German ratings are quite difficult to get your head around if you're not used to them. I came across this post not 40 minutes ago and I've spent the rest of that time trying to work out exactly what is going on. Thanks, Google Translate. The point of the post is that Dead Island, previously banned from sale or import into Germany, is no longer considered "that bad."
It's still indexed, meaning you'll be unable to buy it at your local supermarket or down the high street, but you'll be able to buy it online or import it from other EU countries. You still won't be able to get the DLC (sticking it on the PlayStation Store constitutes advertising, I think, although even there I might be wrong), but the important thing is that if you want it, you can probably get it quickly and easily.
Nobody was surprised when Dead Island was banned from sale in Germany last year, although this slight change in rating spells good things for the future.