaccination recommendation. These are freely available from the RKI website (German) .

Furthermore, clarifications concerning the efficacy and safety can be found in the information and declarations of consent for the COVID-19 vaccine. These documents are available from the RKI’s website.

Further information

Coronavirus vaccination.

Find all the information you need about coronavirus vaccination at the German-language site infektionsschutz.de of the Federal Centre for Health Education (BZgA).

COVID-19 vaccination from a medical perspective

RKI provides a German-language FAQ concerning, for instance, vaccination recommendations, vaccine efficacy and safety as well as vaccination implementation plus further information in English.

Marketing authorisation and testing of vaccines

PEI provides answers to questions on the development and marketing authorisation of vaccines.

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Tracing the Long, Winding Path of an Ancient Roman Aqueduct

The Aqua Marcia was the longest of the city’s aqueducts, running nearly 60 miles from its source in the countryside to the heart of ancient Rome. The author followed its course, above and below ground.

In the Park of the Aqueducts, 20 minutes by metro from central Rome, ancient aqueducts that once supplied the Eternal City with water have been preserved. Credit... Roberto Salomone for The New York Times

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By David Laskin

David Laskin, a frequent visitor to Rome for the past four decades, has written numerous articles on the history, culture, art and architecture of the Eternal City.

• April 24, 2024

The stone arches looped solemnly over their shadows, some teetering above the grass, some sinking into it. It was a dazzling January morning, and I was standing in the Park of the Aqueducts , about 20 minutes by metro from central Rome. Here, the ruined arcades of six of the 11 aqueducts that once supplied the Eternal City with an astonishing volume of water — by some counts double the per capita water allotment of a typical 21st-century American city — have been preserved.

My aim was to trace the course of one of them: the Aqua Marcia, built between 144 and 140 B.C. by Julius Caesar’s ancestor Quintus Marcius Rex.

Hailed by Pliny the Elder as “the most famous of all waters in the world for coldness and wholesomeness,” the Marcia was also the longest of the capital’s ancient aqueducts, running some 56.8 miles from source to city. Only about 6.2 miles stood above ground.

I had always assumed that Rome’s aqueducts were a kind of aerial plumbing, their water channeled atop arches. But the Marcia, like all classical aqueducts, ran largely underground. The water moved by the force of gravity, and arches and bridges, which were expensive and vulnerable to attack, were only used to span ravines, valleys and other dips in the terrain that would have interrupted the flow.

The arcade of the Marcia is now dry, but the same water still feeds mountain springs east of the capital. And though it now travels through a modern network of tunnels and tubes, the water is still referred to by its ancient name and is still considered Rome’s best drinking water.

One of the series of arches that rose before me once carried this current to Rome. But which one?

In the Park of the Aqueducts

The roughly 600-acre Park of the Aqueducts has few signs, maps or directions. Romans come here to jog and walk their dogs. The few tourists wander through a bucolic landscape — green, tranquil, its imposing ruins seemingly untouched by modernity — that has appeared in such iconic Italian films as “La Dolce Vita” and “La Grande Bellezza.”

Michele Alfonsi, a lawyer who heads up Pons Iani , a volunteer group devoted to aqueducts, offered to guide me. “See that?” he asked, pointing to a stone passageway atop massive arches. “That’s the specus of the Aqua Marcia.”

Specus is the Latin term for a roofed channel built at a slight downward slope so that water would run through it without gushing or puddling. This one was nearly high enough to stand up inside.

We clambered up the keystone of the arch, now just a few feet above ground level. When it was completed during the heyday of the Republic, the Marcia was the first aqueduct to bring water to the Capitoline, Rome’s most sacred hill. A small fountain there has been chiseled with the words “Acqua Marcia,” but like modern Rome’s taps, it now spouts a mixture of water from five different founts.

To sample pure Marcia water, I’d need to travel to the source.

‘Where’s the water?’

Sextus Julius Frontinus, the first-century commissioner of the aqueducts, wrote that the fount of the Marcia is near the 36th milestone of the ancient Roman road Via Valeria (roughly 35 miles east of Rome). But I had been warned that the original trenches had been obliterated in 1870 when the Marcia’s long-defunct classical aqueduct was reincarnated as the Acqua Pia Antica Marcia.

“You’ll get close,” said Peter J. Aicher, author of “Guide to the Aqueducts of Ancient Rome,” “by searching for Centro Casetta Rossa Idrico on Google Maps.”

I found the “casetta,” a small red stucco house used by the modern aqueduct’s maintenance personnel, at the edge of a green field. Aside from the inscription “Acqua Pia Antica Marcia 1870” carved over the front door, and the shed-like structures built above springs alongside the road, there was no indication that Rome’s best drinking water originated here.

I took in the rounded hills, hazy blue in the distance, and the Italian cypresses striping their shadows across a little-traveled, two-lane highway. “Where’s the water?” I asked a maintenance man. He pointed down: The underground springs that Quintus Marcius Rex first channeled over 2,000 years ago still bubble beneath this bucolic spot. The only way to plumb Marcia’s depths was to go spelunking.

Which is how, a few days later, I found myself clinging to an exposed tree root on the side of a ravine dropping to the Aniene River east of Rome. “Put your right foot there,” Alfonso Diaz Boj coaxed. “Two more steps and we’ll be at the Marcia’s specus.”

Mr. Diaz Boj, a guide with Sotterranei di Roma , which offers tours of Rome’s underground treasures, was leading a jaunt into the ancient, now-dry aqueduct channels buried near the town of Vicovaro, about eight miles west of the Marcia’s source. Twelve of us met at the Convent of San Cosimato, whose property contains the ruins, to suit up in hard hats and headlamps.

Once we had negotiated the hand- and toeholds and were hunched into the shoulder-high specus, Mr. Diaz Boj pointed to a lozenge of light slanting down from a shaft: “Teams of workers excavated these shafts every 15 meters. When they reached the proper depth, two teams dug toward each other laterally until they joined up.”

We passed bats clinging to the walls, and quills attested to the presence of porcupines. Over the centuries, the Marcia’s water had deposited multicolored bubbles and stripes of calcium on the concrete that Romans used to seal the specus. Mr. Diaz Boj pointed to graffiti scratched into the concrete — mysterious crosses, doodles and the possibly faked signature of Thomas Ashby, the British archaeologist and author of the 1935 “Aqueducts of Ancient Rome.”

After a lunch of lasagna, saltimbocca alla Romana and roast potatoes at the convent, I had a drink from a spigot in the garden. Only later did I learn that Vicovaro is inside the zone that receives the Marcia’s water unadulterated. It was delicious and refreshing, though I can’t say I detected much difference from the mixed water of central Rome.

The Marcia surfaces on arches and bridges several times between Vicovaro and the Park of the Aqueducts, most spectacularly at Ponte Lupo, about 10 miles south of Tivoli. This colossal bridge spanning a deep gorge has been in the hands of the Barberini family since 1633, when Pope Urban VIII acquired the surrounding estate. Guided tours (reserve by email, [email protected] ) are offered occasionally and during the festivals held here in the summer. Fortunately for me, a friend in Rome had arranged a private visit.

Ponte Lupo’s present owner, the actor and activist Prince Urbano Barberini, was waiting for us at the unpaved access road. A trim, handsome man in his early 60s, the prince recounted the site’s recent vicissitudes as he led us down a sloping meadow. When he regained title to the property after a long legal battle, the field and stream around the bridge had been buried in rubbish and frequented by sex workers.

I had seen images of Ponte Lupo, but nothing prepared me for its size and complexity. The original tuff arches carried the Marcia across a steep ravine. Subsequent retaining walls and buttresses have transformed the bridge into a palimpsest of building styles.

“It’s a difficult scramble,” the prince said, gazing up to the precipitous, densely vegetated summit above a dry creek. “Would you like to try?”

I eyed the rugged, tangled sides of the ravine. “Maybe not.”

“Good,” the prince replied, smiling. And we strolled back to the highway.

‘Engineering on a monumental scale’

The Marcia entered Rome on arches at Porta Maggiore , chosen as the entry point for eight ancient aqueducts because of its high elevation on Esquiline Hill. At first glance this busy crossroads near the Termini rail station struck me as rough and forlorn, but I gave it a closer look. Aqueduct arches converge or radiate from every direction. The Marcia’s specus is slotted above a chunky pier built of a volcanic stone called tuff that abuts the gate.

If you tune out the traffic, there is no better place to savor what one historian calls the Roman “knack for practical engineering on a monumental scale.”

It takes about half an hour on foot to trace the Marcia’s path through ancient Rome. From Porta Maggiore, the aqueduct tracked the Aurelian Wall as far as the elegant Augustan arch called Porta Tiburtina. From there, it veered off to follow today’s Via Marsala before emptying into a distribution basin now buried beneath the train station.

The Fountain of the Naiads

After the Marcia was reborn as the Marcia Pia in 1870, the Fountain of the Naiads was conjured up to showcase its purity in the Piazza della Repubblica, a 10-minute walk from Termini station.

Some of Baroque Rome’s most cherished monuments are display fountains, or mostre, celebrating the newly restored aqueducts that once again brought spring water to Rome. The Trevi Fountain is the mostra of the Acqua Vergine, the only aqueduct that has run continuously since antiquity.

But the Fountain of the Naiads is different. Unlike the gravity-fed aqueducts of pre-modern times, the Marcia flowed under pressure created by mechanical pumps, which allowed the fountain’s jets to shoot nearly seven feet high.

Katherine Rinne, the author of the forthcoming “Walking Rome’s Waters,” calls this “the Hugh Hefner fountain” because of its cavorting naked nymphs. It rises in the middle of a busy major intersection. “If you are brave enough to face six lanes of horrendous traffic,” Ms. Rinne said, “you can dangle your feet in it on a hot day.”

Just don’t drink it. Today, the naiads frolic in water that is periodically drained for cleaning and maintenance.

If you are inspired to sip from the source, do as the Romans do and cup a hand under one of the nasoni (big noses) that spout from goose-necked spigots all over town. Two thousand years after Pliny lauded the Marcia as a gift from the gods, Rome’s aqueducts are still lavishing cold, clear spring water on the Eternal City.

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