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Corona vaccination in a doctor's practice (in Freiburg): Applicable vaccination ordinance is "flexible to use"
Photo: Fleig / Eibner-Pressefoto / imago images / Eibner
SPIEGEL:
Professor Leisner-Egensperger, from April on, general practitioners will also be carrying out corona vaccinations - what does that mean for the previous prioritization?
Leisner-Egensperger:
The prioritization of vaccinations will then largely be history.
And that at the very moment when it would no longer be unconstitutional for the first time.
SPIEGEL:
You have to explain that.
Leisner-Egensperger:
The vaccination ordinance of Federal Health Minister Jens Spahn, on which the prioritization is legally based, has so far lacked a parliamentary basis.
On March 4, the Bundestag created a clear legal basis for this for the first time.
The law still has to go through the Federal Council this week, but then the ordinance would finally be sufficiently legitimized.
But now the Chancellor and Prime Ministers have decided that the vaccination ordinance should be "flexibly applied" by general practitioners.
This means that the prioritization is no longer necessary.
To person
Enlarge picturePhoto: private
Anna Leisner-Egensperger
, 50, studied law in Munich and did her habilitation there.
Since 2002 she has been Professor of Public Law and Tax Law at the Friedrich Schiller University in Jena.
As an expert, she has participated several times in legislative deliberations of the Bundestag on the corona pandemic, most recently on the "Law on the Continuation of Regulations Affecting the Epidemic Situation of National Scope", which the Bundestag passed at the beginning of March and which is currently up for adoption by the Bundesrat.
SPIEGEL:
Why?
Leisner-Egensperger:
If the prioritization in the vaccination ordinance is not mandatory, then you basically don't need it at all, because the recommendations of the Standing Vaccination Commission (Stiko) would already be there as a decision-making aid for vaccinators.
In principle, they're going in the same direction.
The fact that the vaccination ordinance partly deviated from it was only significant because it was legally binding, unlike the recommendations.
SPIEGEL:
But doesn't this flexibility make sense?
General practitioners know their patients best - they can therefore assess competently and at the same time unbureaucratically who needs to be vaccinated particularly urgently for health reasons.
Leisner-Egensperger:
Yes, but then you could have
saved yourself a
lot of back and forth over the past few months.
Apparently, politicians are now giving in to the urging of the medical profession: Naturally, they prefer to follow the Stiko recommendations.
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Chancellor Merkel, Health Minister Spahn (during the Bundestag debate on March 4th): "The current regulation looks different"
Photo: Sean Gallup / Getty Images
SPIEGEL:
Last Friday's decision emphasizes that now “mainly” immobile patients who are cared for at home should be vaccinated, as well as patients with special risks due to previous illnesses.
Is that progress?
Leisner-Egensperger:
Yes, absolutely.
The new law now expressly formulates as one of the »vaccination goals« that »people with a particularly high risk of a serious or fatal course of the disease« should be given preferential protection.
However, the current vaccination ordinance looks different: For disabled people who are cared for at home or patients with a particularly high individual risk of a severe Covid disease, there is currently no option to be vaccinated early, i.e. at the highest priority level.
However, this possibility would exist if the vaccination ordinance can be handled flexibly.
SPIEGEL:
At this point, the decision refers to the applicable paragraph on the highest prioritization in the vaccination ordinance - it says that these people are not yet to be vaccinated first.
A mistake?
Leisner-Egensperger:
I don't think so.
I think it was recognized as a failure, but wanted to cover it up a little by referring to it - as if this focus had already existed before.
But the opposite is the case: According to the regulation, these people can only be vaccinated in the second group at the earliest.
Some were vaccinated prematurely anyway, but often secretly, or only because of a court order.
Recommendation for the second dose is necessary
SPIEGEL:
Have these people, seriously ill and severely disabled people, if they do not live in nursing homes, been "forgotten", as one hears again and again?
Leisner-Egensperger:
No, they have not been forgotten, but - you have to put it so hard - so far deliberately not taken into account in the first group.
SPIEGEL:
On what grounds?
Leisner-Egensperger:
Without justification.
You couldn't justify that either.
It is understandable that one wanted to keep the first stage of the vaccination free from such individual decisions and the associated weighing processes.
But this is a matter of life and death, so a hardship case would have been necessary from the start.
In any case, that would have saved many of those affected a great deal of suffering.
SPIEGEL:
What will happen to the vaccination ordinance now?
Leisner-Egensperger:
It has to be changed again.
The "flexible" application also requires a legal basis: if a family doctor prefers a patient to be vaccinated, he in fact denies the vaccination to another, at least at that moment.
Maybe for days too, once it was the last dose.
SPIEGEL:
It is also disputed whether doses should be postponed for the second vaccination.
The countries proceed very differently.
How do you see it
Leisner-Egensperger:
So far, surprisingly, this has not been regulated at all in the vaccination ordinance - but it would be good if it included a recommendation as to which proportion of vaccination doses should be withheld.