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Will Germany follow UK example on vaccines?

February 28, 2021

Pressure is mounting on the German government to extend the gap between the first and second COVID vaccination and speed up the vaccination program. The move could potentially save up to 15,000 lives.

A worker at a vaccination center in Cologne next to a sign that reads "Fast Lane Vaccination"
Extending the interval between the first and second vaccine doses could massively speed up the vaccination rateImage: Oliver Berg/dpa/picture alliance

Stretching timing of second shot 'could save lives'

Germany is moving slowly with its coronavirus vaccination campaign. Shortages are partly to blame, but one simple change could massively speed up the vaccination rate.

To achieve that, the interval between the first and second doses of the mRNA vaccines (produced by BioNTech-Pfizer and Moderna) needs to be extended beyond the current 28 days, said Berlin-based pandemic researcher Dirk Brockmann. This would "mean that you no longer just put the second dose back in the fridge and wait."

In a recent study, the researcher from Berlin's Humboldt University calculated that this would result in "up to 10,000 or 15,000 fewer deaths" in Germany.

"We are now seeing the third wave, so this change could protect a lot more people in the high-risk groups from death and serious illness," he added.

Elderly people sitting in rows in a big hall, waiting for their turn
German octogenarians are eligible to get their inoculation in one of the large vaccination centersImage: Ina Fassbender/AFP/Getty Images

A new study by Brockmann, Michael Meyer-Hermann of the Helmholtz Center for Infection Research and other pandemic researchers looks at the likelihood that the new, more easily transmitted virus variants will also gain traction in Germany. If vaccinations were given twice as fast, said Brockmann, the effect could be enormous.

In fact, studies from Scotland, Israel, and the United States show that even the first vaccination provides significant protection.

"According to that data, there is complete protection against death from COVID in the risk groups after the first dose. That's a huge success," said Brockmann. 

UK vaccinating as fast as possible

Until now, Germany's independent vaccine advisory committee has followed the guidelines of the European Medicines Agency. According to its guidelines, there should be no more than three weeks between the first and second dose of the BioNTech-Pfizer vaccine for the vaccine to have an optimal effect.

But France's central health authority changed track on January 23, recommending a delay of up to 42 days between the first and second dose of the BioNTech-Pfizer vaccine. In the United Kingdom, the gap is as long as 90 days. As a result, more people have received the initial vaccination despite tight vaccine supplies.

"Under normal circumstances, you must adhere to the regulations. However, these are not normal circumstances," Robert Read of the UK Joint Committee on Vaccination and Immunisation told DW in January.

"We have to vaccinate as many people as we can, as quickly as we can, and it's our judgment that by doing this no harm will come to our population," he said. "The corollary of that is that if we don't do this, there will be considerable harm through lost opportunity."

Germany considers change of strategy

In the UK, up to 450,000 people were vaccinated each day this week; in Germany, that maximum daily number was 170,000. One-third of Brits have received their first vaccination so far — either the vaccine from AstraZeneca and Oxford University or the mRNA versions.

The UK success rate is not only due to the earlier start to its vaccination campaign in early December, but also due to the longer vaccination intervals with the novel mRNA vaccines, said Read.

Thomas Mertens, head of Germany's vaccine advisory committee, may now be considering a switch to the British strategy.

"I have no problems with agreeing to an extension, based on the new data," he told DW. "However, it would be a U-turn from the original regulation, which may cause legal problems." It's unclear whether that could affect manufacturers' liability. To date, the supply contracts between the European Commission and vaccine producers have not been made fully available to the public.

Mertens pointed out that since his commission made its vaccination recommendations in early January, more data on the new vaccines has been released.

"At the time of our recommendation, much less was known about the duration of immunity," he said. "Secondly, there was a fear that if you have a lot of partial immunity, you're going to get more pressure of selection and give the virus a chance to evolve."

But the virus is evolving anyway. In many EU countries, more contagious virus variants are taking over. Now the German vaccination commission is considering a delay of 60 or even 90 days between mRNA shots. The decision could come as early as March, possibly together with German recommendation for the vaccine from the manufacturer Johnson & Johnson, for which EU approval is expected soon.

Pressure for COVID restrictions to be eased

Quicker vaccination does not just mean saving lives — it also means easing restrictions on everyday lives. The new vaccination study by Brockmann and Meyer-Hermann, entitled "Potential benefits of delaying the second mRNA COVID-19 vaccine dose," is due to be published just before Chancellor Angela Merkel's next pandemic meeting with German state premiers on Wednesday.

Political pressure has been mounting to ease lockdown measures. The rate of new infections has remained more or less steady since mid-February, very likely because of more contagious virus mutations. 

Last week, the German government gave the go-ahead for the AstraZeneca vaccine to be used to vaccinate teachers. Brockmann has gone a step further, calling for the vaccine to be given to younger people as early as April, in an attempt to stem the spread of the contagious variants. The UK has already been vaccinating people over the age of 16 with preexisting conditions since February 15.

This article has been translated from German.