Vaccinations

Question

Good day,
My daughter’s new primary care physician (my daughter turns 18 in July) has recommended several vaccinations in light of her cystic fibrosis.

Specifically, vaccinations against shingles, as well as meningitis types A, C, W, and Y.

She is currently in a stable condition while on Alyftrek®. Additionally, she has type 3C diabetes and occasionally deals with kidney stones.
In the past, she had ABPA and was colonized with Pseudomonas; however, neither of these is currently an issue.
Would you recommend the aforementioned vaccinations?
Thank you for your professional assessment.

Kind regards,

Answer

Dear inquirer,
The new recommendation from the STIKO (Standing Committee on Vaccination - GERMANY) regarding vaccination against shingles covers:

"Persons aged ≥ 18 years at increased health risk due to a congenital or acquired—particularly iatrogenic—immunodeficiency, or
due to the severe manifestation of a chronic underlying condition; e.g., persons with, or following:
▶ Hematopoietic stem cell transplantation (HSCT)
▶ Cell-based therapies
▶ Solid organ transplantation
▶ Immunosuppressive medication (e.g., rituximab, JAK inhibitors, anifrolumab [Type I interferon receptor blocker], cytostatic chemotherapy)
▶ Malignant neoplastic diseases
▶ HIV infection
▶ Rheumatoid arthritis
▶ Systemic lupus erythematosus
▶ Chronic inflammatory bowel diseases
▶ Chronic obstructive pulmonary disease (COPD) or bronchial asthma
▶ Chronic renal insufficiency
▶ Diabetes mellitus"

As you can see, CF is not explicitly mentioned, although asthma is; therefore, regarding a chronic lung disease such as CF, one could argue either way (especially if lung function remains stable while on modulator therapy). However, in the event of co-occurring diabetes, vaccination would be recommended for your daughter once she reaches the age of 18.

Regarding vaccination against Meningitis A, C, W, and Y, the STIKO (Standing Committee on Vaccination for GERMANY) has issued a new recommendation applicable to all children and adolescents—regardless of any underlying health conditions:

"The STIKO now newly recommends MenACWY vaccination as a standard immunization for all older children and adolescents aged 12 to 14—irrespective of their prior vaccination status—using a quadrivalent conjugate vaccine. A single dose of an age-appropriately licensed vaccine (Nimenrix®, MenQuadfi®, or Menveo®) should be administered in accordance with the prescribing information.
Catch-up MenACWY vaccinations should be completed by the age of 25."

Consequently, your daughter, being 18 years old, falls into this category.
Data have demonstrated that this new vaccination strategy is highly effective in preventing invasive meningococcal infections, not only within this specific age group but also among the older population. Therefore, it is recommended that your daughter receives this vaccination. Although these infections are generally rare, they are associated with a high fatality rate and the potential for long-term sequelae.
I hope this information has been helpful.
Sincerely,
Daniela d'Alquen

17.05.2026