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AstraZeneca COVID vaccine remains unpopular in Germany

February 20, 2021

In Germany, everyone who wants a coronavirus vaccine should receive one by September. But this plan will only work if millions of people accept the vaccine produced by AstraZeneca.

Packaged AstraZeneca vaccine vials
Many Germans have reservations about the AstraZeneca vaccineImage: Stephane Mahe/REUTERS

Six security guards are standing on the wide, empty road leading to the disused Tegel Airport in Berlin. Their yellow high-visibility vests are glowing in the sun. The men are guarding the entrance to a coronavirus vaccination center, which has been set up in what was once Terminal C of the airport.

They don't have much to do. Between three and five vaccination candidates arrive every hour, a guard says when asked. "That's all."

At Tegel, only the vaccine produced by the British-Swedish pharmaceutical company AstraZeneca is available. Because of a lack of studies into its effects on older people, the vaccine has been approved in Germany for people younger than 65. In this age group, vaccinations are currently only available for people with underlying health conditions and members of groups with an increased risk of infection because of their occupations.

AstraZeneca remains on the shelves

Doctors, nurses and other medical staff often reject AstraZeneca because the vaccine is believed to be less effective against the coronavirus mutations than the mRNA vaccines from BioNTech-Pfizer and Moderna. Nationwide, only 87,000 of the 736,800 AstraZeneca vaccine doses delivered to date have been used, according to Germany's disease agency, the Robert Koch Institute (RKI).

The sound of an engine disturbs the peace in front of the vaccination center. A shuttle bus approaches and drops off three young women, medical assistants who work in a Berlin doctor's office.

"I was skeptical about getting vaccinated with AstraZeneca," says one of the women, who has to show the security guards her invitation to get a vaccine and her appointment confirmation. She says her boss then provided her with comprehensive information and also referred to the positive opinion of Berlin-based virologist Christian Drosten.

"That convinced me," she explains, before boarding the shuttle bus that will take her to the vaccination center.

Sign at the entrance to Tegel airport reading "Corona vaccination center Berlin"
Terminal C of Berlin's disused Tegel airport has been turned into a vaccination centerImage: Sabine Kinkartz/DW

Poor communication

AstraZeneca is far better than its reputation, Drosten explained in a recent episode of his podcast "Coronavirus Update." He believes there has been a lot of misunderstanding and communication problems surrounding the vaccine.

Politicians such as health expert Kordula Schulz-Asche from the Greens have a similar view. The skepticism among the population is due to "really disastrous communication," Schulz-Asche told German daily newspaper Die Welt. Too little has been explained, and "horror stories" about the effectiveness of the vaccine are running rampant.

"To say that the AstraZeneca vaccine is second rate is completely off the mark, both scientifically and in terms of actual effects," Carsten Watzl of the German Society for Immunology said in an interview with the Augsburger Allgemeine Zeitung newspaper. To improve acceptance of the vaccine, he suggested that those who receive AstraZeneca doses should be guaranteed a second shot with a different active ingredient.

"You can boost the immunity you triggered with the AstraZeneca vaccine again later with an mRNA vaccine without that causing any problems," he wrote.

Christian Drosten
Virologist Christian Drosten has said concerns about the ineffectiveness of AstraZeneca's vaccine are unfoundedImage: Britta Pedersen/dpa/picture alliance

Berlin abolishes freedom of choice

Klaus Reinhardt, president of the German Medical Association, has emphasized that AstraZeneca's vaccine prevents severe or fatal cases of COVID-19 "with similarly high efficacy" as those from BioNTech or Moderna. For physicians and nurses younger than 65 to insist on getting other vaccines is "inappropriate," he said. Those should be reserved for the elderly, given the overall vaccine shortage.

Until now, Berlin has been the only German state where people could choose their vaccine. But that has now changed.

"There is no freedom of choice about AstraZeneca," Dilek Kalayci, Berlin's top health official, said Wednesday. Different vaccines would still be issued in different vaccination centers, but people under 65 have no choice about which one they receive, she explained.

Kalayci's decision came after a recommendation by the commission on vaccination at the RKI. According to the institute, vaccines that are recommended only for people between 18 and 65 years of age should also be used "primarily" for these groups of people. However, this recommendation alone is unlikely to dispel skepticism about the British-Swedish vaccine and could lead to younger people being reluctant to be vaccinated at all.

Doctors also explain that side-effects such as headaches and aching limbs or even fever are not uncommon after a COVID vaccination. In younger people, side effects occur more frequently because the immune system is still more active and reacts more aggressively to any vaccination than in older people.

Can the vaccination schedule still be maintained?

Meanwhile, the German Central Institute for Statutory Health Insurance (ZI) is concerned that reservations about the AstraZeneca vaccine could considerably set back the vaccination schedule in Germany. Currently, the federal government expects that everyone who wants will be able to get a vaccination offer by the end of September. The ZI calculates that this schedule could be pushed back by up to two months if AstraZeneca's vaccine is not more widely accepted.

Meanwhile, in front of Berlin's Tegel vaccination center, the shuttle bus taking the three medical assistants to their appointment has left. A second bus appears on the other side of the street, bringing two people back who have already been vaccinated.

The driver gets out, stands in the sun and lights a cigarette. He has time to spare. There are no new passengers with vaccine appointments in sight.

This article has been translated from German.