Vaccination in times of Corona
There is still no vaccine against the Sars-CoV-2 virus. At risk groups such as the elderly, however, immunization against other diseases can help protect against superinfection
What does the corona pandemic mean for vaccination? There is still no immunization against the new virus itself. The Robert Koch Institute (RKI) does not expect a vaccine until the beginning of next year - and then not directly for everyone. It is important to maintain a good general state of health in the population in order to relieve the health system, according to the RKI. A comprehensive vaccination protection according to the recommendations of the Standing Vaccination Commission (STIKO) could contribute to this.
FLU: The main risk groups for Covid-19 and Influenza are congruent: Older people over 60 and patients with underlying diseases are particularly at risk. The STIKO therefore particularly recommends the flu vaccination for these groups this year. There was little interest in this in the 2018/19 season. According to the RKI, only around a third of seniors (35 percent) were immunized. In people with chronic underlying diseases, it was a fifth to a half.
In addition, there is a vaccination recommendation for medical staff in hospitals, care and senior facilities and in the health sector, as well as for pregnant women and residents of retirement or nursing homes. If all of these groups want a vaccination, that would be around 40 million people. However, only around 26 million cans are offered. Is there a bottleneck?
"We cannot currently see any shortage of flu vaccines for the 2020/21 influenza season in Germany," says Klaus Cichutek, President of the Paul Ehrlich Institute (PEI). "We are assuming that the manufacturers will provide at least 21 million cans." 13.6 million cans have already been approved for Germany after batch testing, a normal amount for this time of the year. "In the current coronavirus pandemic in particular, the influenza vaccination can only be recommended," emphasizes Cichutek.
The Federal Ministry of Health has also procured six million doses of influenza vaccines for the coming influenza season, says spokesman Sebastian Gülde. These would gradually be available until December, the majority in November and December. The financing comes from funds that the Federal Ministry of Finance also provides to cope with the corona pandemic. In the previous season, only 21 million vaccine doses were available. "The experience of the last few years has also shown that the vaccine quantities available in each case were not completely used in the respective season," adds Gülde.
How effective the new flu vaccination will be cannot be predicted. On the basis of the annual and worldwide monitoring of circulating influenza viruses, the World Health Organization for the northern hemisphere recommends the vaccine composition for the next season as early as February. After that it is produced. Depending on the accuracy, the vaccination protection can therefore fluctuate - usually between 20 and 60 percent. The RKI emphasizes that influenza has a milder course in vaccinated people, i.e. with fewer complications than in unvaccinated people.
The STIKO does not recommend vaccinating children specifically or only for children who have a higher risk of complications because they suffer from certain previous illnesses. The German Society for Pediatric Infectious Diseases recommends vaccinating children. "We know that children transmit the influenza virus to a large extent," said Johannes Huebner, senior physician and chairman of the society, of "Welt am Sonntag". In times of the corona pandemic, in addition to the risks to the health of children, there is a social obligation to protect others.
Medical President Klaus Reinhardt spoke out to the Funke media group (Thursday) for a flu vaccination as seamless as possible for educators and teachers. In his opinion, the flu wave could be more harmless than in previous years, partly because of the corona hygiene rules.
PNEUMOCOCKS: According to the RKI, the pneumococcal vaccination does not protect against Covid-19. However, infections with these bacteria can lead to severe pneumonia and blood poisoning. The RKI has so far assumed that the pneumococcal vaccination can prevent bacterial superinfection by this pathogen in patients with Covid-19. In influenza diseases, bacterial superinfections caused by pneumococci are a known complication.
A pneumococcal vaccine (Pneumovax 23) is currently only available to a limited extent in Germany. For this reason, people who are at a particularly high risk for this disease should be vaccinated at the moment. These include children in the first two years of life and older people aged 60 and over who have not been vaccinated against this pathogen in the past six years. People with chronic lung or heart diseases, insulin-dependent diabetes or certain neurological diseases are also at increased risk and should be vaccinated.
The demand for Pneumovax 23 has risen sharply in connection with the pandemic worldwide and also in Germany, says Ariane Malfertheiner, spokeswoman for the manufacturer MSD. In the Federal Republic of Germany around 1.2 million cans went on the market in 2019. The company is planning 2.5 million cans in 2020 and around 2.6 million cans in 2021. The production of vaccines is very complex and can take up to 36 months. Only in exceptional cases could stocks be reallocated between countries. At the beginning of May the company succeeded in importing 320,000 cans of Pneumovax 23 from Japan and making them available on the German market.
"All manufacturers of pneumococcal vaccines this year brought additional vaccine doses onto the German market due to the great demand," says PEI President Cichutek. Since it takes months to ramp up production, temporary bottleneck situations could still arise for a while.
PERTUSSIS: Whooping cough is also triggered by bacteria. Strong coughing fits are typical of this infectious disease of the respiratory tract. People who are already weakened by Sars-CoV-2 can be more affected by an infection. Or vice versa: According to the RKI, the coronavirus could have an easier time with people who are already weakened by pertussis.
The vaccination is always carried out in combination with other vaccines. In addition to children, all adults should also be vaccinated against pertussis once when the next due tetanus and diphtheria vaccination is due. In addition, women should be vaccinated in every pregnancy, usually from the 28th week.