BERLIN (NYTIMES) - At the start of the year, many Germans were complaining about a shortage of coronavirus vaccines that could free them from onerous lockdowns and limited social lives. Just weeks later, many are now upset that they are not getting the vaccine they want.
As people around the world clamour for inoculations, and many countries have seen severe shortages, a preference for a vaccine developed by the German company BioNTech with Pfizer, is causing a pile-up in Germany of the shot developed by AstraZeneca, a British-Swedish company, according to state health officials.
Many people, including health workers, are skipping appointments or refusing to sign up for the AstraZeneca shot, which they fear is less effective than the Pfizer-BioNTech vaccine, the officials said.
As a result, two weeks after the first delivery of 1.45 million doses of the AstraZeneca vaccine arrived in Germany, only 270,986 have been administered, according to data collected by the public health authority, the Robert Koch Institute.
"The point is that we have a German-made product that is the market leader, but we are not able to get it," said Mr Michael Breiden, 53, a night nurse in a psychiatric hospital in the western state of North Rhine-Westphalia.
He said he would prefer the Pfizer-BioNTech shot, but would take the AstraZeneca one if it meant getting immunised more quickly.
The rejection of the AstraZeneca vaccine has been fuelled by weeks of negative coverage about it in the German media, which has portrayed it as "second class", citing its lower efficacy rate compared with Pfizer-BioNTech, and reporting stories of people suffering adverse reactions.
Clinical trials do suggest that Pfizer's efficacy, at 95 per cent, is higher than AstraZeneca's, which is between 60 per cent and 90 per cent, depending on factors such as the spacing of doses.
Still, it is difficult to directly compare shots unless they are tested head-to-head in the same trial. And many health professionals suggest getting whichever vaccine is available first since Covid-19 poses such health risks.
All the leading vaccines offer strong protection against severe disease and death, but as the overall efficacy rates show, some appear to do better than others in protecting against any form of the disease. Even mild or moderate Covid-19 cases can lead to long struggles with symptoms.
Widespread scepticism about vaccines in Germany has exacerbated people's reluctance to take the AstraZeneca shot.
Medical and other front-line workers have also expressed resentment about being given unused AstraZeneca shots, instead of the Pfizer-BioNTech one, saying it showed a lack of respect after their efforts to help the country fight the pandemic over the past year.
The rejection of the AstraZeneca vaccine has caused delays in a mass vaccination campaign that was already struggling with bureaucratic and logistical hurdles. That has raised concerns that, with new cases of coronavirus infection increasing, even as Germany remains largely locked down, failure to immunise enough people quickly could stymie efforts to return the country to normal life.
The problem runs deeper than just AstraZeneca.
According to a survey by the Bertelsmann Foundation, one-third of Germans say they would not get vaccinated, regardless of who made the shot.
In addition to AstraZeneca, Germany is also administering the vaccine made by Moderna, an American company, without problems or resistance. The vaccine has an overall efficacy of 94.5 per cent.
AstraZeneca's vaccine has been generating negative headlines in Germany since January, when the company said it would significantly cut planned deliveries to the European Union.
Days before the first doses were delivered, Germany's vaccine commission recommended that the AstraZeneca shot be given only to adults up to age 65, citing a lack of sufficient data on its efficacy in older people, advice that was followed by Chancellor Angela Merkel's government.
Then several hospitals were forced to temporarily stop administering AstraZeneca shots after a number of people called in sick the day after their inoculations. They experienced what are considered normal reactions to the vaccine.
Although the hospitals have since resumed vaccinations at a slower rate, the headlines created further uncertainty.
The World Health Organisation has recommended the AstraZeneca vaccine for countries where variants are circulating, and Germany's leading virus experts, the health minister and Ms Merkel, have all defended it as safe.
Recent data from use of the vaccine in Scotland showed that even after one dose, the AstraZeneca vaccine could reduce the risk of hospital admissions by roughly 94 per cent.
But the numbers that have stuck in the minds of many people are those from earlier trials showing that AstraZeneca provides 70 per cent efficacy in protecting against Covid-19, and that the one developed by BioNTech and Pfizer showed higher efficacy.
German doctor associations have issued an appeal urging all medical staff to take advantage of the opportunity to get a shot, stressing that all vaccines approved by the authorities are safe and provided more protection than not getting vaccinated at all.
A study of Britain's mass inoculation programme, released this week, pointed to the effectiveness of the vaccine, even among older people. The study also showed that from 28 to 34 days after the first shot, when it appeared to be at or near peak effectiveness, the AstraZeneca vaccine reduced the risk of Covid-19 hospital admissions by roughly 94 per cent.
But all that has not convinced many in Germany.
Berlin police officers have been unsuccessfully asking state health authorities to make vaccines available for them, said Mr Benjamin Jendro, spokesman for the police union in Berlin.
But this week, with thousands of unused doses of AstraZeneca available, the union was told that 24,000 would be earmarked for the force.
"Now all of the sudden, because no one else wants the AstraZeneca, they say we can have it," he said. "It is all still very new, but when others reject something and then it is offered to the police, it is understandable that many colleagues feel burned. And they are worried, there are so many conflicting reports.
"Some of the colleagues say they will take it immediately, others are more uncertain," he said.