Politics and science warn: The next Corona worry autumn is looming. Only a significant increase in the number of vaccinated people could provide a remedy. In fact, when it comes to the vaccination quota, every percentage point counts.
[Berlin -] The corona numbers in Germany have practically only known the way up for weeks – but the pace of vaccination is slowing down. So far, less than 65 percent of the total population is fully vaccinated.
Federal Health Minister Jens Spahn (CDU) appeals: There must be more. Lothar Wieler, head of the Robert Koch Institute (RKI), warns of a “brilliant course” of the current fourth wave in autumn if the vaccination rate does not increase significantly. Expert estimates show that with every percentage point by which the vaccination rate increases, the situation can relax.
With a nationwide week of action starting on Monday, the federal government wants to boost vaccinations. Together with the federal states, it calls for offers that are easy to perceive in as many places as possible.
Full intensive care units in the next few months
Most recently, the vaccination rate increased only slowly – in August only by around 10 percentage points. According to the latest RKI weekly report, 83 percent of the population over 60 years of age had full vaccination protection. For adults under 60, however, the rate is only 66 percent. For children and adolescents between the ages of 12 and 17, it is currently around a quarter. Corona vaccines are not yet approved for younger minors.
The Cologne intensive care doctor Christian Karagiannidis fears full intensive care units in the next few months without increasing vaccination rates. “For intensive care medicine, the following applies: If we do not significantly increase the vaccination rate again, then we will run into a very difficult autumn,” says the scientific director of the intensive care register of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (Divi) of the German Press Agency .
It is already evident that the vaccination rate is still too low, especially for people up to 60. “We have the problem that the average age in the intensive care units is falling very significantly and many patients are under 60 years old,” says Karagiannidis.
From an incidence of around 200 significant exposure to intensive care units
The RKI estimates what effects an increase in the vaccination rate in the group of 12- to 59-year-olds could have on the occupancy of intensive care beds in the coming months. With a vaccination rate of 65 percent, a very strong increase in the 7-day incidence to up to 400 and up to about 6,000 Covid-19 patients in intensive care treatment at the same time would be expected. For a vaccination rate of 75 percent, the RKI model shows far lower incidences below 150 and only 2000 occupied intensive care beds.
With both an 85 percent and a 95 percent vaccination quota in this group, the incidence no longer rises above 100 or 50 and the intensive occupancy no longer exceeds 1000 beds. According to the RKI, many factors, such as the dominance of the highly infectious Delta variant and the response of people to increasing numbers of infections, are decisive in the estimates of the influence of the vaccination rate.
According to a modeling by Karagiannidis together with Andreas Schuppert from RWTH Aachen University and Steffen Weber-Carstens from Charité Berlin, from an incidence of around 200 it can be assumed that the intensive care units will be exposed to more than 3000 intensive care patients at the same time.
At least five million more vaccinations needed
With significantly increased vaccination rates – for 18 to 59 year olds to around 80 and for over 60 year olds to 90 percent – this burden would only arise at an incidence of around 400, as Karagiannidis calculates. You would then have a little more “time and play”, but he expressly warned against letting the incidences soar in an uncontrolled manner. “The bottom line is that the incidence must not rise steadily. And that’s a huge problem that I see, ”he emphasizes.
Various factors such as the distribution of new infections in the various age groups should be taken into account in all forecasts, estimates and calculations – and they make them so difficult, Karagiannidis points out. Because the mortality rate in younger intensive care patients is often not that high, it could also be that, once they are there, they stay longer in the intensive care units. In addition, there is a lack of broad data on recovered people who did not notice the infection but went through it and are now immune. This unreported figure is unclear, but it plays a prominent role.
Health Minister Spahn said on Wednesday that the targeted vaccination rate for a safe autumn and winter was over 90 percent for over 60-year-olds and 75 percent for 12 to 59-year-olds. At least five million vaccinations are necessary for this.
Increasing the vaccination rate is important
But would a total vaccination quota of over 70 percent – instead of the current only a few percentage points over 60 – change anything? Modeling co-author Schuppert is convinced: “Ten percent do indeed make a difference.” With older people, higher vaccination rates can significantly reduce the risk of high intensive care units.
For adolescents, the effect on the intensive care units is probably rather minor – after all, they rarely have a correspondingly severe course. An increasing vaccination rate for them is clearly reflected in the speed at which the virus spreads, explains the expert.
Increasing the vaccination rate is important for adults of all age groups, emphasizes Schuppert – especially for those aged 35 and over, because the delta variant also pushes the risk of the disease to younger age groups. The fact that it is now often younger people who are in intensive care units, where the vaccination rate is lower than for those over 60, is clear evidence that the vaccinations are having a great effect.
Goal: Vaccinate everyone as possible – both for self-protection and for protection of others
Even supposedly small increases in the quota could in fact cause large differences, Karagiannidis also emphasizes. Using the example of the population between 18 and 60 years of age, he explains: If 10 or 20 percent more people in this group were to be vaccinated, that would be about four or eight million more people who would be protected by the vaccination – “in the end a lot, much fewer intensive care patients ”.
The Braunschweig epidemiologist Berit Lange from the Helmholtz Center for Infection Research explains that it is not only the question of what level the vaccination rate could realistically reach. In practice, it is important who specifically can still be vaccinated and how these people can be reached.
Lange assumes that the as yet unvaccinated third of the population will have to spend far greater resources than before. “People are not all anti-vaccinations, but many are simply not yet fully convinced, have questions and are unsure.” It is important to know exactly in which districts or population groups the vaccination rate is still (too) low – and how these people could be persuaded.
According to the expert, if one could theoretically manage to vaccinate those of the people who have not yet been vaccinated who would have the most contacts due to their occupation or household situation, as well as those with an increased risk of a severe course, one would be able to prevent even more infections. The next few weeks will be about getting these people to vaccinate.
“But it is very difficult to design a vaccination campaign in such a way that these people in particular can actually be reached,” says Lange. And in principle, of course, the goal is to vaccinate everyone as possible – both for self-protection and for protection of others. [dpa]
