Stiko in the crossfire: Doctors explain where they deviate from recommendations - and criticize politics

Created: 12/31/2021, 06:06 AM

From: Andreas Schmid

Stiko boss Thomas Mertens.

Recently the criticism of his person increased.

However, the medical profession also holds politicians accountable.

© Bernd von Jutrczenka / dpa

Late decisions, stress with politics: is the criticism of the Stiko justified?

Munich doctors and the Bavarian Medical Association assess the situation for Merkur.de.

Munich - The Standing Vaccination Commission (Stiko) is under criticism.

The accusation - expressed in particular from politics -: The Stiko act too slowly, it takes too long before they issue an official vaccination recommendation.

Those who are largely responsible for Germany's vaccination campaign assess the situation in a more differentiated manner: Doctors see a need for improvement in the vaccination expert committee, but they also take responsibility for politics.

Doctors criticize politics: "Their irrelevant statements are of no relevance to me"

Opposite

explains the Bavarian State Medical Association to fundamentally geared to the vaccination recommendations of Stiko. “Stiko evaluates the safety and effectiveness of the individual vaccines and carries out a risk-benefit assessment for the wide-spread use of the vaccine in the population. On this basis, the doctors in the Free State decide which vaccinations to recommend to their patients. "

The Munich doctor Florian Vogel also says that the assessments of the Stiko play a decisive role in his vaccination strategy. The vaccination commission is "as a scientific guide, the basic guideline for me as a vaccinating doctor". Therefore, as a general practitioner, he generally adheres to the recommendations of the Stiko. "The political statements on the subject of vaccination, on the other hand, have no relevance for me, because they are often guided by irrelevant and daily political considerations."

As a current example, Vogel cites the “political competition to shorten the vaccination intervals between basic immunization and boosting”.

Particularly annoying for Vogel: “At the same time, the practices are not getting enough vaccine and vaccination centers have been closed.

This means that the necessary prerequisites are missing to meet the expectations aroused in the population. "

The Munich doctor Florian Vogel rates the work of Stiko generally positively.

© fkn

Stiko: “A pleasant counterpoint to politics” or “slowing down the pandemic”?

Vogel rates the Stiko as a "beneficial - because independent - counterpoint to politics with its current cacophony of proposals and decisions." "With a serious evaluation of all relevant studies and individual aspects, hasty decisions, as we are currently often experiencing with political decision-makers." 

His Munich general practitioner colleague Markus von Specht is meanwhile more critical of the Stiko.

It is based on various medical sources such as specialist journals from the European Medicines Agency and the Ministry of Health.

"The Stiko is in principle an orientation aid, but not always helpful in times of pressing decisions." Currently, the Stiko plays "a subordinate role" when it comes to when and with which vaccine his patients are vaccinated, says von Specht.

“Unfortunately, this institution has lost its importance in my work.

Sometimes I found the recommendations to be more of a brake in fighting the pandemic. "

Dr.

Markus von Specht sees the Stiko more critically.

© fkn

Criticism of the pace: "The recommendations of the Stiko are too defensive for me"

Vogel, however, thinks it is correct that Stiko takes its time recommending child vaccinations, for example. "There are good reasons not to make the decision to vaccinate children too easy: Since children only very rarely develop severe courses of Covid, the individual risk of Covid disease must be weighed particularly carefully against that of a Covid vaccination." There are reasons why children are not vaccinated in his practice. "That should be reserved primarily for paediatricians."

Von Specht vaccinates children from the age of five in his practice.

"The recommendations of the Stiko are too defensive for me," says the doctor from the west of Munich, who also works as a lecturer at the LMU-Klinikum Munich.

On December 9th, the Stiko issued the restricted vaccination recommendation for five to eleven year olds.

According to Stiko boss Thomas Mertens, the necessary data was missing for a comprehensive assessment.

“From the Stiko's point of view, there is currently no data basis for a general recommendation.” There are scientifically sound reasons why the Stiko has not issued a general vaccination recommendation for children from five to eleven years of age, but only for previously ill children.

There is not enough data on the safety of vaccines for children, said Mertens. 

Stiko and politics: a problem with communication?

A general problem in Germany's vaccination campaign was the different statements made by Stiko as a scientific expert group on the one hand and the Ministry of Health as the executive policy maker on the other. Again and again there were deviations in communication. The Stiko is subordinate to the Robert Koch Institute, which in turn is an authority of the Federal Ministry of Health. The smooth exchange should actually be given.

Most recently, there were discrepancies between the attitudes of Stiko and the Ministry of Health regarding the booster vaccinations.

In mid-December, the Stiko spoke of a six-month gap between the second and third vaccination, ex-Health Minister Jens Spahn (CDU) already considered five months to be sufficient a month earlier.

Bavaria's Minister of Health Klaus Holetschek (CSU) also positioned himself clearly in this direction before Stiko.

Spahns and Holetschek's statements coincided with the assessments of the EMA, but: Stiko and the acting politicians once again gave different assessments.

Since December 22nd, the Standing Vaccination Commission has been recommending booster vaccinations after just three months.

Bavarian Medical Association: trust Stiko expertise and do not exert political pressure

It is difficult to get in touch with doctors around Christmas.

You are working to the limit and are rarely available.

The everyday stress in practice does not become less when clear communication is lost.

Because that causes disagreement, which the Bavarian State Medical Association (BLÄK) also speaks of.

"Disagreement arises when, as in the case of the corona pandemic, faster decisions appear necessary in order to be able to contain the infection process more quickly," the Medical Association said on request.

“This then sometimes requires a compromise, such as in Bavaria with a booster vaccination after five months for certain groups of people before the vaccination recommendation by the Stiko.” However, one should not overlook the fact that “patient safety is paramount”.

The Medical Association rates “the important work” of Stiko as “fundamentally positive”.

The Standing Vaccination Commission is also in regular contact with Bavarian doctors.

In mid-December there was a lecture by a Stiko member about the updated vaccination recommendations.

Gerald Quitterer, President of BLÄK, publicly called on politicians several times during the pandemic not to question the independence of Stiko and to follow their recommendations.

Because in the 18-member committee sit the experts who can objectively describe the benefits and risks of vaccinations on the basis of the scientific findings, says the President.

You have to trust the technical expertise of Stiko and shouldn't put any political pressure on them.

In the video: Stiko recommends booster vaccination after three months

Doctors criticize politics: "Then we have the buck"

Many doctors also used the Stiko recommendation for boosters.

Vogel, who basically invokes the Stiko, explains that he "occasionally" deviates from recommendations: "When it became apparent, for example, that everyone needed a third vaccination for optimal vaccination protection, I already had the official Stiko- I also started recommending boosting for those under 70 years of age. ”Shortly after the conversation, Florian Vogel's practice gave up vaccination.

"We are stopping the vaccinations because a regular process is becoming more and more difficult: Only a fraction of the vaccine ordered is currently being delivered and patients are increasingly missing appointments - sometimes without prior cancellation."

The fact that a practice in Munich is now discontinuing its vaccination offer is certainly less due to the Stiko than to political decisions such as vaccine procurement.

The procurement of the vaccine is a matter for politicians - but "the buck then we general practitioners have," says Vogel.

In view of the corona situation, clear regulations are now required with regard to the threat of triage.

Do vaccination skeptics have to worry?

Experts come to a clear judgment in the controversial debate.