35,000 family doctors start vaccinating

If you want to be vaccinated, you usually see your doctor. This is how it should now also start in the pandemic. But how exactly does it work when vaccines are initially still in short supply?

The corona vaccinations should now come across the board on a broad front - and the hopes for a breakthrough for more speed are high. After a lot of annoyance about scarce vaccination doses, shaky delivery schedules and complicated appointment bookings for the vaccination centers in the federal states, the nationwide network of practices is now up and running.

"Not a big step, but an important one"

And with it a well-established replenishment system via wholesalers and pharmacies. In the week after Easter, 35,000 family doctors want to get started. But it is a prelude with the handbrake on a little at first.

"On Wednesday, the vaccination will begin - finally, one has to say - in the practices," says the head of the National Association of Statutory Health Insurance Physicians (KBV), Andreas Gassen. "In addition to the 430 vaccination centers that we have so far, there are 35,000 more." It should be the official starting signal for the second phase of the "vaccination campaign", even if in some places the first practices are already involved.

However, there shouldn't be a spontaneous rush immediately after the holidays. Because in the first week, all practices together will initially receive 940,000 vaccine doses. In purely mathematical terms, that only makes a good 26 doses per practice.

"That won't be a big step yet, but an important one," said Federal Health Minister Jens Spahn (CDU). Because with the nationwide entry of the practices, the processes would now be discontinued in order to be able to increase the vaccination numbers significantly in a few weeks.

The orders

On Tuesdays until 12 noon, the practices can order vaccination doses from the pharmacies for the following week. Delivery is then Monday afternoon, as the KBV explains - due to Easter Monday now on Tuesday, Wednesday noon at the latest. Due to the shortage of vaccines, the order quantity is initially limited to 18 to 50 doses per week.

At the beginning it is also to be expected that less than has been ordered. However, the practices should receive notification by Thursday of what will come in the following week in order to possibly be able to reschedule vaccination appointments. This logistics system is "a strict regime", said the President of the Federal Association of German Pharmacists' Associations, Gabriele Regina Overwiening: "It will be reliable."

The extraditions

The vaccination doses are to be distributed nationwide by 110 wholesale branches that deliver to the 19,000 pharmacies several times a day anyway. The preparation from Biontech / Pfizer will be delivered “ultra-low-temperature” at minus 75 degrees, explained Marcus Freitag, Vice-Chairman of the Federal Association of Pharmaceutical Wholesalers.

Thawed and repackaged, the vaccine is then sent to pharmacies at 2 to 8 degrees Celsius. This is followed by the "final assembly" for the practices. Accessories such as syringes, cannulas and saline solution for diluting are always included. There is a key for the distribution, among other things depending on the population share of the countries.

The appointments

There is no central invitation, explains the Federal Ministry of Health. How they assign vaccination appointments can be regulated by the general practitioners themselves - for example by phone or with online bookings. "They know their patients best and will address them specifically and arrange a vaccination appointment with them or come home to non-mobile people," says KBV Vice-President Stephan Hofmeister with a view to the start.

This also serves to ensure that corona risk groups get their turn first. Because the general prioritization also applies in the practices, as the ministry emphasizes. However, doctors could decide more flexibly on site who is to be vaccinated and when, also in order to proceed more efficiently.

The vaccines

In the first two weeks of April, only the vaccine from Biontech / Pfizer should be used in the practices, as Spahn explained - because sufficient quantities are now available. From the week of April 19, Biontech and Astrazeneca will go to the practices, followed by the vaccines from Biontech, Astrazeneca and Johnson & Johnson. Choosing from the doctor which preparation you want to get is not possible for the time being because of the scarce vaccine, even in the practices, explains the Ministry of Health.

The costs

Doctors receive a fee of 20 euros for each corona vaccination, including information and advice. The practices can settle this via the statutory health insurance associations - regardless of whether they are for those with statutory or private insurance.

The federal government is assuming the costs and has initially budgeted up to 1.5 billion euros: parallel to increasing vaccine deliveries, an expected 100 million euros in April, then 650 million euros in May and 730 million euros in June, according to a proposal from the Ministry of Finance.

The documentation

Like the regional vaccination centers, the practices should also report data that the federally owned Robert Koch Institute (RKI) can use to track the vaccination process. However, only a "limited data set" has to be transmitted daily, as the KBV explains: the number of first and second vaccinations, broken down by vaccine, as well as the number of vaccinated over 60-year-olds.

It should be possible to record further data, such as the batch number, with quarterly invoices. The vaccinated get a sticker or note in the vaccination certificate, the doctors note it down as usual in the patient files.

The outlook

In the first weeks of April, around one million doses are planned for practices. In the week of April 26th, it should then go up to more than three million. In addition, the vaccination centers of the countries receive 2.25 million doses per week. The network can still grow, not just among the 50,000 general practitioners' practices.

With up to 87,000 vaccinating practices in general, the enormous potential to reach several million doses per week is shown, according to the KBV. Specialists, private doctors and company doctors are to be added later. “We have to vaccinate, vaccinate, vaccinate,” says Gassen, head of the health insurance company. "Every day counts so that society can return to its normal life."

You can also hear more about vaccination in the family doctor's practice in our podcast

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