For the time being, there will probably not be a uniform line between politics and the Standing Vaccination Commission (STIKO) with regard to the optimal vaccination strategy.

After the vaccination specialists at the Robert Koch Institute had already criticized the decision by the health ministers to lift the age prioritization for the vector vaccines from AstraZeneca and Johnson & Johnson, the shortened vaccination intervals for the first vaccine proposed by Federal Health Minister Jens Spahn (CDU) are now also met with incomprehension.

Joachim Müller-Jung

Editor in the features section, responsible for the “Nature and Science” section.

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    The minister had recently advocated more flexibility and given the vaccinating doctors more leeway when setting the vaccination interval within the four to twelve weeks specified in the approval.

    However, like the STIKO, many scientists are of the opinion that the benefit for society as a whole is greater if the previous recommendation is followed and as many of the people most at risk of Covid-19 are vaccinated.

    "We should not forget that many citizens with a significantly increased risk of severe Covid 19 disease are still not vaccinated," said the Erlangen immunologist Christian Bogdan, who is a member of the Standing Vaccination Commission, on Tuesday.

    Less than ten percent fully vaccinated

    Of those over 60, between 20 and 28 percent are fully vaccinated, depending on the federal state, and two thirds have received at least one dose. Overall, however, less than ten percent of the population is fully immunized and just under a third are at least partially immunized. In fact, a heated debate developed around the question of the extent to which those who have been vaccinated are protected and can help to contain the spread of the virus.

    The AstraZeneca vaccine Vaxzevria is affected. Once approved, the two doses can be administered one to three months apart. According to the study, the vaccinated are better protected at the end if there are three months between the two vaccine doses. Because of the significantly weaker immune reaction to the vector envelope at a large distance and the advantages of maturation in the immune system, the vaccine is then about thirty percent more effective. The STIKO has orientated itself on this data. It is unclear whether this also applies to the slightly more than two million people who were younger than 60 years of age at the first vaccination and who should receive an mRNA vaccine as a second dose because of the slightly increased risk of cerebral vein thrombosis. For them, the recommendation is three months apart.

    Nevertheless, the health ministers have decided to open up shorter vaccination intervals and at the same time have lifted age prioritization.

    The background to this is the concern that there will be more and more vector vaccines because many over 60-year-olds reject it, even though Vaxzevria in particular works very well for them and there is no increased risk of cerebral vein thrombosis.

    The politicians hope to accelerate the vaccination campaign by vaccinating more young people with it.

    Shorter vaccination intervals would be an incentive because they would receive the vaccinated status earlier and enjoy more freedom.

    Study causes unrest

    Possibly bringing forward the second dose could also contribute to better overall protection of society being achieved more quickly, says the Münster-based epidemiologist André Karch. Various scenarios have already been played through. Shorter intervals could also mean that more citizens in total actually receive the very important second vaccination dose. "Overall, however, these advantages are rather theoretical," says Karch. Because even with longer vaccination intervals, a lot has been achieved for civil protection, since the number of those who have been vaccinated once, some of which are protected, then increases faster. Overall, like the STIKO, Karch advocates sticking to the recommended three-month interval because the vaccine effect is so much more effective for each individual in the end.

    Recently, new information from the vaccine manufacturer AstraZeneca from a clinical study that is said to have shown a significantly better effectiveness after a vaccination interval of four weeks has caused concern: 76 percent instead of the almost 55 percent found in four studies. A second vaccination after one month would be almost as effective as after the preferred three months. However, this information has so far only come from an AstraZeneca press release. The STIKO has just as little access to the original data as the Paul Ehrlich Institute responsible for vaccine monitoring. And so the panel of experts remains much more cautious in its recommendations than politicians would like at the moment.