Vaccines: Delivery shortages continue

Lisa Vogel studied departmental journalism with a focus on medicine and biosciences at Ansbach University and deepened her journalistic knowledge in the master's degree in multimedia information and communication. This was followed by a traineeship in the editorial team. Since September 2020 she has been writing as a freelance journalist for

More posts by Lisa Vogel All content is checked by medical journalists.

In addition to Covid-19, getting sick from other pathogens such as pneumococci can be particularly dangerous. In view of the upcoming autumn and winter months, this concern is increasing. Vaccinations are supposed to protect against other diseases. But what happens when vaccine doses are missing? Can the family doctor refuse to have a vaccination?

Coronavirus increases demand

Since the outbreak of the Sars-CoV-2 coronavirus, the demand for vaccinations such as the pneumococcal vaccination has increased significantly. Currently available vaccines do not protect against coronavirus infection. However, additional infections, for example with pneumococci or influenza viruses, can lead to significant complications with Covid-19. A vaccination could therefore at least partially protect.

What at first sounds logical and sensible can cause problems in practice: The high demand is draining the available resources. That is why a constant supply of vaccines is important. But precisely this can be difficult in Corona times with far-reaching restrictions in some places: If there is only one producer for an active ingredient and this is located in a lockdown area, deliveries to Germany will also be delayed - or they will not be available at all.

Vaccine is not enough

The result: the vaccine is no longer sufficient for everyone. It seems to be particularly critical at the moment with the pneumococcal vaccination. There were delivery problems as early as the middle of March this year. In June the situation eased a little: supplies came from Japan and England.

But the situation has hardly improved since then. “For the time being, Pneumovax23 is only available to a limited extent,” writes the Standing Vaccination Commission (STIKO) of the Robert Koch Institute (RKI). And even with vaccines still available, the question remains whether demand can be met in view of the upcoming cold season.

Pneumovax is the only vaccine that works against the most common and dangerous types of pneumococci. The polysaccharide vaccine (PPSV) contains the characteristic shell components of 23 different pneumococcal variants (PPSV23). It is approved for children from the age of two and, according to the Paul Ehrlich Institute, is sometimes only “available to a limited extent”.

Measures against vaccine shortages

This means that some people may have to forego immunization or have to wait longer for a vaccination appointment. In order to regulate who should receive the available vaccines, the STIKO issued a pneumococcal vaccination recommendation for the time of the vaccine shortage in March 2020.

"Such" emergency measures "take place in the context of considerations about a necessary prioritization," says STIKO chairman Professor Thomas Mertens to the political magazine "Report Mainz".

Prioritization necessary

Prioritization is necessary in order to be able to protect particularly vulnerable people with the vaccines that are still available. Because even without an accompanying Covid 19 disease, a pneumococcal infection can be life-threatening. The bacteria mainly cause pneumonia.

"Pneumococcal disease is a fundamentally fatal disease. If we can no longer protect these high-risk patients, more patients will become ill and more patients will die of pneumococci," says pulmonologist Tobias Welte from Hanover Medical School to "Report Mainz".

Preference for risk patients

People with an increased risk of developing severe pneumococci should therefore receive the available vaccine doses as a priority. In this case, this includes:

• Patients with an immunodeficiency or patients who have to suppress their immune system with medication (immunosuppression)
• People over 70 years of age (previously: over 60 years of age)
• Chronic heart disease patients
• Patients with chronic respiratory diseases

The family doctor could therefore initially turn away fellow citizens without an increased risk. This is fundamentally understandable: people outside of the risk groups usually get sick less severely and are often generally less susceptible. In addition, it is usually easier for them to follow infection control measures and thus prevent infection than older patients, for example, who are severely restricted in their mobility.

Are there any alternative vaccines?

There are two other vaccines on the market called Pneumococcal Conjugate Vaccines (PCV), PCV10 (approved for children up to five years of age) and PCV13 (for all ages). These vaccines are mainly used for primary immunization in children and form the first part of the sequential vaccination for immunocompromised and chronically ill patients (you can find out more about this in our article on pneumococcal vaccination).

There were also bottlenecks for these vaccines in the current year. Now they are fully available again, so that at least the basic immunization in children can be carried out completely in accordance with the usual STIKO recommendations. However, according to the RKI, these vaccines are not an alternative to the PPSV23 vaccine for adults. “Because of the broader coverage, Pneumovax23 cannot be replaced by another vaccine,” according to the RKI. On the one hand, doctors use PPSV23 for the standard vaccination of people over the age of 60, and on the other hand, this vaccine represents the end of the sequential vaccination.

Why are vaccinations important?

There is still no effective vaccine against the coronavirus. It is therefore important to use existing active ingredients to protect yourself against other pathogens that can attack the body and, in particular, the respiratory tract. High-risk patients in particular should protect themselves with pneumococcal and flu vaccinations.

This not only reduces the risk for the individual, but also relieves the burden on the health system.Because the vaccination can help prevent serious illnesses from influenza or pneumococci. This could ultimately also reduce the number of hospital patients. And this left more (intensive) beds free for Covid 19 patients. In addition, one of the most important cornerstones in the fight against infectious diseases is to comply with the necessary protective measures.

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