Germany’s vaccine campaign has been spluttering to a halt for quite some time now.

Between mid-June and mid-July 10 million people got their first jab. Between mid-July and mid-August that number had fallen to 2 million additional first timers. That leaves 35 percent of the population that hasn’t had a vaccine (although this includes children under the age of 12).

Attempts to motivate adults to get their jabs are becoming increasingly imaginative.

The latest stunt is a Berlin S-Bahn train that people can jump onto to get inoculated while seeing a bit of the city (presumably the main novelty lies in the fact that the carriages have been disinfected and don’t smell like a sewer for once.)

This initiative was pretty popular, suggesting there is the odd (younger) person out there who simply hasn’t gotten round to being vaccinated yet. But anyone who thinks such stunts will solve low vaccine take up is misjudging the mood among the unvaccinated: they haven’t booked an appointment out of forgetfulness, they are refusing to be vaccinated.

A look at where the refuseniks live is instructive. The states with the lowest vaccine uptake are all in the east.

In Saxony, just 51 percent of the population are now vaccinated. That’s remarkable given the fact that the eastern state has had by far the most deaths relative to its population. Even an initiative to give Saxonians a free Bratwurst with their BionTech couldn’t tempt enough people in the home of Hausmannskost.

Thuringia, which was also hit badly by the winter wave, barely does better on a 55 percent vaccination rate.

At the other end of the scale, the tiny city state of Bremen, which has one of Germany’s lowest death rates, has vaccinated 70 percent of its population.

The fact that Bremen is leading the pack challenges some established cliches. Low vaccine take up is linked to poverty? Bremen is just about the poorest place in the land. And Bremen’s large immigrant population also doesn’t fit easily with the narrative that migrants are suspicious of the vaccine.

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So what explains the low take up in east Germany?

One school of thought has it that the AfD-voting Ossis have become so embittered and contrarian that they would have rejected Berlin’s pandemic policy whatever it had been: had the government just let life go on as normal, they would have taken to the streets bewailing overflowing emergency care stations.

Another school of thought has it that experience of totalitarianism has led east Germans to value their liberty to a higher degree than west Germans do. On this reading, lockdowns that intruded into the privacy of people’s homes were the type of tone-deaf pandemic response that only west Germans could have come up with.

The second argument isn’t without merit.

The GDR imposed mandatory vaccines on its population for a whole host of illnesses from polio to measles. Volksgesundheit trumped individual rights in the communist state. Or, as historian Malte Thießen told broadcaster MDR recently, “in the eyes of the state leadership, those who rejected vaccinations rejected socialism.”

The GDR had notable success with its vaccine campaigns in the early days, wiping out polio while it was still killing dozens of children in west Germany. But the omnipresent public health campaigns, that included vaccines at holiday camps (sound familiar?), schools and businesses, led to weariness among the public. Since the vaccines were often ineffective and some diseases proved too stubborn to be wiped out, that weariness grew even further.

By the late 1980s, despite the GDR’s heavy emphasis on public health, life expectancy in the east lagged behind the west by three years.

Of course, explaining vaccine hesitancy through east German history alone is too reductive. After all, it is not just east Germans that are unwilling: just 58 percent of Bavarians have had their jabs, ignoring the warnings of state premier and Mahner-in-Chief Markus Söder.

The long and short of it is that over 3 million Germans over the age of 60 have not taken up the offer of vaccination, inexplicably disregarding the dangers they will be exposed to come the winter.

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Meanwhile, the government is trying to push up its vaccine quota by encouraging teenagers, for whom the virus is no more dangerous than lung infections that have been around for decades, to use up some of the excess Impfstoff.

But, with the vaccinated still able to pass the virus on, jabbing teenagers isn’t going to stop unvaccinated pensioners from catching Covid and getting seriously ill. If anything, it’ll cement their suspicion that the universal vaccine campaign is politically motivated.

So what should the government do when case numbers escalate in the autumn? Does it have a duty to protect old people who chose not to protect themselves? And if it does, how should it do so?

One thing seems certain, Berlin’s preferred tool of lockdowns and intrusions into personal liberty would have the paradoxical effect of entrenching elderly Germans’ opposition to the medical inventions that could help them survive.

Jörg Luyken is the creator of The German Review. You can sign up to his bi-weekly newsletter on German current affairs here.