BERLIN / DILLENBURG, Germany (Reuters) – Proud of their national reputation for efficiency, Germans are increasingly frustrated by the slow launch of a COVID-19 vaccine that their scientists helped to develop.
The scarce supply of vaccines, the complicated paperwork, the lack of health staff and an elderly and immobile population are hampering efforts to put the first doses of a vaccine made by Pfizer, based in the United States and a German partner, in the arms of the people BioNTech.
Germany has set up hundreds of vaccination centers in sports halls and concert arenas and has the infrastructure to administer up to 300,000 vaccines a day, said Health Minister Jens Spahn.
But most are empty, with most states not planning to open centers until mid-January, as they prioritize sending mobile teams to nursing homes.
A day spent with a vaccination team in the small town of Dillenburg, 100 km (60 miles) north of Germany’s financial capital, Frankfurt, shows how arduous the task is.
The team begins by carrying a thermal box containing 84 doses of the Pfizer vaccine thawed overnight in an ambulance waiting for, and departing for Elisabeth’s nursing home.
There they are received by the manager Peter Bittermann, who has already handled the forms necessary to vaccinate residents and employees, and has given space for vaccines to be administered and recipients monitored after vaccination.
The four-member immunization team, plus two interns, has only a few hours to dispense with the temperature-sensitive Pfizer vaccine before it is no longer suitable for use.
The German Red Cross needs 350 extra people to carry out its local vaccination campaign, said Nicole Fey, a spokeswoman for the local district administration.
“We managed to recruit some, but it is never enough,” she told Reuters TV.
GERMANY LAGS
In the first two weeks of its vaccination campaign, Germany administered 533,000 vaccines, just two-fifths of the 1.3 million doses received. Britain, in contrast, reached the 2 million mark.
Israel, the world leader in terms of share of the covered population, is inoculating 150,000 people a day, with its universal and digitally enabled health system to facilitate the scheduling of consultations.
Germany’s larger size and federal configuration are complicating operations, a problem also faced in the United States.
Elsewhere in Europe, the decentralization of Spain’s vaccination operation exposed differences between regions and generated tensions with the central government.
(Graph – doses of COVID-19 vaccine administered 🙂
Germany’s 16 states blame the federal government for not guaranteeing sufficient doses. Doctors at some centers say shifts have been canceled. In Berlin, a vaccination post was opened, which only closed in the New Year due to lack of vaccines.
Spahn says manufacturing problems, not just a 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 the end of the year. Each recipient requires two shots.
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 go into operation in February, ahead of schedule.
“With the capacity we have already created in Germany, we will be able to carry out between 250,000 and 300,000 vaccinations a day – when we have the vaccine doses,” said Spahn this week.
Germany expects to receive 5.3 million vaccines from Pfizer / BioNTech by mid-February and another 2 million doses of a second vaccine from Moderna, 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 80 years old.
THE LAST MILE
As in Spain, state-to-state performance in Germany varies widely. The first in the class is Mecklenburg-Vorpommern, in the north, with 15.6 vaccinations per 1,000 residents, while Saxony has a rate of just 4.4.
In Thuringia, another latecomer, state premier Bodo Ramelow said on Tuesday that many doses sent to hospitals were returned. “If the brakes are applied with a vaccination rate of 30 or 33%, we have a real problem,” he told Deutschlandfunk radio.
In Saxony, the social affairs ministry said the lack of consent forms, challenges with route planning, COVID home outbreaks and last-minute cancellations have delayed its implementation.
The shots in Saxony were stored centrally until recently, meaning that mobile teams had to travel long distances before going to nursing homes.
In contrast to Dillenburg, Saxony was invaded by people who volunteered for their vaccination campaign, said Lars Werthmann, head of regional logistics for the German Red Cross.
“The next huge task is to coordinate all of these people,” said Werthmann.
Meanwhile, doctors express frustration with appointment scheduling systems that vary from state to state, saying they cause confusion and erode confidence.
To speed up the launch of COVID-19 vaccines, Germany should distribute them through its network of family doctors’ offices as soon as there is a vaccine that can be easily stored in a refrigerator, said Berlin pediatrician Burkhard Ruppert.
Germany hopes to administer injections in doctors’ offices in a second phase.
“Our strong point in Germany is this outpatient care system,” said Ruppert, who runs a local medical association. “We are not a country with large-scale managed systems like the United Kingdom or Israel can 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.”
Reporting by Caroline Copley in Berlin and Annkathrin Weis in Dillenberg; Additional reporting by Emma Pinedo Gonzalez in Madrid and Nadine Schimroszik in Berlin; Editing by Douglas Busvine and Jan Harvey