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It is one of the most pressing questions when it comes to corona vaccine distribution: Who's turn and when?
Because the first batches will not be enough for all Germans, the federal government has to set priorities.
But no sooner have the Standing Vaccination Commission (Stiko) of the Robert Koch Institute and the Federal Ministry of Health presented a plan before a dispute develops.
Namely among the individual professional groups.
As early as the beginning of December protests came from the general practitioners.
That some of the colleagues were placed on the level with only a “moderate risk of exposure” was “bizarre”, said Dirk Heinrich, the chairman of the Virchow Association, who represents the resident doctors in Germany.
"You share this classification with the cleaning staff in clinics and practices," said the head of the association for comparison.
This statement caused great annoyance among the building cleaners.
The statement was "hard to beat in arrogance and arrogance," it said in a letter to Heinrich a few days ago.
The letter, which the professional guild of the building cleaning trade wrote in rare agreement with the IG Bau trade union, is available to WELT.
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“We cannot see what is supposed to be bizarre about it,” it continues.
The employees did important work in clinics, homes and practices.
“They expose themselves to very high dangers every day without having an academic education.” The statement of the doctors is more suitable as an admission for a satirical magazine than for a reasonable statement, write the employers' association and the union.
Specialists only in the third vaccination group
On Friday, Federal Health Minister Jens Spahn (CDU) signed an ordinance that regulates the sequence of corona vaccinations.
“The highest priority” is given to everyone over the age of 80, people in inpatient care and health facilities as well as people in medical facilities who are exposed to a particularly high risk, for example in intensive care units.
Those over 70, as well as general practitioners, but also employees of the public health service follow with “high priority”.
Only in a third step it is the turn of people over 60 years of age and people who work in medical facilities with a low risk of infection, such as in specialist practices.
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Pharmacists, government workers and teachers also belong to this level.
In his ordinance, Health Minister Spahn was based on a recommendation by Stiko, which the experts published last week.
This provided for five different priority groups instead of the current three from the current regulation.
"Further develop prioritization"
At the German Trade Union Confederation (DGB), the discussions about a ranking for vaccines are not seen at the end.
“Focusing on the vulnerable groups and the employees who care for them first is spot on, given the limited amount of the vaccine,” says DGB board member Anja Piel.
"However, after the first vaccination runs, the legislature must continuously develop the prioritization of areas and professional groups and adapt the vaccination strategy so that, if necessary, employees in areas of general interest can also be immunized that were not initially classified as a priority."
In order not to be left behind, some representatives advertise vigorously to high-ranking decision-makers.
The German Fire Brigade Association was also dissatisfied with the original classification of its employees.
“The work of the fire brigade, which is always characterized by dangers, is of particular relevance to the system and is the backbone of danger prevention in Germany,” said the association's vice-president, Hermann Schreck.
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He recently described his concerns in a letter to Federal Health Minister Spahn.
In its recommendation, the Stiko had assigned fire fighters to the “slightly increased risk group”.
In the vaccination ordinance of the Federal Minister of Health, they are on the same level as educators, waste disposers and employees in the food retail sector.
Of course, the association shares the view that the vulnerable groups should quickly receive vaccination protection.
In an immediately following step, however, the authorities and organizations with security tasks should urgently have their turn.
"In the area of rescue services, patient transport and technical assistance in particular, direct contact with people cannot be prevented despite protective equipment and specific deployment concepts," says Schreck, explaining his concern.
Is the vaccine patch carpet threatening?
The fire brigades are now demanding that the federal states disregard the proposed priorities during implementation.
"The association strongly suggests a modified application in the federal states," it says in a statement.
According to the Infection Protection Act, the highest state health authorities are responsible for making public recommendations, the association clarifies.
"Again we have the problem that there is no uniform line for the Federal Republic, but that the states themselves decide on implementation," criticized Christiane Woopen, medical ethicist and chairman of the European Ethics Council.
"The fact that individual associations are now lobbying for their employees is understandable, but problematic."
The so-called systemic relevance of an industry is not a sufficient argument to be prioritized in vaccine distribution.
One must also take into account how well the employees working in the industry can be protected in other ways, for example with protective equipment or quick test options.
"We are dealing with a mix of different possible goals," says Woopen - namely: preventing serious and fatal courses for many individuals, preventing the virus from spreading with a view to public health, and social with a view to society To alleviate burdens.
“It is difficult to achieve these goals all at the same time,” says the medical ethicist.
Will there be a wave of vaccine lawsuits?
Precisely for this reason, from the point of view of the expert, a law would have been needed to regulate the distribution.
"The involvement of the legislature would have provided more clarity and perhaps more confidence in the public," said Woopen.
The current decision is based only on an ordinance by the Federal Minister of Health.
The Bundestag's Scientific Service also criticizes this.
"The prevailing view, according to which the prioritization of certain population groups with regard to access to vaccines requires a formal law, is to be accepted," says a report that was recently published.
This must at least regulate the essential criteria for the distribution of a scarce vaccine.
A participation of the Bundestag would also have brought more legal certainty.
In contrast to a ministerial ordinance, a law has a special final power and could only be collected by the constitutional court.
Medical ethicist Woopen believes that there will now be lawsuits over preferential access to the vaccine.
"I think that's quite likely," said Woopen.
After all, the courts have been in continuous operation for months of the pandemic.
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Previous vaccinations with the help of a lawyer?
This is likely to put those who do not have the money to enforce law at a disadvantage.
Even now, the socially disadvantaged people in particular are suffering from the consequences of the corona pandemic, said Woopen.
"You are not only more affected by pandemic-related income losses, but often also have a higher risk of severe corona courses due to previous illnesses."
However, it still seems unclear whether the dispute between the building cleaners and the resident doctors will go into the next round.
A reaction from the doctors remains to be seen.
Organization is a matter of the country - this is how vaccination will work
In Germany, the corona vaccinations will most likely start this year.
Since vaccination doses are limited at the beginning, many wonder how vaccinations are organized.
And that is exactly what each federal state decides for itself.
Source: WELT / Achim Unser