Health, Vaccinations, Preventive Care — Architecture Over View

What This Is Not About — And What It Is

We are not doctors. A specific vaccination recommendation ("you should get vaccinated against X") is in every EU member state a matter of medical practice: only doctors can give it, based on your personal medical history. What we show here is the architecture — which official bodies issue recommendations, which diseases are relevant in which part of Europe, which healthcare structures exist, and which emergency numbers you dial where.

If you have questions about your personal health, go to the general practitioner in your country of residence or, in the transitional period after arrival, to a travel medicine center in your country of origin. On the country detail pages, you will find references to national advisory bodies.

Who Issues Official Recommendations in the EU

Vaccination recommendations and preventive care guidelines are issued nationally in the EU. Each member state has its own commission or authority:

• Germany: Permanent Vaccination Commission (STIKO) at the Robert Koch Institute. The STIKO vaccination calendar is the reference for all recommended vaccinations, updated annually.
• France: Haut Conseil de la Santé Publique (HCSP) and Haute Autorité de Santé (HAS) develop the Calendrier vaccinal. Santé publique France publishes the final version.
• Spain: Comisión de Salud Pública with the national Calendario común de vacunación. Regional adjustments by the Comunidades Autónomas.
• Italy: Istituto Superiore di Sanità (ISS) with the Piano Nazionale Prevenzione Vaccinale.
• Netherlands: Rijksvaccinatieprogramma (RVP) under the Rijksinstituut voor Volksgezondheid en Milieu (RIVM).
• Scandinavia: national public health institutes (FHI Norway, FHM Sweden, THL Finland, SSI Denmark) with their own vaccination programs.
• Poland, Czech Republic, Hungary, Romania, Bulgaria: national public health institutes publish their own vaccination calendars.

At the European level, the European Centre for Disease Prevention and Control (ECDC) coordinates surveillance and Vaccine Scheduler, and the WHO Regional Office for Europe provides regional guidelines — but they only become binding through national adoption.

Practical note: These recommendations can vary significantly. Some countries are conservative about vaccinations (mandatory school vaccinations in Italy since 2017 with ten vaccinations, France since 2018 with eleven), others only recommend them, and some are relatively cautious (DE for some vaccinations).

Standard Vaccinations — What You Should Consider as an Adult

What is practically recommended as an adult standard in almost all EU states:

• Tetanus, Diphtheria, Pertussis (lockjaw, diphtheria, whooping cough) — booster every 10 years. Recommended during pregnancy
• Polio — as a booster in some travel situations
• Measles, Mumps, Rubella (MMR) — those born after 1970 who have not been vaccinated twice should catch up. Recommended by the WHO throughout the EU
• Hepatitis B — recommended for those medically or professionally exposed; standard introduced in childhood in most EU states
• HPV (Human Papillomavirus) — recommended for young women and, since the expansion, also young men in most countries, typically up to age 18, booster in some countries up to 26 years
• Pneumococcus, Meningococcus — recommended in specific life situations (student dormitories, military service); the national vaccination program determines this
• Influenza (seasonal flu) — annually, recommended for risk groups, special preventive care in many countries in the fall

The order by EU country can vary significantly. Those coming from a country of origin where vaccinations are organized differently should bring their vaccination record (or a doctor's confirmation) — doctors in the destination country check vaccination protection and supplement what is missing.

Two important tips:

• Clarify the payer: Mandatory insurance usually covers standard vaccinations, but not everywhere completely. In DE, the GKV covers STIKO-recommended vaccinations; in some member states, you may need to ask or pay a co-payment.
• Travel medicine stopover: Those coming from a tropical country of origin benefit from a consultation at a tropical institute or travel medicine center before entry. Charité Berlin, BNI Hamburg, Institut Pasteur Paris, ISGlobal Barcelona, and similar institutions offer consultations.

Diseases Whose Occurrence in Europe Varies Regionally

The ECDC surveillance documents which pathogens regularly occur where. As of 2024:

Vector-Borne Diseases (Mosquitoes, Ticks)

• West Nile Virus: registered annually in Italy, Greece, Spain, southern France, southern Hungary, Romania, Bulgaria; occasionally also in Germany (Saxony, Bavaria). Primary transmission in summer months
• Dengue / Chikungunya: Asian tiger mosquito is spreading northward, local transmissions in Italy, France, Spain, occasionally — ECDC publishes weekly reports
• FSME (Tick-Borne Encephalitis): endemic areas in southern and eastern Germany, Austria, Czech Republic, Slovenia, the Baltics, southern Scandinavia. Vaccination recommended for regular stays in forests
• Lyme Disease (Borreliosis): widespread in forested regions across the EU, high prevalence in some areas of Central Europe; no vaccination available, prevention through tick control

Respiratory and Contact Diseases

• Tuberculosis: low overall prevalence in the EU but regionally different. Higher values in Romania, Bulgaria, Latvia, Lithuania. If symptoms (chronic cough >3 weeks, weight loss, night sweats) occur, seek medical advice
• Influenza: seasonal every winter; vaccination annually
• COVID-19: still active but at endemic levels in the EU; booster vaccinations recommended for risk groups

Sexually Transmitted Infections (STI)

• HIV: highest prevalence in urban areas; testing and counseling services available through AIDS helplines free and anonymous in most EU major cities. Pre-exposure prophylaxis (PrEP) is available and often covered by health insurance in many EU states
• Syphilis, Gonorrhea, Chlamydia: increasing in the EU since 2010, especially in major cities. Testing and treatment available through general practitioners or specialized clinics (ZSP/STI centers in DE, CeGIDD in FR)
• Hepatitis A/B: preventable through vaccination; Hepatitis C is today very well treatable with medication

Antibiotic Resistance

EU-wide surveillance by ECDC shows regionally different resistance rates. Southern and Eastern Europe have higher values for resistant E. coli, Klebsiella, and MRSA than Scandinavia and the Netherlands. This is relevant for hospital stays or surgeries — but it is the doctors on site who decide.

Reproductive Health — What Is Available Where

Reproductive healthcare varies more in the EU than the maps of mandatory insurance suggest. Selection of the most important areas:

Contraception

• Pill is prescription-only in most EU states (DE, FR, ES, IT, NL, AT, SE …); exception: Portugal and Belgium with partially over-the-counter hormonal contraception
• Emergency contraception ("morning-after pill") has been available over-the-counter in pharmacies across the EU since 2015 (Directive 2015/1539)
• Condoms are freely available everywhere; copper IUD, Implanon, hormonal IUD are available everywhere, provided by general practitioners or gynecologists
• Payer: Mandatory insurance covers contraception in some countries (FR yes, ES yes for young women, DE up to age 22), in others not (DE over 22 self-payment). Consumer reports show these differences
• In case of conflicts with religiously motivated counseling: In some countries, there are denominational hospitals (DE, ES, IT) with restricted practices regarding contraception. For comprehensive care, consider counseling centers such as Pro Familia (DE), Planning Familial (FR), Federación de Planificación Familiar Estatal (ES)

Abortion

We have covered this in the Gender-Equality-Article. Important here only as a reference: the legal situation varies significantly (Poland, Malta restrictive; France, Spain, Netherlands progressive).

Prenatal Care and Obstetrics

• Mandatory insurance covers prenatal care and childbirth in all EU states
• Midwifery care varies: NL has traditionally strong midwife-centered care, DE/FR/IT rather doctor-led
• Home births are permitted in all EU states but insured differently

HIV Testing, STI Counseling

• In most EU capitals, there are AIDS helplines or public health offices with anonymous, free testing and counseling
• Pharmacy tests are available in some countries (DE, FR)
• Medical test is covered by mandatory insurance; counseling may not be

Mental Health — Important Enough for Its Own Article

Migration is a well-documented stressor, especially in the first 1–3 years. SAD in the north, return pressure (see our article on return pressure), identity questions (identity after 5 years) — we have already touched on individual aspects.

A complete treatment of mental health care will follow in a separate article. For now, only the most important contact points:

• General practitioner is in all EU member states the first point of contact for mental health issues — referral to psychotherapists or psychiatrists usually goes through them
• Migration-specific counseling in many EU major cities: Refugio (DE), Comede and Primo Levi (FR), CEAR (ES) offer culturally sensitive and multilingual services
• Crisis hotlines: Telephone counseling (DE 0800-111-0-111), SOS Amitié (FR), Telefono Amico (IT), often 24/7
• Emergency: Police 112 or local medical emergency service

Emergency Numbers — What You Should Memorize

112 is the emergency number for police, ambulance, and fire department across the EU. Works from any phone, even without a SIM card and credit.

Also relevant:

• Women's emergency number in most EU member states under 116 016 (in DE Helpline for Domestic Violence, in ES 016, in FR 3919, in IT 1522)
• Children's emergency number under 116 111 in most EU member states
• Missing Children Emergency Number: 116 000 in most EU member states
• Medical on-call service: in DE 116 117, in other countries varies (check the phone book of your place of residence)
• Poison control: national numbers, in DE Berlin Poison Control 030-19240 (24/7); other countries have their own structures

Practical Checklist

For the first weeks at your new place of residence:

• Bring vaccination record and possibly medical history, present to general practitioner
• Secure health insurance card (see health insurance)
• Register general practitioner (in some countries mandatory, in others recommended) — in FR, IT, NL registration with the general practitioner is formally necessary, in DE it is not
• Save emergency number 112
• Know local AIDS help or STI center if testing and counseling needs arise
• For chronic illnesses: Clarify prescription transfer before entry; some active ingredients are approved differently in the EU or available under different brand names (use International Freinamen / INN, not brand names)

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Vamosa can explain the architecture of healthcare and preventive care in the EU and refer you to the right recommendation bodies. We do not provide specific medical advice — that belongs in the doctor's office. On the country detail pages, you will find information on national recommendation bodies, AIDS helplines, tropical institutes, and travel medicine centers by country.