Scarce vaccine supply, cumbersome paperwork, a lack of healthcare staff and an aged and immobile population are hampering efforts to get early doses of a vaccine made by U.S.-based Pfizer and German partner BioNTech into the arms of the people.
Germany has set up hundreds of vaccination centres in sports halls and concert arenas and has the infrastructure to administer up to 300,000 shots a day, Health Minister Jens Spahn said.
But the majority are standing empty, with most states not planning to open centres until mid-January as they prioritise sending mobile teams into care homes.
A day spent with a vaccination team in the small town of Dillenburg, 100 km (60 miles) to the north of Germany's financial capital Frankfurt, shows just how painstaking the task is.
The team starts out by loading a cool-box containing 84 doses of the Pfizer vaccine defrosted overnight into a waiting ambulance, and setting out for the Elisabeth residential care home.
There they are met by manager Peter Bittermann, who has already dealt with the forms needed to vaccinate residents and staff, and provided space for the shots to be administered and recipients monitored post-vaccination.
The four-member immunisation team, plus two trainees, has just a few hours to dispense the temperature-sensitive Pfizer vaccine before it is no longer fit for use.
The German Red Cross needs an extra 350 people to run its local vaccination campaign, said Nicole Fey, spokeswoman of the local district administration.
"We've been able to recruit some, but there can never be enough," she told Reuters TV.
GERMANY LAGS In the first two weeks of its vaccination drive Germany has given 533,000 shots, just two-fifths of the 1.3 million doses received. Britain, by contrast, has reached the 2 million mark.
Israel, the world leader in terms of the share of population covered, is inoculating 150,000 people daily, with its universal and digitally enabled healthcare system making it easier to schedule appointments.
Germany's larger size and federal set-up are complicating operations, a problem also faced in the United States.
Elsewhere in Europe, the decentralisation of Spain's vaccination operation has exposed differences between regions and led to tensions with the central government.
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