Vacancies and interstitials in semiconductors play a fundamental role in both high temperature diffusion and low temperature radiation and implantation damage. In Ge, a serious contender material for high-speed electronics applications, vacancies have historically been believed to dominate most diffusion related phenomena such as self-diffusivity or impurity migration. This is to be contrasted with silicon, where self-interstitials also play decisive roles, despite the similarities in the chemical nature of both materials. We report on density functional calculations of the formation and properties of vacancy-donor complexes in germanium. We predict that most vacancy-donor aggregates are deep acceptors, and together with their high solubilities, we conclude that they strongly contribute for inhibiting donor activation levels in germanium.