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VACCINE

German doctors warn against lifting vaccine priority list

The head of the German Doctors' Association has criticised the decision to lift the vaccine priority list in several German states. Doing so will force people to compete for a "scarce commodity", she said.

German doctors warn against lifting vaccine priority list
People wait to get vaccinated in Greifswald on April 16th. Photo: picture alliance/dpa/dpa-Zentralbild | Stefan Sauer

The head of the Marburger Bund, Susanne Johna, made the comments on Monday in an interview with German radio service Deutschlandfunk

Lifting the priority list to allow everyone to book a vaccine – regardless of age, health or occupation – would not lead to there being a greater number of doses of the vaccine, said Johna. “Rather, it simply means that even more people are now competing for a scarce commodity.” 

Her words were targeted at several German states who have made the decision to dispense with the priority system and allow all adults to book a vaccine at their GP.

So far, Bavaria, Baden-Württemberg, Berlin and Brandenburg have taken this step, but this week a number of other federal states plan to join them.

Before that, most states were only allowing those the first three priority groups – meaning over-60s, those with a chronic illness, and certain key workers – to book a vaccine appointment. However two types of vaccine – Johnson & Johnson and AstraZeneca – have recently been made available to all adults, on the condition that they consult with a doctor beforehand. 

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When vaccine priority groups are done away with, people who jostle particularly hard to get an appointment are likely to get one before those who genuinely need the protection, said Johna, adding that many private doctors were already overwhelmed by demand.

“If I now give everyone the idea at the same time that it’s their turn, but at the same time the goods are so scarce that it is not even possible to meet the demand, it will lead to frustration,” she said.

Shortening gaps between vaccines “makes no medical sense”

One proposed solution for speeding up the rate of vaccination roll-out is to shorten the gap between the first and second doses of the vaccine. In most cases, the second vaccine shot for AstraZeneca is scheduled around nine to twelve weeks after the first one – but government officials have recently decided to shorten the gap between the first and second dose of AstraZeneca by up to four weeks. 

According to Johna, however, shortening this gap can drastically reduce the effectiveness of the vaccine

When the 12-week interval recommended by the Vaccination Commission is adhered to, the vaccine is around 80 percent effective. If this is shortened to four-to-eight weeks, the effectiveness dips to around 55 percent. 

READ ALSO: Germany gives green light to offer AstraZeneca vaccine to all adults

“With shorter vaccination intervals, a complete vaccination is certified earlier, but its protective effect is individually poorer and therefore also harbours a higher risk of infection and transmission for the population,” said Johna.

“In addition, the vaccines that are urgently needed in Germany and around the world are not being used optimally. It cannot be that vaccination certificates are more important than medically meaningful action.”

Susanne Johna, head of the Marburger Bund, said the lack of prioritisation would lead to “frustration”. Photo: picture alliance/dpa/Marburger Bund Bundesverband

Medical experts debate vaccine prioritisation

While the Marburger Bund have come out against lifting the priority lists for vaccines, the German Medical Association (BÄK) have welcomed the move as a means of speeding up the roll-out. 

In an interview with RedaktionsNetzwerk Deutschland last week, (BÄK) president Dr. Klaus Reinhart said it was a good idea to dispense with prioritisation because “it leads to bureaucracy and slows us down.” 

Equally, state leaders who have dispensed with prioritisation would likely point to the fact that unclaimed vaccine doses are currently going to waste.

In addition, even though all adults are able to book a vaccine, those who are in one of the priority groups could still be given preferential treatment, for example by being given an earlier appointment than a non-priority patient.

READ ALSO: ‘Mood is getting more aggressive’: Thousands of people in Germany caught skipping line for Covid vaccine

Some states are vaccinating faster than others 

Though German’s inoculation campaign has been accelerating in recent weeks, access to vaccines is still something of a postcode lottery.

As of Monday, 37 percent of the population had received at least one dose of the vaccine, while 11.2 percent were fully vaccinated. 

However, there are significant differences from state to state. In Saarland, for instance, around 41 percent of people have had their first jab, while in Brandenburg and Saxony, this number is only 32 percent.

Thuringia, meanwhile, is where the largest proportion of the population (15 percent) is fully vaccinated, while in Lower Saxony, this drops to only nine percent.

Speaking to the RedaktionsNetzwerk, Reinhart said he felt positive about the current speed of the vaccine rollout.

“We can trust that with the growing immunisation of the population, the third wave will finally ebb,” he explained.

If the vaccination continues at the current speed, Germany would likely achieve herd immunity by mid- or late-July, he added. 

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COVID-19 RULES

EXPLAINED: The Covid rules in place across German states

Many Covid restrictions have been dropped in Germany, but some rules remain in place. And as infections increase again, it's important to be aware of what you should do if you get Covid.

EXPLAINED: The Covid rules in place across German states

Germany has relaxed or changed many Covid restrictions in recent months. However, with Covid infections rocketing again, people are reminding themselves of what rules remain in place, and what they have to do if they get a positive test.

Here’s a quick roundup of what you should know. 

Face masks

Covid masks have to be worn when travelling on public transport, including planes departing to and from Germany. 

They also have to be worn in places where there are more vulnerable people, such as care homes, hospitals and doctor offices. 

Masks are not mandatory anymore in shops (including supermarkets) and restaurants, but individual businesses can enforce the rule so watch out for signs on the door. 

READ ALSO: Germany’s current Covid mask rules

FFP2 masks have become the standard in Germany, but in some cases other medical masks are sufficient.

There are no longer any entry rules to public venues such as the 3G or 2G rule, meaning that people had to show proof of vaccination, recovery or a negative test. 

However, they could return in autumn if the infection protection laws are adapted, and if the Covid situation gets worse.

Mandatory isolation 

The rules on isolation differ from state to state, but there is one general requirement: those who test positive for Covid have to go into isolation at home and avoid all contact with people outside the household. The isolation period lasts at least five days or a maximum of 10 days.

If you get a positive result at home, you should go to a test centre and undergo a rapid antigen test. If it is positive, the quarantine obligation kicks in. If it is negative, you have to get a PCR test.

If you have Covid symptoms, you should contact your doctor, local health authorities or the non-emergency medical on-call service on 116 117. They can advise or whether you should get a PCR test. 

Across German states, the isolation period lasts 10 days, but – as we mentioned above – there are differences on how it can end earlier. 

In Berlin, for instance, it can be shortened from the fifth day with a negative test if you have been symptom free for 48 hours. If this isn’t the case, the isolation is extended until you have been symptom-free for 48 hours and tested negative. But you can leave without a negative test after 10 days. 

A positive Covid test.

A positive Covid test. Photo: picture alliance/dpa | Sebastian Gollnow

Anyone who tests positive for Covid using a rapid test at a testing centre can have a free PCR test to confirm whether they have Covid-19. If the PCR test is negative, there is no obligation to go into quarantine.

In Bavaria, the isolation period is five days after the first positive test. For isolation to end on day five you must be symptom free for at least 48 hours. Otherwise, isolation is extended for 48 hours at a time until the maximum of 10 days. 

A test-to-release is not needed to end the isolation, unless the person works in a medical setting. 

READ ALSO: Germany sets out new Covid isolation rules

After isolation, Bavaria recommends that you wear an FFP2 mask in public places indoors and reduce contact for an extra five days. 

The state of Hesse has a similar system to Bavaria where a test is not needed to end the isolation early (unless the person works in a medical setting).

In North Rhine-Westphalia and Hamburg, residents can end their Covid isolation on the fifth day if they get a negative test (carried out at a testing centre). Otherwise the isolation period continues until the 10th day, or until they get a negative test.

Close contacts of people infected with Covid (including household contacts) no longer have to quarantine in Germany, but they are advised to get tested regularly and monitor for symptoms, as well as reduce contacts for five days. 

As ever, check with your local authority for the detailed rules.

Travel

Germany recently provisionally dropped almost all of its Covid travel restrictions, making it much easier to enter the country. 

The changes mean that entry into Germany is now allowed for all travel purposes, including tourism. The move makes travel easier – and cheaper – for people coming from non-EU countries, particularly families who may have needed multiple Covid tests for children. 

People also no longer have to show proof of vaccination, recovery or a negative test against Covid before coming to Germany – the so-called 3G rule. 

However, if a country is classed as a ‘virus variant’ region, tougher rules are brought in. 

It is likely that travel rules could be reinstated again after summer or if the Covid situation gets worse so keep an eye on any developments. 

READ ALSO: Germany drops Covid entry restrictions for non-EU travellers

Vaccine mandate

The mandate making Covid vaccinations compulsory for medical staff remains in place. A vaccine mandate that would have affected more of the population in Germany was rejected by the Bundestag in a vote in April

READ ALSO: Germany’s top court approves Covid vaccine mandate for health care workers

Workplaces

Masks are no longer mandatory in workplaces, unless it is in a setting where more risks groups are, such as hospitals or care homes. 

The government no longer requires people to work from home, but employers and employees can reach their own ‘home office’ arrangement.

Tests are also no longer mandatory, but workplaces can offer their employees regular tests. 

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