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VACCINE

6 Covid-19 vaccine challenges Germany is facing right now

From hundreds of thousands of unused doses to organisation difficulties, why is Germany struggling so much with its vaccination programme?

6 Covid-19 vaccine challenges Germany is facing right now
A Kita worker receiving her vaccine in Bremen. Photo: DPA

As of Friday, around 4.4 percent of the population had received at least one jab against coronavirus. Almost 2 million people have received both doses, and about 3.8 million people have received one jab. 

German Health Minister Jens Spahn also said that 11 million coronavirus vaccine doses will have been delivered to the 16 federal states by the end of next week.

So although progress has been made in the inoculation campaign that started at the end of December, impatience is growing over Germany’s slow rollout of the vaccine. 

Here are some of the challenges that the country is facing right now.

Supply problems

It’s been well documented that many European countries have struggled with supplies, and this has been blamed on the EU’s purchasing strategy. Critics say the Commission signed its contracts too late and paid the pharma firms too little money.

Adding to the supply issues is that the main vaccine providers – BioNTech, Moderna and AstraZeneca – all failed to deliver the agreed amount of doses for the first quarter of the year.

Health Minister Spahn said recently that the vaccination campaign would not speed up until the second quarter, from April onwards, when more doses are delivered. 

READ ALSO: How can Germany increase its supply of vaccines?

People refusing AstraZeneca

In the past week, The Local and other media outlets have been reporting how Germany is struggling to give out the AstraZeneca vaccine. 

According to the Robert Koch Institute (RKI), only around 270,000 shots have been administered from the first delivery of around 1.5 million doses. 

There have been several reports of people refusing the AstraZeneca jab – saying they would prefer the BioNTech/Pfizer or Moderna jab, which are also approved in Germany.

Citing a lack of data about efficacy in the elderly, Germany’s vaccine commission said AstraZeneca was recommended only for people aged 18 to 64 years old.

But there has also been misleading coverage in the media about the jab. Business paper Handelsblatt and Bild daily had reported that efficacy among above-65s was below 10 percent – claims that were rejected by the German government and the company.

READ ALSO: ‘Millions could be vaccinated quickly’: Should Germany grant wider rollout of AstraZeneca

People are also reacting to studies that show the AstraZeneca vaccine is slightly less effective than the other two vaccines approved in Germany, as well as reports of side effects after receiving the jab. However, health officials say effects, such as feeling unwell, can be expected after all vaccinations.

The government is trying to address these problems by assuring those aged 18-64 who qualify for it that AstraZeneca is safe and effective.

Chancellor Angela Merkel’s spokesman Steffen Seibert tweeted on Monday to say the AstraZeneca vaccine is “safe and highly effective”.

“It prevents many infections and protects against serious illness,” he said. “Vaccination can save lives.”

Adding to the misleading coverage are foreign media headlines that say Merkel “refused” the AstraZeneca vaccine. 

In an interview with German daily FAZ this week, Merkel had said AstraZeneca was a “reliable vaccine, effective and safe”, approved by the European Medicines Agency and “recommended in Germany up to the age of 65”.

When asked whether she would accept the jab herself, the German Chancellor, who is 66-years-old, said she did not belong to the recommended age group for AstraZeneca. 

This led to several headlines on English language newspapers worldwide saying Merkel refused the AstraZeneca vaccine.

As commentators pointed out, Merkel does not qualify for AstraZeneca because of her age – this is not the same as refusing it.

Vaccine not being rolled out efficiently

As we said earlier, Germany is struggling with supply issues. So even if some people do not want the AstraZeneca vaccine, that still doesn’t explain why there are so many doses hanging around. 

The whole debacle is exasperated by organisational problems and the fact not all priority groups are allowed to book appointments yet. 

Due to what appeared to be a lack of leadership on moving away from strict rules, health officials remained focused on the highest priority group which includes over 80s and health care employees with a high risk of contracting Covid-19.

“We should release the AstraZeneca vaccine for the first three priority groups,” Social Democrat health expert Karl Lauterbach told Spiegel on Monday.

However, the country is beginning to open up the AstraZeneca doses to other priority groups (remember that only under 65s qualify for it in Germany), including school teachers. 

Spahn on Friday also said that to speed up the rollout, Germany will aim to quickly distribute the shots through its network of family doctors’ practices.

Earlier this month, Chancellor Merkel admitted that the sluggish start of the vaccine campaign has been a “disappointment” and added that the vaccination centres will soon operate “at full capacity”. Let’s hope so.

READ ALSO: ‘Take AstraZeneca now’: Health officials plead for people to take vaccine

Different procedures across the country

Many people across Germany have reported confusion and stress over trying to get a vaccine appointment. The system differs from state to state. Some areas, like Berlin, are sending letters out to people eligible for appointments. Other regions say that people who qualify for a jab should call up or book an appointment online. 

There is also no plan that’s been made public on how the mass rollout will work. The German government has said it will update the public on how people will be able to get a vaccine appointment in due course.

But many people, including readers of The Local, are looking for an idea of the plan now to see how vaccinations will be carried out when the rollout speeds up from April onwards. 

Vaccine hesitancy 

Polls suggest that more Germans could be losing confidence in vaccines.

A recent study by Germany’s Bertelsmann Foundation found a third of respondents said they did not want any Covid-19 vaccine.

Health experts say more public health information campaigns on the vaccines should be rolled out to increase trust.

The weekend effect

Many vaccination points in Germany do not open, or are partially opened at the weekend. Social Democrat health expert Karl Lauterbach said lots of centres only vaccinate five days a week for eight hours at a time.

Lauterbach, among others, has urged Germany to open up the AstraZeneca vaccine to all priority groups and “increase the utilisation of vaccine centres to seven days a week”.

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ANALYSIS

Covid health pass: What can Germany learn from France?

Germany has its own version of a Covid health pass - the 3G rules. But does it actually do the job? The Local editor Rachel Loxton found Germany could learn lessons from its neighbour after a recent trip to Paris.

Covid health pass: What can Germany learn from France?
A sign outside a Munich restaurant informs guests that entry is only permitted for vaccinated, recovered or people with negative tests. Photo: picture alliance/dpa | Sven Hoppe

While surveying the terrace for a table in a Paris bar on a sunny Friday afternoon, an employee stopped us. 

“Pass sanitaire?” he said a few times before I understood what was going on. “Oh, the Covid health pass,” I said as I fished out my phone to present the EU digital certificate I received in Germany. After it was scanned, we were free to find a table in the sun. 

Despite Germany having its own version of the ‘pass sanitaire’ – the 3G rules that mean entry to indoor spaces is only allowed if you can show proof of vaccination (geimpft), recovery from Covid (genesen) or a negative test (getestet) – I get the impression that the Covid health passport culture is different to that of France. 

In Berlin, for instance, I have dined indoors a few times recently, visited an exhibition and a bar – and not once been asked for proof of vaccination, recovery or test.

“Here in Paris most places ask for the pass, and it’s surprising how quickly it has become normal,” The Local France editor Emma Pearson tells me.

“It takes a second just to have your phone scanned by a waiter or security guard and personally it makes me feel a lot more relaxed about socialising.”

Emma says readers of The Local suggest that the pass is asked for less often in smaller places like village bars, but there doesn’t seem to have been “any type of widespread refusal of businesses to enforce it”.

“So far I have not seen anyone protesting when being asked to show the pass, and I’ve only witnessed a couple of tourists who were confused about the system, everyone else seem to have made it a habit pretty quickly,” she adds. 

OPINION: Majority of French have accepted the health passport with little more than a shrug

During my weekend in Paris I also had my vaccine certificate scanned when going to a museum and eating out.

French Prime Minister Jean Castex has his health pass checked as he arrives to take part in a three-day-gathering of French ruling liberal party La Republique on September 6th, 2021. Photo: JEAN-FRANCOIS MONIER / AFP

That’s not to say that proof is never asked for in Germany. In gyms, for instance, I’ve heard they always ask for one of the Gs before you’re allowed inside to sweat with strangers (thankfully). Events and places where ticketing is needed at the door like cinemas, are on the whole more strictly enforcing the rules.

My EU vaccination certificate has also been checked before travelling by plane from Berlin. 

Yet it’s clearly very patchy. According to a survey released earlier this week by the opinion research institute Civey for Business Insider, 40 percent of respondents said the 3G or 2G (only for vaccinated or recovered people) rules in Germany were not enforced when they visited a restaurant, bar, cinema or other indoor event. 

Just under 30 percent said proof was checked but they did not have to show photo ID as well, which is meant to be the requirement. Only nine percent had their documents fully checked.

READ ALSO: 

So why hasn’t Germany embraced the culture of showing the digital pass in the same way as France – or even other EU countries like Italy?

Trust system

I suppose restaurants, bars, cultural and leisure facilities are trusting customers to have been vaccinated or taken a test. Perhaps they don’t want to dampen the mood by asking people to provide some kind of documentation during social gatherings.

After rafts of businesses being shut down by the government for several months last year and in the first half of 2021, restaurants, cafes and bars are simply happy to see guests again and actually be allowed to make money. Why risk turning people away or making them feel awkward?

We all know that Germany is a freedom-loving country, too, and perhaps asking everyone to get proof out is viewed as a controlling step too far. Small businesses are also understaffed and maybe they don’t want to take on additional bureaucratic burdens.

But given the high percentage of people in Germany who have not been vaccinated, I would feel better knowing that everyone has shown proof during social occasions. Particularly when visiting places like Berlin’s infamous Raucherkneipen (smoking bars) which are not known for their high-quality ventilation. 

The latest data shows 66.3 percent of the German population has received at least one jab and 61.9 percent are fully vaccinated. That’s a long way off health experts’ plea for 80-90 percent vaccination coverage. 

READ ALSO: Unvaccinated workers in Germany could lose pay in quarantine

The restrictions on entry only apply in Germany to indoor areas like dining in restaurants or bars. I also prefer the French way of requiring the proof to sit outside too. Because why not? We’ve gone to all this trouble of vaccinating millions of people, let’s show the proof – or at least make sure people are tested.

“My personal view is that I feel a lot more safe and secure going out for dinner, drinks, etc, knowing that everyone around me is either vaccinated or has tested negative,” says Emma from the Local France. “This will be important over the next couple of months as the temperature falls and socialising moves off the café terraces and indoors.”

Different system 

In France, a QR code has become the standard way of showing proof of vaccination. Although not perfect, it seems that the majority of businesses and people have accepted it. The system can also be used with the EU digital vaccine certificate, like the one we can get in Germany.

“So far there seems to have been fewer problems than anticipated and most of the technical problems have concerned people who were vaccinated outside France,” says Emma.

“EU vaccine certificates can be used on the French app for the health passport but it’s been more tricky for people who got their vaccines in non-EU countries, although the NHS app used in parts of the UK is now compatible with the French system.

“For people who got their vaccine in France the rollout has been remarkably smooth and I think it helped that they made it part of the TousAntiCovid app, which many people were already using. There is also an option to show proof on paper for people who either don’t own a smartphone or don’t want to use the app.”

Germany does not require that everyone has an official QR code, although we are encouraged to get it. People in the Bundesrepublik – a privacy-loving country famous for  shying away from digital upgrades – can use their yellow vaccination booklet or other proof of vaccination, recovery or test.

I think the different ways of showing proof has added to the feeling that it’s not quite a uniform system that everyone is part of. 

Would it make a difference?

Emma says there were two points to the health passport being introduced in France. “To control infection rates and to persuade people to get vaccinated by making daily life inconvenient for those who are not vaccinated,” she says. 

“The vaccination rates saw a huge spike straight after the passport was announced and more than 13 million people have now been jabbed since the date of the announcement. France is now among the European countries with the highest vaccination rates, which is not bad when you consider that back in January 60 percent of French people were telling pollsters that they might not get the vaccine.”

Although the two countries have roughly the same percentage of their population vaccinated at the moment, I wonder what the effect of a similar system to France could be on Germany. 

Of course, the countries differ on many points – France has also introduced mandatory vaccines for healthcare workers – so there are lots of factors to consider.

When it comes to infection rates it’s harder to tell.

France is seeing around 11,000 cases a day, although that’s been dropping steadily for over a month. 

“However that also coincided with the summer holidays – whether that can be sustained now that schools are back, people are back from holidays and in offices etc., remains to be seen,” says Emma. 

As Germany’s vaccine campaign has ground to an almost halt and Covid cases have generally been rising since July – on Friday 12,969 cases were logged within 24 hours – perhaps enforcing a stronger health pass message would be a helpful way of getting everyone on the same page. 

That’s not to say France hasn’t seen problems.

“There have been demonstrations every Saturday for six weeks now,” Emma says. “However, at their peak around 250,000 people demonstrated while 13 million went to get vaccinated. My impression among people I talk to is that it is accepted and in fact a lot of people actively like it.”

A demo outside the Eiffel Tower in Paris against the health passport on September 4th. Photo: picture alliance/dpa/AP | Thibault Camus

What’s with the German name?

Lastly, it’s hard to write an article about 3G rules in Germany without mentioning the name. As some people have pointed out on Twitter, it’s a bit baffling that Germany has chosen to use a name associated with mobile phone Internet coverage. Not least because there are some conspiracy theorists who believe that getting vaccinated is linked to Bill Gates implanting us all with 5G microchips (for the record – no, that is not happening, it’s fake news.) 

3G makes perfect sense in German since it refers to the German words for vaccinated (geimpft), recovered (genesen) and tested (getestet).

But I can’t help but think another name such as CovPass, which is the German app that many people use to upload their vaccination certificate, might have been a better choice in this case. Especially since Germany is desperately trying to convince vaccine sceptics to get their jabs. 

It’s fair to say every country has its own battles when it comes to Covid vaccinations and controlling the pandemic, and Germany has had its ups and downs. 

I do think that looking to France on the relative success of their pass sanitaire would be a helpful exercise. I and many others are more than happy to show our vaccine certificate before settling down for a beer. 

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