The COVID-19 Immunisation Programme in New Zealand

By Marie Cheeseman – AMWA member. 24 March 2021

As countries around the world look to rapidly vaccinate entire populations against COVID-19, we take a look how this is being achieved in New Zealand, in the third webinar in the “COVID-19 Vaccine - Your Questions Answered” AMWA webinar series. In this webinar, Loretta Roberts, National Manager of the Immunisation Advisory Centre (IMAC), based at the University of Auckland, New Zealand, outlines the implementation and delivery of the COVID-19 vaccine rollout in New Zealand.

The New Zealand COVID-19 vaccine strategy

The New Zealand vaccine strategy has been put together with the Ministry of Health New Zealand, in conjunction with numerous partners, including Maori and Pacific partners and IMAC. “It is incredibly important that we are ensuring that the right people get vaccinated and that it is the right time to help protect all New Zealanders”, says Loretta, who also highlights New Zealand’s obligation to uphold and honour Te Tiriti o Waitangi (The Treaty of Waitangi). Importantly, she stresses that “no vaccines in New Zealand will be made mandatory and all vaccines will be provided free of charge”.

Loretta outlined the four-tier strategy currently being employed in NZ:

• Border and quarantine workers, followed by their family and household contacts;
• Frontline healthcare workers, and at-risk people living in settings with a high risk of transmission or exposure;
• People aged 75+, then people aged 65+, followed by people with underlying health conditions;
• The remainder of the population - approximately 2 million people.

The vaccinator workforce

NZ has a long history of a vaccinator workforce, explains Loretta, with a national vaccinator training programme in place since the year 2000. In May last year when it became apparent there would be a need to vaccinate the population, a provisional training course was developed, to increase the number of vaccinators.  A wide range of health professionals completed the course, including paramedics, students and occupational therapists, and NZ currently has approximately 8000 vaccinators. The vaccinator workforce includes the 3800 registered GPs in NZ, 100 defence force members trained as vaccinators and a Ministry of Health surge workforce database, comprising retired health professionals.

IMAC education aims and objectives

“We are really wanting to build a culturally competent vaccinator and support workforce”, says Loretta, with the development and delivery of education being a big part of the role - not just education, resources and tools for vaccinators, but also non-vaccinators who are key communicators in their area. The people that our families and whanau will be speaking to, “we would like them to have answers to questions that are going to come up” so that “they are going to be confident to give those answers”.

How far have we got?

In New Zealand, we have started with the mRNA-CV (Comirnarty; Pfizer) vaccine, which is expected to be the main vaccine for NZ, comprising two doses given 21 days apart. The delivery of this vaccine “is a little different for our vaccinators, in terms of the reconstituting of this vaccine and the multidose” with 6 doses in the vial, and there are logistical challenges associated with the need for the vaccine to be held at -70 degrees and around managing it once it comes out of the freezers, as it then will only last up to 5 days, and only 6 hours once mixed. She points out that there has been “quite a big piece of planning work to make sure we are not having any vaccine wastage.”

How New Zealand compares with Australia

Compared with Australia, the roll out in New Zealand is “probably a little easier to manage” due to a smaller population, and central government decision making. We have national programmes, we don’t have any states in New Zealand, Loretta explains. She then stresses that “we have also made sure that the vaccine is available to everybody in New Zealand regardless of any visa status” and that the vaccine number we have purchased is greater than we will need, with New Zealand having an agreement in place “that we will share some of those vaccines with six different pacific island countries.”

Challenges

Several challenges remain for achieving vaccination of our population, notes Loretta, not least of which is managing the cold chain, particularly in moving the vaccine around the country. Matching workforce demands is another challenge, with the need to be very careful with taking workers away from their usual business, as this means “something else in the health system is actually not getting done”. Communication is always a big challenge, Loretta explains, with the need to ensure information is accessible for both communities and health professionals, particularly given the many channels of communication for people, with local, national and international communication around the COVID-19 vaccine as well as social media, and “we are starting to see some myths come through” so need to “make sure the correct information is out there”.

Questions remain

Will a booster be required?

Will the vaccine protect against variants?

Will vaccination be needed annually?

How quickly does immunity to the vaccine wane?

What about administration concurrently with other vaccines?

Are we going to achieve herd immunity and what will that threshold be?

What about children, when are they going to be vaccinated?

What will happen when the borders open?

What does the future hold?

If we look back, most of us “wouldn’t have thought that we would be where we are today 1 year ago”. While many countries are a little ahead of New Zealand, in terms of vaccine rollout, it is a global solution that is required, and we all need to work together. It is “incredibly important that we have equitable access” Loretta says, pointing out that New Zealand is part of the COVAX programme, “working particularly with our pacific neighbours”, including the three Realm countries, Niue, Tokelau and the Cook Islands, as well as Samoa, Tonga and Tuvalu.

Watching this webinar helps with understanding the scale of the challenge involved in vaccinating an entire population in a short period of time. The behind-the-scenes work involved, particularly with the upskilling and development of the vaccinator workforce, is impressive.

A full replay of Loretta Roberts’ presentation is available to AMWA members here.

Register for upcoming events in the webinar series to continue learning the answers to your questions about the COVID-19 vaccines.

AMWA member Marie Cheeseman is a freelance medical writer based in Auckland, New Zealand. As a writer in the medical communications industry for almost 20 years, Marie delivers quality results on time across a wide range of therapeutic areas. She creates content for agencies, pharmaceutical companies and academics around the globe.