COVID-19 Jabs In Kiwi Arms – How, Where & When?

What’s going on? Time to know the plans to turn the vaccines into millions of vaccinations?

Great news New Zealand has begun its COVID-19 vaccination programme. We are all pleased to have heard Minister Hipkins and Director General Bloomfield declare that small batches of vaccine have arrived for border and managed isolation and quarantine (MIQ) workers and they are being vaccinated over the next few weeks. Yet so far we have heard very little about what the actual detailed implementation plans are to deliver the vaccinations to the general NZ public. Except for broad statements on how the Government is planning to turn the COVID-19 vaccines into actual vaccinations, with jabs into millions of Kiwi arms, the actual preparations remain largely unknown to the public. Limited information is available Ministry of Health’s website ‘COVID:19-Our roll-out plan’ (updated 1/3/21). Many healthcare providers such as DHBs, GPs, pharmacies and businesses are also seeking information so they can do their own critical planning.

We know vaccination delivery is a very complicated logistic exercise requiring detailed interagency planning and coordination. On our news daily we see many countries are struggling with the difficulties of this challenge. The Government has repeatedly said this is the biggest vaccination role out in our county’s history and they are still working on the roll-out planning. It is time to hear the details what these plans might be here in NZ.

By now plans should be well advanced, the question is what are they? It's important that we hear promptly in order to ensure there is opportunity for community comments and consultation prior to them being locked down for implementation. Publishing detailed plans to the public and seeking feedback will help reduce potential vaccine hesitancy and minimise the risks of mis-information and conspiracy theories being circulated in an information vacuum. It will also help businesses prepare their plans essential to their viability.

The Ministry of Health will be cognisant of the Simpson & Roche Review which highlighted shortcomings in their COVID-19 response. It stated poor interagency governmental coordination during our early response to the pandemic. Recently the Ministry has had other problems of significant concern; unacceptably long waits for community virus testing and access to the Healthline call-centre. Both of these issues further emphasise levels of poor planning and logistic coordination. It is imperative that such failures are not repeated during this critical vaccine roll-out.

NZ will have some unique implementation challenges. For just 5 million people there is a complicated layered web of health governance structures. With 20 District Health Boards, 30 Primary Health Organisations, many health related Non-Governmental Organisations and with General Practice essentially operating as a private model essentially privatising primary care in NZ, all this creates a patchwork of potentially conflicting plans with variable incentives and motives. This will present significant risks to a well coordinated national role out of vaccinations.

Some of the questions the public, communities, many healthcare providers need to know are:

• It seems the Ministry of Health has devolved roll-out accountability to DHBs? How will the coordination work, nationally, regionally, locally? What role do Primary Health Organisations play?
• How will a patchwork of conflicting roll-out responses be avoided? How will the standard NZ immunisation schedule be maintained including the flu vaccinations?
• How and where will the 40000 Aged Care residents be vaccinated? What ages get priority?
• Where will the public be vaccinated? Immunisation clinics, schools, sports arenas, convention centres, community halls, Marae, pharmacies, GP practices, parking lots?
• How will the members of the public make immunisation appointments? How will people register for a vaccination; online, phone or will people be called forward? Once immunised will vaccination certification/passports be issued?
• How will equity of vaccine distribution and immunisation across the country be managed? Can an individual get vaccinated outside of their DHB region?
• Many thousands health professionals, other than doctors and nurses, need to supplement the vaccinator workforce. Who are they? How many are there? Are they mostly in the larger urban areas? Where and how will they be deployed?
• How will the rural NZ get vaccinated?
• Will primary care be be overwhelmed with delivering vaccinations at the expense of critical primary care standard services?
• GPs are presently trying to negotiate a fee schedule with the Ministry of Health and some GPs arguing that pharmacies should not provide COVID-19 vaccines. How are the commercial/private interests going to be managed?
• Will regions get different vaccines? Will these vaccines offer the same level of protection across the country?
• Will such a critical plan to the county’s well-being be independently peer reviewed?

Many countries Australia, Canada, USA, UK , Israel, to name a few, have already either published detailed early plans for consultation or published their final implementation plans as they are already vaccinating their populations.

Minister Hipkins and Director General Bloomfield it's time to let the team of 5 million in on these vital planning details, after all it is the biggest vaccination role out in NZ history.

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