The majority of the German federal states are now starting to offer particularly vulnerable groups a booster vaccination against Covid-19. You are following a recommendation from the federal and state health ministers and are taking advantage of the new Corona Vaccination Ordinance, which came into force on Wednesday, September 1st. Some countries had already started vaccinating, which is why around 13,000 so-called booster injections have been administered so far. This was the result of a survey by the FAZ among the 16 federal states. According to calculations by the Central Institute for Statutory Health Insurance (ZI), 10 to 10.5 million refreshments can be expected by the end of the year, 3.14 million of them in the current month alone. After that, the number drops to 2.5 million in October and 1.4 million in November.

Christian Geinitz

Business correspondent in Berlin

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This also has to do with the fact that most countries want to close their vaccination centers at the end of September. From then on, the injections will mainly be given by resident doctors, company doctors, some vaccination teams and hospitals. Individual regions keep vaccination centers in "standby mode". A third vaccination, or, in the case of Johnson & Johnson, a second vaccination, is provided for people who were vaccinated at least six months ago, i.e. in March at the latest. The focus is on the elderly, those in need of care, those with previous illnesses and people with a weakened immune system. Vaccination is also an option for those who have recovered from Covid-19, as well as for those who have previously only received vector preparations from AstraZeneca or Johnson & Johnson.Booster vaccinations take place exclusively with the mRNA vaccines from BioNTech / Pfizer or Moderna.

There are concerns as to whether, in view of the low vaccination rates in other countries, it would not be necessary to first allow basic vaccinations there before one could think of third-party vaccinations in rich industrial countries such as Germany, France, Israel or the USA.

The European Center for Disease Prevention and Control (ECDC) said it saw "no urgent need" for refreshments in the general population.

However, they are recommended for people with a weakened immune system.

Priority must be given to serving people who have not yet been fully immunized.

Criticism of booster vaccinations

The World Health Organization (WHO) had previously asked rich countries to refrain from boosting as long as millions of people were waiting for their first vaccinations. The EU rejects such criticism. Internal Market Commissioner Thierry Breton said the community would need a maximum of 350 million cans for the refreshments. That is how much vaccine is produced in the EU in just one month.

In fact, there is much more vaccine available in Germany than is needed, so that donations abroad can grow despite the third-party vaccinations. With shipments plentiful and daily injections down from more than a million to just 240,000, there is far too much vaccine in the country. The federal states have already returned slow-moving goods to the federal government, and there is also the risk that the shelf life will expire. According to the Munich statistics service provider Analytic Services, there are currently 12.8 million units in stock, 7.5 million of them in vaccination centers and 3.5 million with general practitioners. 9 million of the excess doses are mRNA vaccines, 3.4 million of which are from Moderna. It is unclear what will happen to its deliveries when the vaccination centers close;So far there is no modern logistics to the practices.

It is entirely possible for the contract doctors to take over the refresher courses. In the fourth quarter of 2020, they got 13 million flu vaccinations, both in the practices and in the homes they care for. However, the ZI points out differences. The use of the single doses of the influenza active ingredient is much easier to handle and plan than that of the larger mRNA vials, which you order two weeks in advance and for which you always have to bring six patients together.

"The prerequisites for nationwide refreshments are not yet in place," criticizes ZI boss Dominik von Stillfried. The vaccination ordinance refers to a recommendation of the Standing Vaccination Commission STIKO, which is still missing: "This would now have to justify quickly for which age groups and for which risk factors a third vaccination is recommended so that the practices can call these patients." The STIKO recommendation is expected for next week. The National Association of Statutory Health Insurance Physicians and the German Medical Association also criticized the fact that it was not yet available.