Why this year the flu vaccine is so scarce

An influenza vaccine can still be useful, advises the Robert Koch Institute. But the vaccine is scarce in many places.
There have been delivery bottlenecks since October. The authorities are trying to remedy the bottlenecks with imports from abroad or pharmacies’ file-sharing networks, with limited success.
Presumably, more Germans want to be vaccinated this winter than in the previous season. Also, doctors ordered a somewhat hesitant vaccine.

In October, Health Minister Jens Spahn announced that the vaccination against flu was too low. Now the influenza season is in full swing, with more than 4,000 laboratory-confirmed flu cases this week alone, with an upward trend. The prospect of keeping the bed for weeks with fever, coughing and body aches drives many latecomers to vaccinate in the doctor’s office.

There, however, she often expects a disappointment. Many doctors and pharmacies ran out of the vaccine. Some doctors complain that no vaccine has been available for months. Others had already “vaccinated” their doses in November. According to the Bavarian State Office for Health and Food Safety, “larger amounts of vaccine from other European countries are available for the German market.” In a branch in the city center of Munich, it is said that one could perhaps order vaccine from Spain – when it comes, but it is not clear.

The vaccine has been scarce for months

“At this time of year, it is normal for the vaccine to be in short supply,” explains a spokeswoman for the Paul Ehrlich Institute (PEI), the Federal Institute for Vaccines. Rar, the substance is already longer: Some patients are since December at their family doctors on the waiting list. After the medication, the immune system takes about two weeks to build up protection. It is therefore recommended to be vaccinated between September and December. In Thuringia, the vaccine ordered for about 20,000 people was missing in December. Also in Berlin, Schleswig-Holstein and other federal states there were bottlenecks. At the end of 2018, the Bavarian Association of Statutory Health Insurance Physicians estimated that there was a “factor 10” gap between demand and supply. On 23 November, the Federal Ministry of Health officially stated a supply shortage.

For years, a lot of money and effort has been made to motivate Germans to vaccinate against influenza – for example, from the Federal Center for Health Education with the campaign “We’ll get the flu first.” But things seem to have gone wrong this season. How come?

From the WHO to the family practice

Every year in February, the World Health Organization predicts which flu strains rage in the next season. Influenza viruses mutate rapidly, so the vaccine is different every year. In the spring, family doctors report their needs for the upcoming season – mostly based on the number of patients who were vaccinated last winter. The production of the vaccine takes several months, so manufacturers can not provide additional funds in the current season.

The Joint Federal Committee of Doctors and Health Insurance recommended this season binding the quadruple vaccine for all patients, making him thus to the cash benefit – but only in April. At the time of the pre-order, there was uncertainty among many doctors as to whether or not health insurances would take over the expenses, and they, therefore, ordered hesitantly. “The vaccine does not last long,” explains a spokeswoman for the Bavarian Pharmacists Association. “If you order too much, you have to throw it away.” Last winter, three million vaccine doses were left over. This season, the Paul Ehrlich Institute has released 15.7 million cans, a million more than last year. Although there are no official figures, presumably this season could be vaccinated significantly more people. Also, the vaccine was unevenly distributed according to PEI. While some regions have been immunized since September, others have not yet received a vaccine. Delivery delays contributed to regional bottlenecks.

Supplies from France and Switzerland

The Federal Ministry of Health, therefore, facilitated imports in November, for example from France or Switzerland. Also, exchanges were created for medical practices and pharmacies. Excess funds should be quickly passed on. However, only ten pharmacies are currently registered in the Bavarian pharmacy exchange, with barely enough funding for three hundred people. Even foreign countries can partially cover the vaccination needs of the Germans. According to the Association of Statutory Health Insurance Physicians “smaller and smaller doses could be procured again and again.” But the district chairman of the Bavarian Pharmacy Association Peter Sandmann, says: “That one ordered does not mean that you get it.”

How can such chaos be prevented? The PEI emphasizes the importance of accurate pre-orders from GPs. But this winter, many were surprised by the Germans’ willingness to vaccinate. The Association of Statutory Health Insurance Physicians in Bavaria, on the other hand, sees politics and manufacturers as responsible. It is essential that such bottlenecks no longer occur to maintain vaccination motivation. “Anyone who wants to be vaccinated should be able to do that,” says Birgit Grain, a spokeswoman for KVB. Currently, for patients with vaccination, only the option of phoning practices in search of the last vaccine remains.


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