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interview Spontaneous vaccinations: why the phenomenon could get even bigger

MDR: The vaccination start in Saxony was quite bumpy - what is the current situation?

Kai Kranich: It's getting better and better, especially because we're now getting noticeably more vaccine. However, the issue of residue contamination remains difficult - i.e. the cans that are left over at the end of the day and are not allowed to go back into the refrigerator. The problem is with Biontech and Moderna vaccines.

At Biontech, for example, the vaccine is stored at minus 75 degrees, thawed in the central warehouse and can then be kept for five days. It is distributed from the central warehouse to the vaccination centers and then to the mobile vaccination teams. If, at the end of the day, it turns out that we need less vaccine than we thought, that is basically not a problem at first. Then the ampoules are simply put back in the refrigerator and used the next day. But if vaccination doses have actually been pulled out of an ampoule with syringes, then it becomes difficult. Because then the remaining vaccine doses have to be inoculated within a few hours.

Why are there any vaccine doses left over?

There are various reasons for this: With the Biontech vaccine, for example, six doses can be drawn out per ampoule. In reality, however, it is sometimes more or less. In addition, sometimes not so many appointments are made in a day that all ampoules are empty. It is a huge poker game every evening in the Saxon vaccination centers around the question: Do we have to open another ampoule or not? The problem could get even worse.

With the vaccine from Biontech we get around six vaccine doses from one ampoule, with the manufacturer Moderna it is ten doses. So if an ampoule is opened there, there are potentially more vaccine doses left. So we usually have to look for more people for spontaneous vaccinations.

What exactly happens if the ampoules are not completely empty in the evening?

There are lists in the vaccination centers that have been agreed with the Association of Statutory Health Insurance Physicians and with the municipalities. It is noted on it who belongs to priority vaccination group 1. Then the people are telephoned. This means an enormous amount of stress for the employees in the vaccination centers. To extrapolate: In Saxony there are 28 issuing offices for vaccines. There, on average, three Biontech vaccine doses can be left over per day. In total, in the past five weeks - since the vaccination centers started operating - around 3,000 vaccine doses had to be inoculated spontaneously. It's always a tightrope walk: on the one hand, do not throw away any vaccination doses, on the other hand, if possible, only vaccinate people with the highest priority. So far we've always succeeded - we didn't have to throw away any vaccine.

In the past few weeks there has been some severe criticism: In Saxony, almost 400 police officers were spontaneously vaccinated, even though they did not belong to the highest priority group. Has that changed anything?

Of course, because of the criticism, the attention is greater. We take this very seriously and now only give out the remaining doses to people in the critical infrastructure who also belong to priority group 1. In any case, this increases the pressure on employees: on the one hand, often finding people willing to vaccinate late in the evening and then waiting until the people have arrived. A lot of overtime has already been accumulated. The Federal Ministry of Health recently made it possible for people from priority group 2 to be vaccinated in an emergency. We have agreed that at that moment only the heads of the vaccination centers can make this decision. But we try not to use that.