Reply to "Focusing COVID-19 vaccinations on elderly and high-risk people".

In his commentary, Hermann Brenner provides timely data on the epidemiology of COVID-19 in Germany [1]. His-main message is that focusing vaccination on elderly and high-risk people in Germany (one third of the population) could avoid the vast majority of COVID-19 deaths. We agree. But Brenner goes one step further: Based on his estimates, he questions the need, justification and ethics of a full population roll-out of COVID-19 vaccinations in Germany and probably globally, instead proposing a herd immunity approach for the remaining two-thirds of the population. Thus, he misses to consider the significant impact of relaxing control measures on health service capacity, severe morbidity, long-term health consequences (long COVID), and the likelihood of emerging vaccine escape mutations until herd immunity is reached [2,3].

In Germany, the first SARS-CoV-2/COVID-19 epidemic wave in spring 2020 has been well controlled through a rapid employment of intense and comprehensive non-pharmaceutical interventions (NPIs) [4]. In February 2021 - after about three months of light/moderate lockdown measures against the large second epidemic wave - COVID-19 incidence is slowly decreasing. There is now again an intense and controversial discussion on relaxing NPIs, particularly in view of the rapidly emerging more dangerous mutants of SARS-CoV-2 [3]. Thus, in addition to quickly vaccinating as large a proportion of its populations as possible, Germany should consider implementing an adapted No-COVID strategy to heed the lessons learned from the much more successful control approaches in WHO Western Pacific countries such as China, Taiwan, South Korea, Vietnam, Thailand, Australia, and New Zealand [4,5].

Author Contributions

Olaf Müller designed the letter; all authors contributed significantly to the content of the letter and have accepted the final version.

Declaration of Interests

The authors have nothing to disclose.