Germany should have led the world at handling the pandemic. But experts slam Merkels vaccine response as a disaster

The general practitioner says she has no idea how to get her vulnerable patients vaccinated after repeatedly lobbying for shots and repeatedly being turned down. "I am very concerned and I don't know who to turn to."

She voices the concerns of many -- that Germany's vaccination rollout is a bureaucratic nightmare with deadly consequences.

The country was applauded for its initial handling of the pandemic, thanks to widescale testing and its fast response to the outbreak. Despite a high number of reported cases, Germany's Covid-19 mortality rate remains low.

Part of the problem is that Germany has only been offering shots at specific vaccine centers and not at doctors' offices -- unlike in the United Kingdom, where local doctors have been vaccinating people for months, and where more than 30% of the population has received a first dose.

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Chancellor Angela Merkel has admitted to failings with the speed of the vaccine rollout and said Wednesday that doctors' offices should be able to vaccinate patients by the end of March.

Katzenstein notes there are around 50,000 general practitioners' offices in Germany and "it's a lot easier for patients to reach their own doctor."

The system for patients to book a vaccination slot at a center is complex, with numerous different processes in the country's 16 states. Katzenstein argues it's tricky for a 90-year-old to navigate the online system.

"I think we have a social obligation as a whole society being in lockdown. We need to do everything which is quick, pragmatic."

Germany has been in varying degrees of lockdown since November and this week restrictions were extended again until the end of March.

But internal logistics and bureaucracy are only part of the issue.

Factors at play

At the start of the pandemic last year, everything was in place for Merkel to handle it with success.

Germany -- a country with a global reputation for efficiency -- held the EU Council Presidency and in Ursula von der Leyen, a former German defense minister, it had an ally at the top of the European Commission.

When it came time to secure vaccines, Merkel insisted that the EU should focus on procuring shots as a bloc instead of Germany and other member states going it alone. But the EU's rollout has been slow and plagued by delays.

 

"Germany is the architect of the European failure because Germany and Merkel were behind pushing for the European process that was a failure from the beginning," Julian Reichelt, the managing editor of Germany's largest selling tabloid newspaper Bild, told CNN.

"She wanted to make it all about Europe and her being a great European," he says.

The day after, French President Emmanuel Macron described the AstraZeneca vaccine as "quasi-ineffective" in older people, saying "the first results are not encouraging for those over 60-65 years old." The claim was disputed by multiple scientists, and real-world data has since shown that the AstraZeneca vaccine is highly effective at preventing hospitalization in older populations.

The likes of France, Spain, Italy and the Nordic nations followed suit, limiting authorization of the vaccine to younger segments of the population. They are also now performing U-turns on their decisions.

The damage is done

The decision by STIKO to initially bar the use of AstraZeneca shots in older populations "really was a mistake" because it resulted in "everyone in Germany" losing confidence in the vaccine, said Dr. Uwe Janssens, head of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI).

Janssens understands why STIKO came to its initial conclusion, and said that if the call had gone the other way, there would have been criticism of that decision too. Either way, he said, "we didn't have enough vaccine from the beginning because of the consequences of the shopping tour from the European Union, because they didn't buy enough."

Tobias Kurth, a professor of public health and epidemiology and the director of the Institute of Public Health at the Charité university hospital in Berlin, described the German regulator's original decision as a "communications disaster."

A day after STIKO imposed an age cap on the AstraZeneca vaccine, the European Medicines Agency approved it for everyone over the age of 18. The World Health Organization followed suit on February 8.

"They have now corrected their recommendation finally, but now the disaster has already happened," Kurth told CNN. "People say they don't want to have the AstraZeneca stuff because it is really bad," and there's no way to correct them because "you can't get it out of people's heads."

There are currently around 1.3 million doses of the AstraZeneca sitting unused in storage in Germany, partly due to the fact elderly populations until now have not been allowed to take it. Some Germans also see the AstraZeneca vaccine as a lower quality shot, because of its slightly lower efficacy rates compared to other authorized vaccines.

CNN has contacted the German Ministry of Health for comment.

'Complaining about a candy'

Those running a vaccination center at Berlin Brandenburg airport, which administers both the Pfizer-BioNTech and the AstraZeneca vaccine, say early on barely anyone wanted AstraZeneca, but that is now changing.

"My impression and what the numbers tell us is that the acceptance of the AstraZeneca vaccine is rising. We can see that with the bookings. It started very slowly, but as of yesterday evening 80% of the available appointments have been taken," Christian Wehry, a spokesperson for the Association of Health Insurance Physicians Brandenburg said.

"I think people in Germany are just too spoiled. It reminds me of children playing on a playground, complaining about a candy, thinking they deserve another candy because someone tells them it's better," Thomas Buchhammer, a medical doctor, told CNN after he received his first dose of the AstraZeneca vaccine on Thursday at the vaccination site.

STIKO changed course and approved the AstraZeneca vaccine for over-65s, citing new data, on Thursday. It said in a statement that its previous recommendation on January 28 "was completely correct based on the data available at that time."

Meanwhile, Merkel -- speaking ahead of the STIKO statement -- announced Wednesday that the interval between administering first and second doses of Covid-19 vaccines would be stretched "to its maximum" in order to "vaccinate more people faster for the first vaccination."

The Chancellor said there would now be a 42-day gap for the second Pfizer shot and a 12-week one for the second shot of Oxford/AstraZeneca -- a move that is more in line with the UK's policy of administering second doses of both AstraZeneca and Pfizer towards the end of a 12-week gap.