Among people over the age of 60, 3 million remain unvaccinated. Pressure to change that is mounting, yet falling just short of implementing an actual vaccine requirement. Much of public life in Germany now requires proof of test, vaccination or recovery from COVID-19. In some places, only the latter two will do.

As of Monday, the cost of rapid antigen tests is no longer covered by the state. That means unvaccinated people may be out €10 to €25 ($11 to $29) every time they want to join public life, for example to go a restaurant or get a haircut.

Starting November 1, unvaccinated people will not receive compensation for lost pay if coronavirus measures force them to quarantine.

The loss of earnings for all citizens who have to quarantine and cannot work because of a suspected or actual coronavirus infection has, until now, been covered by the state.

Despite fears over a potential spike in COVID-19, Health Minister Jens Spahn has defended the move. "Why should others pay for the fact that someone has decided not to be vaccinated?" he said. 

He did stress, however, that it is still the right of every citizen to choose not to get vaccinated. His center-right Christian Democrat party (CDU) has staunchly opposed compulsory vaccinations across the board.

"It is not about pressure, it is about fairness," said Spahn.

Getting the unvaccinated to change their tune "makes a lot of epidemiological sense," Berit Lange, an epidemiologist at the Helmholtz Center for Infection Research, told DW. "We'll have to see if it works."

Targeted efforts are key, she added, to find out why people still have not gotten their shot and what can be done to encourage them.

"It's very difficult to say where exactly we are in this pandemic. Globally, we can assume it will go on another two to four years," said Lange. "What we do know is that there is not enough immunity in Germany to avoid serious outbreaks that burden hospitals."

At least 68% of people in Germany have received at least one shot, according to the Health Ministry, and at least 85% of those over 60 are fully vaccinated. The figures could be higher, based on a recent analysis by the Robert Koch Institute for public health (RKI). The uncertainty is due, among other things, to some doctors not registering all vaccinations.

Is Germany already through its fourth wave?

To many Germans, it may feel like the country is through the worst of the pandemic. Just 42% of those polled in a recent survey said they worry about rising infections. In the summer, that figure was at 62%.

Based on recent statistics, it appears Germany has been able to avoid a dramatic developments in its fourth wave of the pandemic, which began in mid-August. The seven-day incidence rate has kept steady for the last several weeks at around 60 people per 100,000 — which is higher than the same point one year ago.

Yet that is only part of the picture. Since late summer, German health officials have also been judging the situation based on the hospitalization rate, which better reflects serious cases and the burden on the health care system. At 1.6 per 100,000 people, COVID-19 hospitalizations are in the green. The number of those patients occupying intensive care beds is also low.

There are greater concerns at the local level, such as the four dozen cities or municipalities with incidence rates of at least 100, and in some cases 200. In the western state of North Rhine-Westphalia (NRW), Germany's most populous state, 280 COVID-19 patients are in the hospital, half of them on ventilators.

A large majority of the seriously ill are unvaccinated people.

Cautious optimism

The seasons are changing and as Germany approaches winter, social life is moving inside. This increases the risk of infections, which was the case during Germany's second wave last autumn and winter. Spahn has warned that the vaccination rate is insufficient to guarantee that this won't happen again.

"We best not go too quickly, but step-by-step. So we don't have to take a step backward," he said.

Epidemiologists like Lange have said that unlike in the United Kingdom, people in Germany should not expect "freedom day," when all restrictions are lifted, anytime soon.

"Whether you can declare one is a political question. Whether you can stick to it is an epidemiological one," she stated. Rules will be necessary, she added, if infections rise and again burden the system.

Children remain unvaccinated

With so many adults vaccinated, attention has turned to those still without a shot, including those still too young to get one. There are about 9 million children under the age of 12 in Germany who cannot get vaccinated. Infections are high in this group, but health officials point out that there are few serious cases.

Rules vary based on state, where educational policy is decided, and from school to school. One of the biggest points of contention is face masks. The RKI wants kids to be wearing them in class, though some pediatricians disagree with that recommendation.

This article was translated from German

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