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BERLIN / DILLENBURG, Germany: Proud of their national reputation for efficiency, Germans are increasingly frustrated by the slow launch of a COVID-19 vaccine that their scientists helped develop.
Tight vaccine supplies, cumbersome paperwork, a lack of healthcare personnel, and an aging and immobile population are hampering efforts to get the first doses of a vaccine made by US-based Pfizer.
Germany has established hundreds of vaccination centers in sports halls and concert arenas and has the infrastructure to administer up to 300,000 vaccines a day, Health Minister Jens Spahn said.
But most are empty, and most states don’t plan to open centers until mid-January as they prioritize shipping mobile equipment to nursing homes.
A day spent with a vaccination team in the small town of Dillenburg, 100 km north of Germany’s financial capital Frankfurt, shows how laborious the task is.
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The team begins by loading a cooler containing 84 doses of Pfizer vaccine thawed overnight into a waiting ambulance and heading to the Elisabeth nursing home.
There they meet manager Peter Bittermann, who has already processed the necessary forms to vaccinate residents and staff, and provided space for vaccinations to be administered and recipients to be monitored after vaccination.
The four-member immunization team, plus two trainees, has only a few hours to dispense the temperature-sensitive Pfizer vaccine before it is no longer suitable for use.
The German Red Cross needs an additional 350 people to run its local vaccination campaign, said Nicole Fey, a spokeswoman for the local district administration.
“We have been able to recruit some, but it will never be enough,” he told Reuters TV.
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GERMANY LAGS
In the first two weeks of its vaccination campaign, Germany has administered 533,000 injections, just two-fifths of the 1.3 million doses received. Britain, by contrast, has hit the 2 million mark.
Israel, the world leader in terms of the proportion of population covered, is vaccinating 150,000 people daily, with its universal and digitally-enabled healthcare system that makes scheduling easy.
Germany’s larger size and federal structure are complicating operations, a problem that is also faced in the United States.
In other parts of Europe, the decentralization of the vaccination operation in Spain has exposed differences between regions and caused tensions with the central government.
Germany’s 16 states blame the federal government for not ensuring sufficient doses. Doctors at some centers say shifts have been canceled. In Berlin, a vaccination center was opened, which was closed for the New Year due to a lack of vaccines.
Spahn says manufacturing problems, rather than too few orders, are to blame for the limited supply, after Pfizer and BioNTech in December cut their production forecast in half to 50 million doses by year-end. Each recipient requires two injections.
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The government is working with BioNTech to open a new production site in the western city of Marburg, he said. BioNTech’s chief executive said last week that the Marburg plant could enter service in February, ahead of schedule.
“With the capacity that we have already created in Germany, we will be able to perform between 250,000 and 300,000 vaccines per day, when we have the vaccine doses,” Spahn said this week.
Germany expects to receive 5.3 million injections of Pfizer / BioNTech in mid-February and another 2 million doses of a second Moderna vaccine, recently approved by the European Union, by the end of March.
However, this will barely be enough to cover the 5.7 million people, or 6.8% of the population, over the age of 80.
THE LAST MILE
As in Spain, performance from state to state in Germany varies greatly. Top of the class is Mecklenburg-Vorpommern in the north, with 15.6 vaccinations per 1,000 inhabitants, while Saxony has a rate of just 4.4.
In Thuringia, another laggard, state Prime Minister Bodo Ramelow said Tuesday that many of the doses sent to hospitals had been returned. “If the brakes come on at a vaccination rate of 30 or 33 percent, we have a real problem,” he told Deutschlandfunk radio.
In Saxony, the Ministry of Social Affairs said that the lack of consent forms, challenges with route planning, COVID-19 outbreaks in homes and last minute cancellations had delayed their implementation.
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Vaccines in Saxony were stored centrally until recently, meaning that mobile teams had to drive long distances before heading to residences.
Unlike Dillenburg, Saxony has been invaded by people who volunteered for its vaccination campaign, said Lars Werthmann, head of regional logistics for the German Red Cross.
“The next gigantic task is to coordinate all these people,” Werthmann said.
Doctors, meanwhile, are expressing frustration at appointment booking systems that vary from state to state, saying they cause confusion and erode trust.
To speed up the launch of COVID-19 injections, Germany should distribute them through its network of family medical practices as soon as there is a vaccine that can be easily stored in a refrigerator, Berlin pediatrician Burkhard Ruppert said.
Germany hopes to administer injections in doctors’ offices in a second phase.
“Our strength in Germany is this ambulatory care system,” said Ruppert, who runs a local medical association. “We are not a country of large-scale managed systems like the UK or Israel might be.”
“We are in a race against a virus,” he added. “We will only win if we vaccinate as much and as quickly as possible.”
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