Vaccinations are the new solidarity

With the coronavirus it is a bit like in the story of the hare and hedgehog: Whenever the hare runs off to catch the hedgehog, it is already there. This is the case with our rapporteurs in a similar way: what still appears to be very topical today in the pandemic will be overtaken by other news tomorrow. So while the dispute over responsibility for the slow start of vaccination is still raging in this country, two virus mutations are spreading on our continent, which initially occurred in Great Britain and South Africa.

Despite all the lockdown measures taken since November, infection rates and death rates have continued to rise. In particular, the elderly are affected again, who, according to the Robert Koch Institute, make up half of the fatalities and focus on the control strategy in the homes. Like a menetekel, the mutant points to the coming months, i.e. the phase in which it was believed that the pandemic could be managed.

While the dispute over responsibility for the slow start of the vaccination campaign has not yet been resolved, the political soup that some politicians are currently cooking is likely to get cold if, as predicted, the virus becomes more aggressive and spreads 40 to 60 percent more widely.

However, questions remain: has the EU Commission done the wrong thing to stop buying vaccines or securing options and to spread the risk, as was all too often spread after a post in the Mirror? In contrast to the USA, Canada and Switzerland, for example, has it secured far too few vaccines from Biontech/Pfizer – out of consideration for suppliers, for cost reasons or because it was suspicious of the new gene-based vaccines? Should it have had an emergency authorisation at the cost of security, as in the United States, Israel or the United Kingdom, which could therefore start vaccination weeks earlier? Or should Health Minister Jens Spahn, when it was foreseeable from August that Biontech would be the first to reach the finish line in this run, have cut out of European solidarity and gone on a shopping spree on his own in order to provide the best possible care for its own population?

Chaos in the federal states

What is certain is that there were too few doses of vaccine available for the start of vaccination in the Federal Republic of Germany, which is also due to the fact that Pfizer had estimated its potential production capacity and had to reduce production from 100 to 50 million. The truth is, however, that most of the Länder responsible for carrying out vaccinations did not give a good figure. What Spahn euphemistically described as “jerking” offered the image of organizational chaos: non-functioning or overloaded hotlines, a non-transparent invitation policy that confused and overwhelmed the eligible elderly, unclear responsibilities, sluggish construction and equipping of vaccination centers. It repeated what was already observed in the summer with regard to schools: sitting out on a federal patchwork rug, through whose patchwork hems threaten to drop the people threatened by Covid-19.

The situation was exacerbated by Biontech’s sophisticated vaccine, which has to be stored at minus 70 degrees and places high demands on transport and storage. It was reported that already thawed doses of vaccine had to be destroyed because they were not properly treated or there was a lack of staff or vaccines. A major reason for the suboptimal start of vaccination, however, is probably that the health boards, which were once responsible for vaccination, have been so thinned out in terms of personnel over the past 20 years as part of an irresponsible austerity policy that they can no longer even carry out infection tracking. A third of all jobs have been lost by the NHS in the past two decades. Ute Teichert, chairwoman of the Federal Association of Doctors of the Public Health Service, sees this as a decisive reason for the currently unoptimistic vaccination situation. But even if the start of vaccination had gone well, some scientists do not believe that long-range vaccination would change the situation quickly. At the end of December, for example, Helmut Fickenscher, an infectious medicine physician from Kiel, was already convinced that no significant relaxations would be possible even if the vaccine was sufficient.

Vaccines for the Global North

The on-defensive health minister is now repeating prayerfully that he has followed the European solidarity that politicians are so fond of calling for in Sunday speeches when it came to obtaining vaccines. Indeed, the EU’s vaccine deal is one of the rare actions in which the Community has also brought on board those countries that are economically unable to compete in the highly competitive market. However, the fact that the EU has only accepted orders on demand, which are then to be paid by the countries themselves, instead of simply taking money in their hands to supply the 450 million EU citizens in total, may have been a reason to shift to the cheaper vaccines, which is why Biontech has ordered comparatively little. A dose of Biontech’s vaccine currently costs around twelve euros, with the British-Swedish group AstraZeneca only charged around two euros.

In any case, it is thanks to EU purchasing that even poorer countries such as Greece or Bulgaria and Romania get some of the life-saving stuff. However, this EU nationalism, if you may call it that, shows little solidarity in some countries. In Greece, for example, the first batch of vaccines that arrived in the country was first and with a lot of media noise vaccinated to the political celebrity, instead of giving it to the highly elderly first, as in other countries.

Globally, the “people’s vaccine” that UN Secretary-General Antonio Guterres hoped for in September, and which, through the International Vaccine Alliance Covax, was also intended to benefit the countries of the global South, is, in any case, dream rather than reality. Meanwhile, rich nations, which make up only 13 percent of the world’s population, have secured more than half of the vaccines expected to be available in 2021. African countries, in particular, are laggitly behind: only one in 13 of the 1.3 billion Africans can hope for vaccination protection. Duke University’s Global Health Innovations Center has calculated that it won’t be enough vaccine to protect the world’s population from Covid-19 until 2024.

More rights for vaccinated people?

In this country, politicians are confronted, on the one hand, with the unsurprising viral mutation, the spread and effects on the disease, and on the other hand, the restrained willingness of medical personnel to vaccinate. This is not good publicity for the vaccination campaign. That is why the Bavarian Prime Minister Markus Söder brought back into play in mid-January a vaccination obligation for nursing staff, even though the political leaders had always rejected this and now judge it as unhelpful: “To speculate at the moment about a vaccination obligation is forbidden,” said Minister of Labour Hubertus Heil (SPD) to the colleagues from Bavaria. Like many others, this advance is part of Söder’s profiling repertoire, which has been staging itself as an “iron hand” since the beginning of the pandemic. But Söder’s initiative also highlights the rising level of panic among politicians who no longer ask for reasons – such as the fear of previously unknown long-term consequences of the vaccine – but govern more and more authoritarianly and by regulation.

Thus, the only hope in the “second pandemic”, as SPD health expert Karl Lauterbach first called it in mid-January, rests exclusively on the vaccines. However, it is not yet known whether the vaccinated can still pass on the virus and whether the vaccines have a lasting effect against the mutation variants. But once the elderly are cared for and younger people are increasingly able to benefit from the vaccination, a discussion will flare up again – especially in the face of a tougher lockdown – which could only be swept under the carpet in December and which recently re-ignited Foreign Minister Heiko Maas: Are vaccinated, as far as can be proven no longer contagious, to expect restrictions on fundamental rights, even though they do not pose a danger? Why not use transportation, attend concerts or cinemas or go to the restaurant? And conversely, organizers reopen their doors specifically for this group, not least in order to survive the crisis economically?

“We are fighting the crisis together and we will overcome it together,” the health minister had issued the slogan in December in the debate on “exclusive rights”. He received a lot of applause for that. But just as global and EU-wide solidarity is beginning to become fragile as the pandemic progresses, so it will be difficult to keep the vaccinated sections of the population at bay. The constitutional lawyer Steffen Augsberg, a member of the German Ethics Council, is not the only lawyer who expresses concerns: “If vaccination means immunization and non-infectivity, then the basic justification for state measures is no longer applicable to vaccinated people.”

So it could be that vaccinated citizens go to the courts to claim their fundamental rights – with an open outcome. But then we would also be with the “multi-class society” in this respect, in which Augsberg already sees us in the pandemic long ago. Even those who can only use their own study for the home office know what they are talking about.

Compulsory licenses for vaccine development?

Another debate could also be fueled by the political left. In order to expand the vaccine capacities, health expert Achim Kessler from the Left Party called on the Minister of Health to force Biontech to issue licenses under the Infection Protection Act in order to enable the rapid post-production" of the vaccine, otherwise the federal government would endanger “countless lives”. Protect the help he received, of all things, of FDP-Chef Christian Lindner, who demanded a “crisis of production”.

In the case of Biontech, compulsory licences seem justified simply because the German state has contributed 375 million euros to research and development of the vaccine. In the case of Curevac, the state even holds a direct stake, which has earned it 1.6 billion euros so far. The current shortage situation would therefore be quite a case described in section 13 of the Patent Act and in section 5 of the Infection Protection Act, in which an invention can be used “in the interest of public welfare”. Biontech has so far refused licenses and is limited to producing cooperation partners who do not infringe patent secrecy, or to new production facilities such as the plant in Marburg acquired by Novartis. The Swedish-British group AstraZeneca, on the other hand, has voluntarily granted a license to the world’s largest vaccine manufacturer Serum Institute of India in Pune. Pfizer’s" spontaneous " failure to deliver in January also reveals its sensitive dependence on industry.

So the pandemic is testing justice in many ways – whether it’s the global or domestic distribution of the vaccine, the material and health benefits that come from it, or the circumstances in which people have to live during the lockdown. The solidarity that was so celebrated in the beginning is now lying on the bed of national, entrepreneurial, political and private egoisms. Whether she will survive this has yet to be seen.