Minister Spahn expects corona vaccinations this year. The countries are already preparing vaccination centers. How will the vaccinations work? What about side effects? The answers to the most important questions.
By Dominik Lauck, tagesschau.de
When is the earliest possible date for EU approval?
There is an accelerated approval process at the European Medicines Agency (EMA). Pharmaceutical companies can report their corona vaccine candidates to the EMA during the clinical trial phase. At the moment, in addition to Biontech, the British-Swedish company Astrazeneca is also taking this path. It is clear that there will be no provisional approval in Europe.
When the EMA experts have evaluated their results, they give their recommendation to the European Commission. It decides whether approval is granted – in the positive case for all EU member states. The EMA has recently been confident that it will be able to give the green light for a first vaccine before the holidays.
When are vaccines available in Germany?
Several companies are already in the starting blocks and have announced that they will be able to ship their vaccines as soon as the regulatory authorities clear the way for them. Biontech and Pfizer, which were the first Western providers to present promising test data, stated: “Delivery is scheduled to start at the end of 2020, subject to regulatory approval.” Federal Minister of Health Jens Spahn expects the first vaccinations this year.
How will the vaccination take place?
The vaccines currently under development will not initially be available in sufficient quantities to vaccinate the entire population of 83 million. Therefore, the vaccination doses should be used as efficiently as possible for the common good.
Vaccination is to be given in vaccination centers commissioned by the state and by mobile vaccination teams in nursing homes. First, people with previous illnesses, for example of the lungs or bronchi, should be vaccinated, older people and employees in particularly important professions – such as doctors, nurses, police officers, firefighters, teachers and educators.
But at first the vaccine will probably not be enough for all these people. So there is still further priority. To this end, the Ethics Council, Vaccination Commission and Leopoldina want to refine the recommendations they have already submitted. But according to the Federal Ministry of Health, this is not yet possible because the properties of the vaccine are not yet clear. “For example, if a vaccine is approved that works for the 45-50 age group, it doesn’t make sense to want to vaccinate those over 60 first.”
According to Spahn, up to 40 percent of people in Germany belong to the risk group. Risk factors include old age, obesity, high blood pressure, heart, lung, kidney or liver diseases, diabetes, smoking and a weakened immune system.
How many vaccination centers are planned?
The centers have a bridging function. They should take on the mass vaccination until the doctors in private practice in Germany can continue this task. These central points are necessary because the Biontech vaccine, for example, has to be stored at temperatures as low as minus 70 degrees. Spahn has asked the federal states that the vaccination centers should be ready for use in mid-December.
As a rule, one vaccination center is set up per district or urban district. Exceptions are large cities: There can be more than one center there. Berlin, for example, is planning six such facilities so that 20,000 people can be vaccinated every day. In Hamburg only one central vaccination center will be built, which will have a peak capacity of over 7000 vaccinations per day. In addition to the stationary centers, mobile teams should visit people with restricted mobility in care facilities or at home in order to vaccinate them.
According to the Technical Relief Organization (THW), the state of the preparations is different in the federal states. In some cases, plans were still in progress, but there are already vaccination centers that are being set up. “Everyone is working flat out to ensure that we have these vaccination centers available as quickly as possible,” said THW President Gerd Friedsam RBB. The aim is to have as many as possible ready for action by mid-December.
The President of the German Association of Cities, Burkhard Jung (SPD), however, warned against the hope that there could be vaccination centers in many places from January. “In fact, we are assuming that mobile vaccination teams in particular will travel to nursing homes and hospitals well into spring,” says Jung. No unrealistic expectations should be aroused. “According to the plans of the federal and state governments, mass vaccinations for the general population will be possible from summer at the earliest.”
How effective will the vaccines be?
The previous vaccine candidates are said to be highly effective. According to preliminary data, the vaccines from Biontech and Moderna are around 95 percent for double vaccinations. The vaccine developed by the pharmaceutical company Astrazeneca was – depending on the administration and dosage – with an effectiveness of 90 or 62 percent. Taken together, this results in an effectiveness of 70 percent.
This is remarkable and has exceeded the expectations of epidemiologists, said the general director of the international pharmaceuticals association IFPMA, Thomas Cueni. The Berlin virologist Christian Drosten also speaks in Ed– Podcast of very good news. “These vaccines are all surprisingly efficient. Everything is somehow better than you would have thought.”
How great is the risk of unwanted side effects?
With the previous vaccine candidates, nothing indicates greater dangers. The stated side effects are nothing unusual compared to other vaccinations, explained Sandra Ciesek. However, the director of the Institute for Medical Virology at the University Hospital Frankfurt limited: “Only when you use the vaccine or medication in the area can rare side effects occur that you have not discovered in studies because the number of participants is limited.”
What do the vaccines cost?
Vaccine manufacturers and governments have negotiated different prices, not all of which are public. In Europe, these range from around 2.50 euros per dose for the AstraZeneca vaccine to 15.50 euros per dose that the vaccine from Biontech and Pfizer should cost according to EU circles.
In Germany, the vaccines are to be made available free of charge. The costs for setting up and organizing vaccination centers are to be borne by the federal and state governments and from funds from statutory health insurance and private health insurance. The Federal Ministry of Health did not want to comment on possible costs at the moment. This also depends on the type of vaccine.
What percentage of the population needs to be vaccinated to enable a “normal life”?
According to the European Center for Disease Prevention and Control (ECDC), immunization of around two thirds of the population is enough to stop the spread of corona. Vaccinations are designed to help achieve this penetration.
According to experts from the World Health Organization (WHO), a vaccination coverage of 60 to 70 percent of the population is necessary. Only then could the virus no longer spread well, said the WHO’s top vaccination expert, Katherine O’Brien.
In Germany, the willingness to vaccinate is high. According to a survey by Infratest dimap for the ARD-DeutschlandTrend, 37 percent definitely want to be vaccinated if a vaccine is available. 34 percent think it is likely that they will be vaccinated. On the other hand, 29 percent stated that they “probably not” or “definitely not at all” want to be vaccinated.
According to experts, a very quick return to life like before Corona is unlikely: Especially in the initial period after approval, vaccination rates will be rather low, so that measures such as hygiene and contact restrictions will likely be the order of the day for a while .
How long does it take to vaccinate people in Germany?
According to the Standing Vaccination Commission (Stiko) at the Robert Koch Institute, 100,000 vaccinations a day take 150 days to vaccinate 15 million people.
Matthias Schrappe, internist at the University of Cologne, has made a calculation based on 60,000 vaccinations per day. Then it would take around a thousand working days – i.e. four years – to vaccinate around 60 million people in Germany.
What other hurdles are there?
The international pharmaceutical association IFPMA warns against too great expectations. Many people think that the development of a vaccine is the critical development step, but in fact manufacturing is a challenge, said IFPMA Director General Thomas Cueni. Around 70 percent of the time in the manufacturing process is necessary for quality controls. “Some vaccines have 450 quality controls.” A possible shortage of glass vials for filling the vaccine could also influence the process.
Can a vaccinated person pass on the virus?
That is still unclear and of great importance. Because that would be problematic especially for the health sector. Findings so far suggest that the first vaccines to hit the market will at least prevent people from contracting Covid-19. According to experts, however, it cannot be ruled out that those who have been vaccinated will continue to be infected with the virus and pass it on to others unnoticed.
In particular, infections of the respiratory tract are difficult to completely block with vaccines, says Bodo Plachter, deputy director of the Institute for Virology at the teaching hospital of the University of Mainz. They would arguably help reduce the amount of virus circulating. “It may well be that the vaccinated people excrete fewer viruses, which slows the pandemic,” he says. “But it is a false assumption that vaccination alone will prevent the pandemic.”
How long does the vaccination last?
This is also unclear, as no long-term studies can yet be available that provide the corresponding answers. It is considered unlikely that a vaccine immunization against corona will last a lifetime. It could be more likely that you have to repeat it regularly, as with the flu vaccination. Even a Covid 19 illness that has been overcome may not protect against a renewed infection in the long term.
Will there be compulsory vaccination in Germany?
There should be no compulsory vaccination in Germany, as Health Minister Spahn has repeatedly emphasized. If compulsory vaccination is even considered – given a better knowledge of the vaccines – then, according to expert opinion, this may only take place on the basis of serious reasons and with a precisely defined group of people – for example people who are in constant contact with high-risk groups.