BERLIN / DILLENBURG, Germany (Reuters) – Germans are proud of their national reputation for efficiency and are increasingly frustrated with the slow rollout of a COVID-19 vaccine that the scientists helped develop.
A sparse vaccine supply, cumbersome paperwork, a lack of medical personnel, and an elderly and immobile population are hampering efforts to get early doses of a vaccine made by US-based Pfizer and German partner BioNTech into the arms of the people.
Germany has set up hundreds of vaccination centers in sports halls and concert arenas and has the infrastructure to take up to 300,000 shots a day, Health Minister Jens Spahn said.
But the majority are vacant, and most states do not plan to open centers until mid-January, as they prioritize sending mobile teams to care homes.
Spent a day with a vaccination team in the small town of Dillenburg, 100km (60 miles) north of Germany’s financial capital, Frankfurt, shows just how painstakingly the task is.
The team starts by loading a cool box containing 84 doses of the Pfizer vaccine that has been thawed overnight in a waiting ambulance and leaves for the Elisabeth residential care center.
There they are met by manager Peter Bittermann, who has handled all the forms necessary to vaccinate residents and staff, provided space for the injections to be administered and checked the recipients after the vaccination.
The four-person immunization team, plus two interns, 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 350 more people to carry out its local vaccination campaign, said Nicole Fey, spokeswoman for the local district administration.
“We’ve been able to recruit a few, but that can never be enough,” she told Reuters TV.
GERMANY LAGS
In the first two weeks of its vaccination program, Germany gave 533,000 injections, just two-fifths of the 1.3 million doses received. Britain, on the other hand, has hit the 2 million mark.
Israel, the world leader in terms of the proportion of the population covered, vaccinates 150,000 people daily, with its universal and digitally activated healthcare system making it easier to schedule appointments.
Germany’s larger size and federal set-up complicate operations, a problem also facing the United States.
Elsewhere in Europe, the decentralization of the vaccination operation in Spain has exposed disparities between regions and created tensions with central government.
(Graph – COVID-19 Vaccine Doses Administered 🙂
Germany’s 16 states blame the federal government for not providing enough doses. Doctors at some centers say shift work has been canceled. One vaccination center was opened in Berlin, which was closed only on New Year’s Eve due to lack of injections.
Spahn says manufacturing problems rather than under-orders are at the root of the limited supply after Pfizer and BioNTech halved their production forecasts to 50 million doses by the end of the year in December. Each receiver needs two shots.
The government is working with BioNTech to open a new manufacturing site in the western city of Marburg, he said. BioNTech’s CEO said last week that the Marburg plant could be commissioned in February, ahead of schedule.
“With the capacity we’ve already created in Germany, we can run between 250,000 and 300,000 vaccinations a day – if we have the vaccine doses,” Spahn said this week.
Germany expects to receive 5.3 million injections of Pfizer / BioNTech by mid-February and an additional 2 million doses of a second vaccine from Moderna, just approved by the European Union, by the end of March.
Still, this will hardly 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 varies widely by state in Germany. The best in class is Mecklenburg-Vorpommern in the north, with 15.6 vaccinations per 1,000 inhabitants, while Saxony has only 4.4 vaccinations.
In Thuringia, another laggard, Prime Minister Bodo Ramelow said on Tuesday that many doses sent to hospitals had been returned. “If the brakes hit at a vaccination rate of 30 or 33%, we have a real problem,” he told radio Deutschlandfunk.
In Saxony, the Ministry of Social Affairs said missing consent forms, route planning issues, COVID outbreaks in homes and last-minute cancellations had delayed the rollout.
Until recently, shots in Saxony were centrally stored, forcing mobile teams to travel long distances before going to care homes.
Unlike Dillenburg, Saxony is overrun with people volunteering for the vaccination, said Lars Werthmann, regional head of logistics at the German Red Cross.
“The next gigantic task is to coordinate all of these people,” said Werthmann.
Doctors, meanwhile, express frustration with appointment booking systems that differ from state to state, saying they cause confusion and erode trust.
To speed up the rollout of COVID-19 shots, Germany needs to distribute them through its network of GPs as soon as there is a vaccine that can be easily stored in the refrigerator, Berlin pediatrician Burkhard Ruppert said.
Germany hopes to administer injections in doctor’s offices in a second phase.
“Our strength in Germany is this outpatient care system,” said Ruppert, who heads a local doctors’ association. “We are not a country with large-scale managed systems like the UK or Israel.”
“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; Edited by Douglas Busvine and Jan Harvey