Especially since the coronavirus pandemic weakens the immune system and increases the impact of respiratory illnesses like the flu and common cold, demand for the influenza vaccine is higher today than in previous years. Although demand typically rises after the warm months, this year the pandemic has made the flu shot particularly important. People covered by the Social Security Institution (SGK) are wondering whether SGK will cover the cost of the flu vaccine.
Demand for the Flu Vaccine Has Increased
The coronavirus pandemic has led to a significant rise in the number of people seeking the flu vaccine. While the flu shot does not treat COVID-19, contracting influenza can increase the likelihood of becoming infected with coronavirus, so many people do not want to risk catching the seasonal flu as temperatures fall. Based on expert recommendations and personal preference, the flu vaccine has seen much higher demand this year.
Experts have stated that “the flu vaccine can be used during the COVID-19 pandemic. If influenza and COVID-19 occur at the same time, the flu shot can help reduce the severity of influenza and lower mortality risk, thereby reducing the combined mortality risk of the two diseases. For this reason, the flu vaccine should be recommended for people who have frequent contact with others.” Such statements have increased interest in vaccination, while another key concern is whether employees covered by social security must pay for the flu shot themselves.
Does SGK Cover the Flu Vaccine?
SGK has made regulatory arrangements concerning the flu vaccine. According to these rules, the vaccine cost is covered once per year by SGK for: people aged 65 and over; residents of nursing homes or care facilities; pregnant women from the 13th week of pregnancy until delivery; individuals with chronic pulmonary or cardiovascular disease, including asthma; people with chronic metabolic diseases, including diabetes; those with immunodeficiency or receiving immunosuppressive therapy; individuals with chronic renal dysfunction or hemoglobinopathy; and children aged 6 months to 18 years who have been on long-term acetylsalicylic acid therapy—provided these conditions are documented with a medical report.
For persons who do not fall into these categories, SGK does not cover the flu vaccine. If the relevant treatment or health condition is not present in an insured employee or a retiree, the vaccination remains outside the insurance scheme. There is an important detail regarding coverage: the “once per year” rule should not be interpreted as requiring a full 12 months to pass after vaccination. A vaccine eligible for SGK coverage can be given within the defined flu season even if a full year has not elapsed since the previous dose. Since the flu vaccine season is considered to be September through January, someone who received a vaccine in December of the previous year can receive another covered shot in September of the next season.
Pay Attention to SGK’s Time Limit for Covered Flu Vaccination
SGK covers the cost of the flu vaccine for the specified mandatory groups. For these at-risk groups, receiving the vaccine at least once a year is seen as beneficial. Medically, there is no strict requirement for a specific time of year to get vaccinated. Experts generally recommend an annual flu shot, and because influenza can also circulate in spring months, vaccination may be advised then as well. However, SGK does not cover flu vaccines administered in the spring for any group.