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The Permanent Commission on Vaccination recommends vaccinating the population in a fixed order. She designed six categories for this. Who belongs to which group and what happens next: an overview.
By Dominik Lauck, tagesschau.de
What categories are used to determine who will get vaccinated first?
The Standing Commission on Vaccination (Stiko) of the Robert Koch Institute has created six categories in which it has classified the population according to its urgency. In doing so, he relied primarily on age, but also on possible previous illnesses and professional activities. The first five categories, which have increased their priority, each list between 5.5 and nine million people. The majority of the population, about 45 million people, is classified in the lowest category with “low priority”. This recommendation is not final. The Federal Ministry of Health, which makes the decision, is also receiving advice from other experts on its considerations.
Who should get vaccinated first?
All people over the age of 80 belong to the first group: they are assigned a “very high priority”. The group also includes home residents, outpatient and hospital sector nurses, as well as employees of emergency rooms and Covid-19 wards, as well as other employees of nursing homes, people with disabilities, and dementia patients and their caregivers. These groups of people are at particularly high risk of severe or fatal courses or are particularly exposed at work or have close contact with people who are particularly at risk, Stiko writes in her 62-page report.. In total, the group includes more than 8.6 million people.
Who else is one of the first to get vaccinated?
Some six million people are assigned a “high priority”; they are placed in the second highest category. These are all people between the ages of 76 and 80. In addition, personnel at high risk of exposure in medical facilities (for example, in infection rooms, dental offices, or when transporting emergency patients), people with dementia or intellectual disabilities in institutions, and people who work in outpatient or hospital care of people with dementia or intellectual disability. .
Who will follow then?
The third category lists people with a “moderate priority.” These are all persons between 71 and 75 years of age. In addition, people with prior illnesses are at higher risk and their closest contacts, residents of asylum and homeless shelters, and close contacts of pregnant women. In addition, there are personnel with a moderate risk of exposure in medical facilities (for example, doctors in dermatology and orthopedics) and in positions that are particularly relevant to the maintenance of hospital infrastructure (for example, cleaning personnel in clinics and offices or employees in hospital technology), as well as those employed in the public health service. According to the RKI, this includes around 5.5 million people.
Who is in the other categories?
The fourth category (“highest priority”) lists all persons between the ages of 66 and 70. In addition, people with previous moderate-risk illnesses and their closest contact persons, personnel with low risk of exposure in medical facilities (without contact with patients with infectious diseases), teachers and educators. In addition, all people in precarious living or working conditions, for example seasonal workers or employees in the meat processing industry or in parcel service distribution centers. In total, that’s about 6.9 million people, according to the RKI.
The fifth category (“slightly higher priority”) includes everyone between the ages of 60 and 65. In addition, employees in retail, personnel in key positions in the state and federal governments, as well as professional groups in critical infrastructure, these include, for example, firefighters, the German armed forces, the police, public transport and waste management. In total, there are around nine million people.
All other people belong to the lowest category (“low priority”): about 45 million people.
What previous illnesses are taken into account?
A model was designed that gathers a large amount of data and uses it to calculate the rate of hospitalization and death for people with various prior illnesses. Depending on the availability of vaccines, people with previous illnesses are considered in descending order of risk. These diseases are important: asthma, chronic kidney and liver diseases, COPD, cancer, diabetes mellitus, high blood pressure, cerebrovascular disease or stroke, obesity, myocardial infarction, coronary disease and cardiovascular diseases.
Can the prioritization still be changed?
Yes, adjustments may be made over the course of vaccine approval. It could be that a vaccine is more effective in a certain age group, said a spokesman for the Federal Ministry of Health.
What is the post-procedure like?
Following these recommendations from Stiko, follow a three-day declaration procedure, until Thursday at 12 noon. “Then the recommendation will be published,” said the Ministry of Health when asked by tagesschau.de With. A statutory ordinance will then be drafted based on this recommendation. “This ordinance will be published in December.”
Have there already been reactions to Stiko’s recommendation?
According to the German Foundation for Patient Protection, the highest priority group is too large. “Putting more than eight million people seemingly equal in priority to number one cannot work,” said Eugen Brysch, a member of the Foundation’s Board. Therefore, people in need of care and seriously ill people should first have the opportunity to get vaccinated. Only then is it the turn of people who work in the fields of medicine and nursing. “If the federal government now deviates from this clear classification, people who need care will quickly become losers in the battle for the first vaccine.”
Are infected people already vaccinated?
No. Anyone who has already been shown to be infected with Sars-CoV-2 will not be vaccinated initially. Whether, and if so, when, these people will be offered a vaccine later on has not yet been decided. “Based on the data available so far, there is no evidence that vaccination represents a risk after a Sars-CoV-2 infection that has already gone unnoticed,” explains Stiko. Therefore, there is no need for vaccination.
How are people invited to get vaccinated?
The exact procedure is not yet known. It is planned that for preferred vaccines in vaccination centers certificates of general practitioners will be presented, from which it is inferred that there is “an increased risk related to the disease of a serious or fatal course of the disease” with respect to Covid-19 . General practitioners reject this procedure because it would overwhelm practices. Prioritization decisions would be “thrown out the back door to general practitioners.”
What should be considered when vaccinating?
The Biontech / Pfizer vaccine, which has not yet been approved, requires two vaccinations every 21 days. Those who have already received the first of the two doses of vaccine needed take priority over those who have not yet received a vaccine. For this, the vaccine should be reserved accordingly. Anyone who becomes infected after the first vaccination should not initially receive a second vaccine. A series of vaccines that has already started must be completed with the same product, even if other vaccines have been approved in the meantime.
Is it clear when individual groups of people will be vaccinated?
Exactly that is still not certain. It is clear that the first category is at the beginning. The subsequent procedure depends mainly on the number of vaccination doses available and the willingness of citizens to vaccinate. According to a survey by Infratest dimap for ARD-DeutschlandTrend, 37 percent definitely want to get vaccinated if a vaccine is available. 34 percent believe they are likely to get vaccinated. On the other hand, 29 percent said they “probably don’t” or “definitely don’t want to” get vaccinated.
In an ongoing cross-sectional study conducted in cooperation with RKI, the willingness of medical personnel to vaccinate was lower than that of the general population. Compared with other population subgroups such as people with chronic diseases or the elderly, the willingness of medical personnel to vaccinate is the least likely.
These numbers may not be sufficient for “herd immunization.” According to experts, immunization of around two-thirds of the population is necessary to stop the spread of Corona.
