The first snowflakes are falling and the queues at the Munich vaccination stations do not stop. Nothing is reminiscent of the summer when there was a certain reluctance to vaccinate in the city. Vaccination fatigue – at the end of August the health department used this term to describe the sluggish progress in a submission to the city council. He then decided to significantly reduce the capacities in the vaccination center in Riem.
A misjudgment? The department is currently in the process of reversing everything and increasing capacities again. But the decision at that time also had other reasons: At the end of August, it was not certain how the vaccination center would be financed. The state government had changed its vaccination strategy. From now on, company doctors should primarily vaccinate Munich residents. Everything was shut down. Although vaccination was soon going very slowly, at least in Munich, the health department assumed that the incidences in autumn and winter would not exceed 225 by far. On Thursday, the incidence was almost twice as high, despite 72.3 percent of people being double-vaccinated.
Were 450 mobile vaccination campaigns not enough in the summer?
The fourth wave of infections had already made itself felt in the Munich clinics at the end of July. Therefore, there should be more low-threshold and decentralized vaccination offers throughout the city. Uncomplicated and without an appointment, for people who had not yet dared to have an injection.
Vaccine fatigue, it sounds as if you only have to wake up those who have not yet picked up a vaccine. Put a tent or the vaccination bus in front of the door – as a wake-up call, so to speak – so that they can see that the pandemic is not over yet. The crisis managers had to painfully realize that it is not that easy endeavor. The intensive care units are fully booked, and many unvaccinated people have to be treated there. Have you not met enough vaccination options in the district?
The call for district vaccination campaigns first came from the districts in which there is evidence that many people live who face many social challenges in life. Be it because they have no or badly paid work, are not well educated, are ill or are disadvantaged in some other way. The Feldmoching-Hasenbergl district committee applied for mobile vaccination teams to the health department in May. There were also similar demands in Laim, Berg am Laim and Milbertshofen-Am Hart. All driven by the concern that parts of the city where rents are still low, unemployment rates are high and doctors are few, could be left behind from the rest of the city.
As far as health care is concerned, some neighborhoods have fallen behind anyway. According to an evaluation by the Institute for Health Economics, a doctor in Feldmoching-Hasenbergl has to look after 1533 patients statistically. In Thalkirchen-Obersendling-Forstenried-Fürstenried-Solln there are 486. The number of doctors gives an indication, but is not the only factor that can be looked at, says Günter Neubauer, who recently published an opinion on “Municipal Medical Care Centers” for Rosa -Luxembourg Foundation as well as the party Die Linke has created. In it, he also used postal codes to examine how often diabetes occurs in the individual districts and compared the result with Covid infections. “You can see that there is a very close connection between the two,” he says.
Experts agree that social status is a major risk factor for developing type 2 diabetes. There are many indications that it could be similar with Covid-19 infections. According to Neubauer, the city could have orientated itself to the corresponding key figures from the health insurance companies in the summer and sent targeted mobile vaccination teams to the affected districts. Society as a whole underestimated that the fourth wave would come so quickly. It is still important to meet the people there. “You have to use people who can deal with such situations and ring the doorbell instead of waiting for someone to come to the vaccination station,” he says.
First the old, then the others
The responses from the health department to the district committees indicate that the city was neither ignorant nor inactive. First, however, the elderly should be protected – strictly according to vaccination prioritization. It was not until July that the mobile vaccination teams were sent out across the city. By mid-October, the health department had initiated 450 actions in which 48 015 vaccinations could be carried out within five months, according to a response to a city council request. A spokesman for the unit said of the information policy: “There were corresponding press releases, as well as flyers that were thrown in the selected city districts, as well as multilingual information on the Internet.”
In Feldmoching-Hasenbergl there were therefore a total of six vaccination campaigns – with different responses. 120 people came to a municipal advice center, while in the Mira shopping center, however, an injection was given to 580 people willing to vaccinate. So has the north of Munich been adequately taken into account? This is where the biggest problem lies: the city has no idea where there is still a need for vaccinations. The streets in which vaccinated and non-vaccinated people live is not evaluated – although the address must be given for the vaccination. Studies suggest that the pandemic will hit poor people particularly hard. “In December and January, Covid-19 mortality in socially disadvantaged regions was around 50 to 70 percent higher than in regions with less social disadvantage,” says a paper from the Robert Koch Institute.
Anti-Corona guides are supposed to help
Although anyone can suffer from a severe course of Covid 19, there are also many people from difficult social and economic circumstances in the Munich clinics. “Especially with them, who live in a confined space and rarely can work from home, we have to communicate more intensely and advertise vaccinations,” says Left City Councilor Stefan Jagel. The city has already achieved a lot with the mobile vaccination teams, but he believes that language barriers must be taken into account and access to information improved. He refers to Bremen, where vaccination teams have worked proactively and outreach. The two-city state has the highest vaccination quota in all of Germany, more than 80 percent of Bremen residents have been vaccinated twice. There they vaccinated particularly early on in an unconventional way in hotspot areas.
The parliamentary group Die Linke / Die Party has therefore proposed the introduction of so-called “anti-corona guides”. People who help residents in the disadvantaged districts of Munich to get information about vaccinations in their mother tongue. Due to a corona outbreak in the city council, this application cannot be resolved for the time being.