Germany’s smallest state is No. 1 in vaccines.

BREMEN, Germany — This northern port city, combined with neighboring Bremerhaven, makes up the smallest and by many measures the poorest state in Germany’s federal system. In state comparisons of education or addressing child poverty, it consistently ranks dead last.

But when it comes to vaccines, Bremen is No. 1, with more than 90 percent of its population fully vaccinated. It has achieved its success in a country that has managed to vaccinate only slightly more than three-quarters of its people, and that voted last week against a bill that would have made vaccinations mandatory for people 60 and over.

“Bremen was so successful because they realized pretty early on that you’ve got to go into the neighborhoods, that you can’t just have one central vaccination center, but that you have to go into communities and approach people,” said Marieke Gerstmann, who runs a community health mediation center that advocates vaccinations in one of Bremen’s poorer neighborhoods.

What makes Bremen’s elite vaccination status all the more striking is that immigrants — who make up one-third of Bremen’s population, the most of any German state — are less likely to get vaccinated than people born in Germany, according to recent studies by the Robert Koch Institute, the national health authority.

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