The German dilemma: what to do with the huge amount of vaccines they have accumulated

The German government is feeling the same pressure it had at the end of 2020 when the citizens of that country demanded as many vaccines as possible in the shortest possible time. Now that the pressure is on that adequate centers be built to store the enormous reserves of doses at its disposal. The dilemma was unthinkable until just a few weeks ago, when it was not yet so easy for many citizens to get an appointment to be vaccinated. But German perseverance meant that from one moment to another they began to accumulate so many doses that they did not know where to put them. And the worst part is that many can be unusable in a matter of days. Either they build large refrigeration structures or they get lost.

Some German states have already asked the federal government to stop sending them vaccines because they have nowhere to store them. Health authorities in those states have reported that the AstraZeneca vials they have may have passed their expiration date. And they transferred the responsibility to the federal government. On Monday, German Health Minister Jens Spahn of the center-right CDU sent a document to states assuring them that “since vaccine availability is now significantly higher than demand, until August, the available vaccines will no longer be delivered in their entirety to states, medical offices and company medical centers ”. In other words, the federal government, responsible for purchasing the vaccine, can no longer dispose of its doses.

According to the Robert Koch Institute (RKI), the German center for disease control, last week 106 million doses were distributed and 90 million were used. But shipments continue to pile up in Berlin and in the third quarter, according to Minister Spahn, more than 100 million additional doses are expected. The exact number of vaccines in storage is not known, but to get an idea, in the third quarter of the year, Germany will receive more than 70 million doses. In July, Pfizer / BioNTech and Moderna delivered more than 4.5 million weekly doses of their coveted mRNA vaccine to Germany. Federal government advisers believe that all adults have a chance to get the vaccine before the onset of the common cold in September. The Federal Ministry of Health has even announced that it hopes to achieve this goal before mid-August.

The Ministry of Health of the southern state of Baden-Württemberg has already announced that 4,000 doses they have accumulated in vaccination centers will be “affected by short term expiration”. In Bavaria, “a four-digit number” is threatened and in the north-west of Schleswig-Holstein, up to 2,480 doses of AstraZeneca will be discarded as they expire on August 10. In the southwestern state of Saarland, another 6,000 doses will become unusable on the same date. In the central state of Hesse, approximately 200,000 doses remain in stock for vaccination centers. They will expire in October.

Angela Merkel’s government has already pledged to donate part of the reserves to other countries, but the task is neither technically nor legally simple. States and public or corporate vaccinations cannot independently give vaccine doses, because “this is reserved exclusively for the federal government.” The Ministry of Health is organizing the return of the remaining doses to send them abroad, but vials must have a remaining shelf life of at least two months. Appropriate transport for transporting vaccines from states to Berlin and from there to other countries also requires extensive infrastructure and logistics. The government says it will donate up to 80% of available doses to the COVAX system, the international initiative for more equitable vaccine distribution. A lesser part, up to 20%, will be donated under bilateral agreements, “in particular to the Western Balkan States, to the Eastern Partnership (which includes Ukraine, Moldova, Belarus, Armenia and Azerbaijan) and Namibia”. Of course, they will receive the remains of AstraZenaca and Johnson & Johnson, which are the least effective in combating the Delta variant of the coronavirus of Indian origin. Details and specific amounts are currently under negotiation. The only sure thing is that from the month of August, all AstraZeneca deliveries received will be donated.

The problem remains how to keep the entire vaccine stock with the necessary refrigeration to keep them effective. MRNA vaccines should be refrigerated at minus 70 degrees Celsius, and special equipment is needed to reach this temperature. Most German states do not have this infrastructure, so vaccines are now stored only in a refrigeration complex managed by the federal authorities. Several companies in the food industry had to bring their own “ultra-cold refrigeration” equipment.

Of course, the dangerous Delta variant of the coronavirus complicated matters. German health authorities have announced that will give a third booster dose to deal with this extremely contagious strain. And they still have to convince a lot that they don’t want to be vaccinated. Earlier this week, the Koch Institute reported that at least 85% of all people aged 12 to 59 will need to be fully immunized to keep the Delta variant at bay, which is spreading rapidly. In people over 60 years of age, the vaccination rate should be at least 90%. However, so far only 50% of the German population has been fully vaccinated.

There are strong opponents of vaccines in the population, but they do not exceed 10%. That is why German states are focusing heavily on people who do not refuse on principle to be vaccinated against COVID-19 and who are simply undecided or they prefer to go on vacation and leave the case for later. According to an RKI survey, 17.1% of those under 60 who have not yet been vaccinated are undecided as to whether they will take the step. “We must reach these undecided by serving them the vaccine on a silver platter”, said Frauke Hilgemann, health secretary of the eastern state of Mecklenburg-Western Pomerania. The silver metal bin has not yet been used, but there are towns that They invite everyone who gets vaccinated to a good German beer. Others give memory concerts for the cell phone. And some offer discounts on local taxes. They all have mobile units that roam the neighborhoods and offer to be vaccinated to anyone passing through. In Rhineland-Palatinate, the Land government has just distributed 30,000 doses of BioNTech to colleges, universities and polytechnics, where they can be administered without an appointment. Anyone between the ages of 18 and 27 who lives or studies in the state can receive the dose.

The final decision on what to do with the remaining vaccines will likely be left to the who is the winner of the September 26 elections, during the election of Chancellor Angela Merkel’s successor.

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