Why are fewer people getting vaccinated against Covid in eastern German states?
German authorities are panicking over the slowing vaccination numbers. And uptake appears to be a particular problem in the east of the country. What's going on?
What are the vaccination rates in the east?
In Saxony, 52.6 percent of the population had been fully vaccinated up to and including Monday, according to figures from the Robert Koch Institute (RKI). In the western city state of Bremen, that figure stood at a far higher 71.5 percent.
Brandenburg was also below the national average of 61.4 percent with 55.6 percent, as was Thuringia with 56.5 and Saxony-Anhalt with 58.4 per cent. Mecklenburg-Western Pomerania came in just under the national average at 60.0 percent.
Across Germany, more than 61 percent of the population is fully vaccinated, while 65.9 percent have received at least one dose.
What's the reason for the lower rates in eastern states?
There's no easy answer.
Marco Wanderwitz, the federal commissioner for eastern Germany and himself a native of Saxony, speculated in mid-August that it could partly be down to politics. Eastern states have a higher number of supporters for the far-right Alternative for Germany (AfD).
"There is a clear connection between approving of the AfD and rejecting vaccination," he said. "It cannot be explained away."
When the CDU politician warned of "dramatic conditions" due to rising incidences in eastern states and hinted at "stricter measures for the unvaccinated", he received a rebuke from a high profile AfD leader.
Thuringian AfD faction leader Björn Höcke said: "The man has no idea about the east. Yes, freedom-loving people live here who are fed up with paternalism once and for all and who make self-determined decisions about their lives as well as their health - and that is very good!"
Do AfD supporters really play a role in the low vaccination rate?
According to the study Covid-19 in Saxony conducted by the Technical University of Dresden in June, there is an above-average number of vaccination sceptics in the federal state.
Around 12 percent even state that they would "definitely not be vaccinated", compared to just under five percent nationwide, according to the study.
And those Saxons who consider themselves to be to the right of centre or who lean towards the AfD are far more likely to say that they would "rather not" or "definitely not" have themselves vaccinated, says the study.
Study author Hans Vorländer even differentiates regionally within the federal state. "It is obvious when you look at the election results: in the regions of Saxony with higher AfD shares, vaccination scepticism is also more widespread," Vorländer told DPA.
What do others say?
Other experts are cautious about naming the causes of the low vaccination rates. When asked, the Robert Koch Institute stated: "We cannot help here. Nor can we speculate on the development."
From the point of view of the Association of Statutory Health Insurance Physicians in Thuringia, the causes are "not empirically proven." However, spokesman Matthias Streit speculated that several points certainly play a role, such as the willingness to vaccinate in individual regions.
Jonas Schreyögg, a health economist from Hamburg, also told DPA: "I can't give you a clear reason why it differs in the east."
The data situation is weak and the number of respondents in the east in the regular survey of his Hamburg Center for Health Economics is too small, he said.
However, Schreyögg does see a connection with doubts about the quality of vaccines. "Especially in the east, only 54 percent say in our survey that they have confidence in vaccine safety," he said.
In the west and north of Germany, it is 64 percent, according to the survey. "Structural aspects could also play a role, i.e. the supply of vaccines, for example at doctors' offices or in vaccination centres," said the scientist. But according to Schreyögg there is a lack of data on this too. Meanwhile, confidence and vaccination rates are also comparatively low in parts of Bavaria, he said.
What else is important to know?
Currently the number of Covid infections in eastern states is lower than in western states. So perhaps people in the east are holding out to get vaccinated because they simply do not think there's an urgent need for it.
The state with the lowest 7-day incidence of Covid infections currently is Saxony-Anhalt, where – at 25.3 per 100,000 people – the incidence is still below the critical ’35’ threshold.
The fellow eastern states of Thuringia, Brandenburg, Saxony and Mecklenburg Western-Pomeria also have incidences under 40.
The Saxon Ministry of Social Affairs also sited this as a possible explanation for the lower interest in vaccinations.
What are the consequences of low vaccination rates?
Experts say low vaccination rates will push up the number of Covid infections and pressure on hospitals.
Schreyögg said: "If the vaccination rate remains so low in the east, but also in some districts in Bavaria, then this will of course have an effect on the incidence rates."
Eastern states - particularly Saxony and Thuringia - suffered badly last autumn and winter with spiralling Covid infection rates so the situation can deteriorate rapidly.
Where can German officials do to convince people?
That is what everyone is trying to figure out right now.
Uncomplicated vaccination offers - like vaccine stations outside football stadiums, and incentives like offering a free Bratwurst - are being expanded.
After the end of the school holidays in Saxony, vaccination rates could also increase, Vorländer suspects.
"But there are the hardened opponents of vaccination, the hardcore critics of the whole measures, who you will never reach," Vorländer told DPA.
There is a "pattern of resistance" in the Ore Mountains, for example. Overcoming that will be extraordinarily difficult. "You can't fight the hardliners," Vorländer said.