Strategy paper on medical practices: Germany must be able to vaccinate masses in April

According to internal calculations by the Federal Ministry of Health, the number of vaccine deliveries already exceeded the vaccine capacities in April. Jens Spahn's house is working flat out to include the doctor's offices. But there are still questions unanswered.

Now the pressure is in the kettle: "In most countries the number of available vaccine doses will already exceed the maximum capacities reported by the countries in the vaccination centers in April," states the Federal Ministry of Health (BMG) in a proposal for the further development of the national vaccination strategy. The ministry draft dated March 1st has been submitted to the editors of RTL and ntv. It says nothing less than: In four weeks the country must be able to vaccinate masses. But there are serious doubts about this.

By the end of the first week of March, the ministry expects the delivery of 11 million vaccine doses, 6 million of which have so far been injected for first and second vaccinations. That means: by Friday there are almost as many cans in pharmaceutical refrigerators as Germany managed to squirt within eleven weeks. Many of these doses are withheld for a second vaccination. But according to calculations by the Central Institute for Statutory Health Insurance in Germany, the backlog of around 680,000 vaccine doses a week ago.

Deliveries will be made in the second quarter

"The vaccination campaign must now gain significant momentum," state the BMG authors. The number of vaccinations actually carried out in the vaccination centers and by the mobile vaccination teams of the countries per week must "be doubled as promised," it said. That alone is a challenge, especially since the vaccination of the elderly is becoming more fragmented with the completion of the vaccination in the old people's homes.

But how to proceed from April is the real sticking point: Five vaccine manufacturers want to deliver vaccine for 76.9 million immunizations in April, May and June – provided that the substances from Curevac and Johnson & Johnson are likely to be approved. The 170,000 daily vaccination appointments that Germany currently manages are not even close. The National Association of Statutory Health Insurance Physicians (KBV) estimates that a maximum of 2.1 million vaccinations per week are feasible with the existing structures.

Vaccination prescription in the second week of March

Accordingly, Spahn's ministry plans to no longer rely solely on vaccination centers and mobile vaccination teams from April onwards: then the doctors in private practice should also be involved; In addition to general practitioners, this could theoretically also be gynecological or ENT practices. Who and how exactly should determine a vaccination ordinance planned for the coming week. According to the paper, since the beginning of the year the ministry has been negotiating with the National Association of Statutory Health Insurance Physicians, pharmacy associations and pharmaceutical wholesalers about the remuneration and distribution of the vaccine and its accessories. Two months later there are obviously still unanswered questions.

The question of the allocation of appointments remains unaddressed in the paper: The order of prioritization should be maintained and the respective doctor independently decide whether it is actually a turn of a patient who wishes to be vaccinated. So the doctors have to have a large number of additional appointments, as well as the uncomfortable conversation about whether someone is sufficiently ill for the second or third priority group.

Hurdle: billing and documentation

Dominik Graf von Stillfried, CEO of the Central Institute for Statutory Health Insurance, still considers a million vaccinations a day to be possible: "We will achieve that one million if 50,000 medical practices across Germany take part in the vaccination campaign and each one manages an average of 20 vaccinations a day," he said in conversation with ntv.de. The problem: According to Stillfried, a practice has to spend three hours for 20 vaccinations. The effort also stems from the necessary billing of the services provided and the digital documentation of the vaccinations.

The chairman of the board of the National Association of Statutory Health Insurance Physicians, Andreas Gassen, therefore warned last week of additional bureaucracy and recommended a more flexible handling of the vaccination sequence: "Prioritization has so far been strictly medically planned, without reference to the actual vaccine volume," explained Gassen. "As soon as the vaccine arrives at the doctor's office in large quantities, this prioritization will quickly become subordinate."

Last week the KBV and the Central Institute presented a model calculation of how the greatest possible vaccination capacity can be achieved and made corresponding proposals to the Federal Ministry of Health, for example for billing and vaccine delivery. It remains to be seen whether this will lead to easier handling in practices by the coming week, when the BMG's vaccination ordinance is due. However, those responsible around Minister Spahn hardly have time to postpone a solution. In the second quarter, the blame for a sluggish vaccination campaign will not be again put on the vaccine manufacturers or the EU.

. (tagsToTranslate) Politics (t) Jens Spahn (t) Federal Ministry of Health (t) Corona vaccine (t) Doctors