German doctors warn against lifting vaccine priority list

German doctors warn against lifting vaccine priority list
People wait to get vaccinated in Greifswald on April 16th. Photo: picture alliance/dpa/dpa-Zentralbild | Stefan Sauer
The head of the German Doctors' Association has criticised the decision to lift the vaccine priority list in several German states. Doing so will force people to compete for a "scarce commodity", she said.

The head of the Marburger Bund, Susanne Johna, made the comments on Monday in an interview with German radio service Deutschlandfunk

Lifting the priority list to allow everyone to book a vaccine – regardless of age, health or occupation – would not lead to there being a greater number of doses of the vaccine, said Johna. “Rather, it simply means that even more people are now competing for a scarce commodity.” 

Her words were targeted at several German states who have made the decision to dispense with the priority system and allow all adults to book a vaccine at their GP.

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So far, Bavaria, Baden-Württemberg, Berlin and Brandenburg have taken this step, but this week a number of other federal states plan to join them.

Before that, most states were only allowing those the first three priority groups – meaning over-60s, those with a chronic illness, and certain key workers – to book a vaccine appointment. However two types of vaccine – Johnson & Johnson and AstraZeneca – have recently been made available to all adults, on the condition that they consult with a doctor beforehand. 

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When vaccine priority groups are done away with, people who jostle particularly hard to get an appointment are likely to get one before those who genuinely need the protection, said Johna, adding that many private doctors were already overwhelmed by demand.

“If I now give everyone the idea at the same time that it’s their turn, but at the same time the goods are so scarce that it is not even possible to meet the demand, it will lead to frustration,” she said.

Shortening gaps between vaccines “makes no medical sense”

One proposed solution for speeding up the rate of vaccination roll-out is to shorten the gap between the first and second doses of the vaccine. In most cases, the second vaccine shot for AstraZeneca is scheduled around nine to twelve weeks after the first one – but government officials have recently decided to shorten the gap between the first and second dose of AstraZeneca by up to four weeks. 

According to Johna, however, shortening this gap can drastically reduce the effectiveness of the vaccine

When the 12-week interval recommended by the Vaccination Commission is adhered to, the vaccine is around 80 percent effective. If this is shortened to four-to-eight weeks, the effectiveness dips to around 55 percent. 

READ ALSO: Germany gives green light to offer AstraZeneca vaccine to all adults

“With shorter vaccination intervals, a complete vaccination is certified earlier, but its protective effect is individually poorer and therefore also harbours a higher risk of infection and transmission for the population,” said Johna.

“In addition, the vaccines that are urgently needed in Germany and around the world are not being used optimally. It cannot be that vaccination certificates are more important than medically meaningful action.”

Susanne Johna, head of the Marburger Bund, said the lack of prioritisation would lead to “frustration”. Photo: picture alliance/dpa/Marburger Bund Bundesverband

Medical experts debate vaccine prioritisation

While the Marburger Bund have come out against lifting the priority lists for vaccines, the German Medical Association (BÄK) have welcomed the move as a means of speeding up the roll-out. 

In an interview with RedaktionsNetzwerk Deutschland last week, (BÄK) president Dr. Klaus Reinhart said it was a good idea to dispense with prioritisation because “it leads to bureaucracy and slows us down.” 

Equally, state leaders who have dispensed with prioritisation would likely point to the fact that unclaimed vaccine doses are currently going to waste.

In addition, even though all adults are able to book a vaccine, those who are in one of the priority groups could still be given preferential treatment, for example by being given an earlier appointment than a non-priority patient.

READ ALSO: ‘Mood is getting more aggressive’: Thousands of people in Germany caught skipping line for Covid vaccine

Some states are vaccinating faster than others 

Though German’s inoculation campaign has been accelerating in recent weeks, access to vaccines is still something of a postcode lottery.

As of Monday, 37 percent of the population had received at least one dose of the vaccine, while 11.2 percent were fully vaccinated. 

However, there are significant differences from state to state. In Saarland, for instance, around 41 percent of people have had their first jab, while in Brandenburg and Saxony, this number is only 32 percent.

Thuringia, meanwhile, is where the largest proportion of the population (15 percent) is fully vaccinated, while in Lower Saxony, this drops to only nine percent.

Speaking to the RedaktionsNetzwerk, Reinhart said he felt positive about the current speed of the vaccine rollout.

“We can trust that with the growing immunisation of the population, the third wave will finally ebb,” he explained.

If the vaccination continues at the current speed, Germany would likely achieve herd immunity by mid- or late-July, he added. 


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