One, two, or three doses? Following a sudden rule change, the millions of people in Germany who received the single-dose Johnson & Johnson vaccine against coronavirus have been left confused about their vaccination status. 

One Johnson & Johnson jab no longer counts as fully-vaccinated

It was one of the biggest advantages of having the Johnson & Johnson (sometimes called Janssen) coronavirus vaccine: people were considered fully-vaccinated after a single dose. But a sudden change to the definition of “fully vaccinated” (and therefore also “boosted”) in Germany has left many of the 5,3 million people who have received the jab so far in the lurch. 

The German Ministry of Health and the Paul Ehrlich Institute have recently updated advice to state that a single dose of J&J will no longer count as a full vaccination. According to the new guidelines, a second shot of either J&J or an mRNA vaccine is required to complete somebody’s “basic immunisation." A third vaccination is then required to be considered “boosted."

“The frequency of distribution of vaccination breakthroughs observed in Germany according to the interval between vaccination and disease indicates a deficient primary vaccination protection by a single Janssen vaccination,” a Health Ministry spokesperson explained to The Local. “Therefore, after completion of the basic immunisation as recommended by STIKO [one J&J shot followed by a second shot]... a further booster vaccination can subsequently be administered with a minimum interval of a further three months.” 

Rule change has implications for 3G, 2G and 2G+ rules

This means that many people who previously considered themselves fully vaccinated - or boosted if they had received a top-up shot - could soon find themselves on the wrong side of Germany’s 3G, 2G and 2G+ rules. People who have only had one J&J shot will be excluded from certain public spaces, while even those who have had the top-up will need a negative test to go out for a meal or a drink with friends. 

It also has implications for people working on-site and those using public transport, areas where 3G rules are still in effect. Deutsche Bahn confirmed this week that they would follow the Paul Ehrlich Institute’s advice on the definition of “fully-vaccinated," and so people who have only had one shot of J&J will need a negative test result to get on trains. 

Confusion and outrage over Health Ministry’s handling of change

The sudden rule change has provoked outrage on many sides, with the Health Ministry especially criticised for its handling of the rule change. Many believe that those affected were not adequately informed. Describing the situation as a “scandal," Welt commentator Benjamin Stibi lambasted the fact that “hundreds of thousands of people were downgraded overnight to unvaccinated without their knowledge.” 

Adding to the confusion is the fact that Germany’s federal states are implementing the new definitions differently. In Hamburg, Hesse, Rhineland-Palatinate and Thuringia, people with one J&J jab plus a second vaccine are considered boosted, but in other states like North Rhine-Westphalia, Schleswig-Holstein and Bavaria, two extra shots are required. 

The government has been called on to provide urgent guidance on how the rules can be straightened out, effectively communicated, and how they impact other sectors like international travel.