Challenges and problems in vaccine strategy

Since Germany began its vaccination process in late December, together with the rest of the EU, it has faced a number of logistical challenges.

Now, almost a month after the program, its slow progress is causing frustration and concern among German parliamentarians and health professionals.

Health Minister Jens Spahn had targeted 300,000 vaccinations a day, but so far the country has failed to achieve this. Data from the public health agency, the Robert Koch Institute, published on Tuesday, showed that in the last 24 hours a little over 62,000 vaccinations were performed (most being the first doses).

In total, since Germany started vaccinations in all 16 states on December 27, almost 1.2 million people in Germany (priority groups at the moment are health workers, nursing home residents and staff and the elderly) received a first dose of coronavirus vaccine and nearly 25,000 received a second dose.

Instead, the UK, which was the first country in the world to approve and launch the Pfizer-BioNTech vaccine (partially developed in Germany) and then the Oxford-AstraZeneca candidate, began its Covid vaccination program earlier this month. December, has so far vaccinated 4 million people with their first dose of vaccine (over 450,000 had the second dose) and exceeded 300,000 vaccinations a day by the end of last week.

The EU has pursued a policy of buying coronavirus vaccines as a bloc, but some countries, including Germany, have also entered into their own additional purchasing agreements.

However, supply problems were a problem at the very beginning of vaccination in Germany, with a lack of available vaccines observed in some centers, as well as other difficult logistical problems related to the vaccination of its priority groups, such as the elderly. . This has created uneven performance of the vaccine implementation from state to state in the country.

Dr. Stefan HE Kaufmann, a renowned immunologist and microbiologist in Germany and founding director of the Max Planck Institute for Infectious Biology in Berlin, told CNBC on Tuesday that the vaccination process has faced challenges from the beginning.

“The number one priority (in the vaccination process) is currently the elderly and people with serious pre-elimination diseases, especially in nursing homes. This process is good ethically, but it is very time consuming. It also includes medical staff and medical staff in nursing homes and hospitals. It seems that some of the nursing home staff are hesitant about vaccination, “he said.

So far, only vaccines created by Pfizer and BioNTech and Moderna have been approved by the European Medicines Agency for use in bulk. The candidate that is easier to store and transfer (and cheaper) from AstraZeneca and Oxford University has not yet been approved.

Time is of the essence when it comes to launching the vaccine, especially amid an increase in cases due to the more transmissible mutations that have become widespread. However, Germany has had fewer cases than many of its neighbors, with more than 2 million infections so far. The death toll is 47,958.

For both the UK and the EU, a key issue is that supply cannot meet current demand for vaccines, and Germany is no exception, with early reports of people struggling to receive vaccination schedules amid a shortage of doses. But vaccine manufacturers have promised to increase production and deliver millions of extra doses to be delivered in the next few weeks and months.

In the meantime, however, “the doses provided for immediate use are insufficient,” Kaufmann noted.

“While so-called vaccination centers have been set up throughout Germany, there is currently a lack of vaccines for maximum rapid vaccination coverage in these centers. “The hope is that the process will be accelerated with the difficult and time-consuming vaccination (in old people’s homes) has been achieved,” he said, noting that Germany’s speed of vaccination action would have been faster if it had been be provided several doses from BioNTech and Moderna “.

In my opinion, everything must be done to ensure more doses for immediate or short-term use. This is even more important because of the growing incidents of mutant strains that could evade vaccine-induced immune responses, he warned.

Germany is not alone in seeing a slow start to vaccination. There has been criticism at EU level of the European Commission for not purchasing enough vaccines for the bloc to start.

Florian Hense, a European economist at Berenberg, told CNBC that the approval and acquisition process meant the EU was behind the line, or at least behind other countries, including the United Kingdom and the United States, when it came to receiving vaccines.

“To the extent that the EU has negotiated with pharmaceutical companies and approved vaccinations on behalf of its member states, Germany’s vaccination action will always be ‘non-German’, no matter what is associated with that term,” he said on Monday. CNBC.

“I suspect that subsequent EU approval has delayed the start of vaccinations and has since limited the pace of vaccinations per day, as vaccinations have reached the EU at a slower pace than they had (per capita) in the UK, USA”

Needless to say, there have been criticisms from other parliamentarians about the government’s overall strategy. Dr Janosch Dahmen, a German doctor and MP for the Green Party, told CNBC that he was “very worried because Germany is already behind”.

“The progress of the vaccination campaign is much too slow and one of the reasons is the lack of supply, but the more urgent problem is that the vaccination infrastructure reveals multiple problems, especially lack of staff, distribution problems in the federal states and a too centralized approach , he said.

“As a doctor and politician, I am very concerned about the situation here and in addition to all the efforts we have to make in a more effective vaccination campaign at national level, we have to build bridges through testing, self-testing and we need to work harder in the area of ​​contact tracking, which is another important part of fighting this pandemic, “Dahmen said.