AEven if more than 200 candidates are currently being developed for a vaccine to protect against Covid-19 and are already in the third phase of testing, there will by no means be enough vaccine doses available immediately after approval. Federal Health Minister Jens Spahn (CDU) has therefore asked the German Ethics Council, the National Academy of Sciences Leopoldina and the Standing Vaccination Commission (Stiko) to develop a distribution plan for the vaccines, which may be available in limited numbers as early as the beginning of 2021.
Political correspondent in Berlin, responsible for the “educational worlds”.
In a joint guideline for a vaccination recommendation, which was presented on Monday in Berlin, it is stated that the prioritization must follow medical, ethical and legal principles. These should be presented to the population in an understandable form. The self-determined vaccination decision requires continuous transparent information and education of the population about the effectiveness of the vaccination and possible risks. In order to recognize such vaccination risks in good time and to reduce them, there must be a system for the rapid recording and evaluation of undesirable side effects.
Vaccinations should be given in centers
It is still unclear how pronounced and how long immunity lasts after surviving Covid-19 disease, which factors favor it and whether the immunity acquired through an infection differs from that after a vaccination. According to the current state of knowledge, the vaccination will be necessary in two doses with a minimum interval of three to four weeks.
In the opinion of all three committees, in order to make prioritization legally secure, there must be a legal basis. The Infection Protection Act and the Basic Law contain only brief statements on distribution. Evidence-based justifications must be made transparent and justified, otherwise the preferential treatment of certain groups of people cannot be justified, according to the guideline, which calls for justice and equality of rights. It should not be family doctors who are responsible for vaccination, but state-mandated vaccination centers (e.g. health authorities or similar institutions). Above all, Leopoldina, Stiko and the Ethics Council hope that the prioritization will not be undermined.
The guiding principle for vaccine distribution should be to prevent severe Covid-19 courses and deaths (age or cognitive impairments alone do not make a person a high-risk patient). The residents of nursing homes and other long-term care facilities should be vaccinated just as much as people who, due to their age or previous health condition, have a significantly higher risk of serious or fatal disease.
The second group named are those working in the health system who have to expose themselves to the virus through regular contact with patients. This includes employees in inpatient or outpatient facilities for health care and care for the elderly. Thirdly, the guideline defines the employees of the health authorities, the police and security authorities, the fire brigade, teachers and educators, as well as all those who have contact with potentially infected people, as particularly sensitive groups.
Before the end of the year, Stiko will present a matrix based on scientific data in which the initially named groups of people will be more precisely hierarchized.
All three institutions consider it extremely important to inform the population well and transparently, taking into account different levels of education and communication difficulties. If there is positive evidence about the safety and effectiveness of a vaccine, it should also be promoted through social media.
The Federal Center for Health Education and the Federal Ministry of Health could take on a central part of the information. There is an urgent warning against neglecting the hygiene rules after vaccination. “The availability of vaccines does not replace prevention through hygiene measures”, especially since the vaccination rates will be very low at the beginning, according to the paper.