Large vaccination centers are closed, incidence values ​​have receded into the background. And the Covid-19 vaccination certificate? Hasn't been shown for a long time. Clinics have heard that Covid 19 patients have become part of everyday life. Despite these developments: Even three years after the first confirmed case of Corona in Germany on January 27, 2020, considerations about vaccination against Corona are not obsolete. An overview.

The status: New vaccines that have been adapted to the omicron variant have been available for several months. According to the recommendation of the Standing Vaccination Commission (Stiko), certain groups, such as people over 60, should receive a second booster vaccination to improve protection against a severe course of the disease. However, the vaccination rates for second boosters have so far been low and vary greatly from region to region. "In the meantime I was disappointed. I would have wished for greater acceptance of the recommended vaccinations," says Stiko boss Thomas Mertens.

Population: Despite vaccination gaps - experts speak of good basic immunity. The virologist Christian Drosten recently pointed out in the "Coronavirus Update" podcast that the virus is now much easier to transmit than at the beginning of the pandemic. One of the main reasons for the relative calm at the moment is population immunity, which is curbing the spread of the pathogen.

Permanent rest? Research will keep an eye on how long this protection lasts. "In the future, we will have to monitor this very closely when new variants appear, for example on the basis of hospital admissions," said Leif Erik Sander, director of the Berlin Charité Clinic for Infectious Diseases. Even if there is no data for longer periods of time because of the still relatively new nature of Sars-CoV-2, some researchers see reason for optimism. The immunologist Andreas Radbruch, for example, assumes lasting immunity based on the data on the first Sars virus (2002/03).

Future Fall Boosters? Some doctors express the idea that in future vaccination against Corona should always be given in autumn, as before the flu epidemic. However, Sander is skeptical as to whether the coming corona waves will fall as predictably in the winter months as is typically the case with flu: "It will probably be a while before we really have synchronous, strictly seasonal corona waves." Therefore, regular corona vaccinations for certain, endangered groups may be conceivable every one to two years.

And what does the Stiko say? One has to assume that primarily certain risk groups should receive further booster vaccinations in the future, says Mertens. It is not yet possible to scientifically name the exact time interval, but a one-year interval might be reasonable.

Who is particularly at risk: To put it very simply, one could say that the risk of a severe course of Covid 19 disease increases with age and the number of previous illnesses, says the Stiko boss. "In detail, everyone has to discuss this with their doctor." In addition, there are people whose immune system is not working 100 percent due to illness and/or medication – according to Mertens, further protective measures such as distance and masks can also be useful for them. According to Sander, people for whom the vaccination does not work at all should be treated very early in the event of a corona infection. "For example, with antiviral preparations, the risk of a serious illness can be reduced very significantly."

Protection against (re)infection: "The protection against serious illness through vaccination is very good, but avoiding reinfection with vaccination is only possible for a short period of time at most," said Mertens. For people without risk of severe Covid-19, he therefore currently does not expect the vaccination recommendation to be expanded. For the Charité infectiologist Sander, it is conceivable that younger people with a healthy immune system may only need a refresher every few years - if the virus itself does not provide the refresher with repeated infections. Further developed vaccines can also be expected in the future.

Vaccination motivation: As is well known, the days of baiting campaigns, such as free bratwurst for those who want to be vaccinated, are over. Strenuous, long-term work is ahead in order to reach people at risk with vaccination offers in the future, said Sander. One thing bothers him: "In retrospect, some are now spreading the narrative that the corona vaccination was superfluous. In fact, it was the decisive switch to get out of the pandemic."

The first evidence of a corona infection in Germany was announced in Bavaria on January 27, 2020. As of January 25, 2023, more than 37.7 million laboratory-confirmed infections were reported to the RKI. There are countless more under the radar. The number of people who died in connection with this is now over 165,000.