On Wednesday, 3 February the College hosted Dr Nikki Turner, College Fellow and Director of the Immunisation Advisory Centre for a COVID-19 vaccine webinar. She was joined by President Dr Samantha Murton and Medical Director Dr Bryan Betty.
The recorded webinar and the slides Nikki spoke to are now available.
Nikki spoke based on the questions that GPs and other health care professionals had submitted via a survey about the COVID-19 vaccine. Thanks to everyone who sent in questions because it helped direct the content and ensure we covered off the most popular topics. The Immunisation Advisory Centre is also hosting FAQs about the vaccine on its website and would love to hear if you have questions not covered already, so it can build a detailed, up to date repository. It also has information for vaccinators on its site. It’s very important that the information around the vaccine is clear and accurate and not surrounded by myth.
The four vaccines
New Zealand has pre-purchase arrangements for four different vaccines and will lead out with Pfizer-BioNTech (needs to be transported at -70C) likely coming very soon. This will be given to border workers, MIQ workers and their immediate families through a targeted campaign, then frontline health workers in contact with these people. Following that, the next group with be the broader health care front line, including general practice teams.
- All current COVID-19 vaccines are multi-dose vials, which will need some training.
- We are currently unsure of the duration of immunity for these vaccines.
- The COVID-19 virus(es) do mutate, but not like influenza viruses do.
- None of the current COVID-19 vaccines are live so there are very few contraindications.
- General practice will not be delivering the Pfizer (frozen) vaccine. These will be delivered at vaccination centres set up by the DHBs.
- General practice will be very involved in the nationwide rollout in the second half of the year.
Vaccine safety and data
The Pfizer/BioNTEch vaccine coming first is an RNA, not a DNA vaccine. This means it will not affect the genome.
New Zealand is in the fortunate position of being able to access data from parts of the world that have vaccinated earlier. So far, we know from the USA’s sample size of more than 12 million doses of the Pfizer/BioNTech vaccine delivered that there are no unexpected events in response to the vaccination – sore arms, fever - yes in over two thirds of people, anaphylaxis in around 5/million and no concerning signs. Background rates of significant neurological, autoimmune, cardiovascular and a range of other conditions were monitored, and rates were not increased in those vaccinated. Frail elderly in long term care were monitored for four weeks after vaccination, and there was no increase in death rates.
No clinical trials have been done yet for under 16-year-olds or pregnant people, so no data exists. Ideally GPs should wait for data, or until their patient is no longer pregnant, before giving the vaccine - but don’t say no to a pregnant woman who wants a vaccine. These are not live vaccines, so there are not expected to be any safety concerns in pregnancy. The vaccine is being given to pregnant women overseas with no issues. There is no concern around breastfeeding.
Informed consent
The Immunisation Advisory Centre is rapidly developing resources which will be available on its website, including informed consent videos.
The role of general practice
General practice won’t have a large active role in the initial Pfizer vaccine rollout, as this will be managed through targeted DHB-run vaccination centres. The wider rollout is expected from mid-year onwards so there is time to prepare. Dr Betty said that, “realistically we should expect some problems because this is the biggest vaccination event in New Zealand’s history, but general practice and all those involved in vaccinating will need to roll with the punches a bit.”
The general population rollout in the second half of the year will be done under a mixed model – some through general practice and pharmacy, and some likely through vaccination centres.
It’s going to be a busy year – get your arms warmed up, vaccinate for MMR catch up now, then you can do Fluvax (likely to come in the middle of April (the Ministry will confirm soon), then COVID-19. To re-iterate, general practice will not be expected to deliver the Pfizer (frozen) vaccine.
Car clinics will be allowed again for Fluvax
Delivery of the vaccine in relation to other vaccines
- There needs to be a two-week gap between giving Fluvax and then the COVID-19 vaccine.
- There needs to be a four-week gap between giving other vaccines (e.g. MMR, Tetanus) and the COVID-19 vaccine.
Patient access to the vaccine
The vaccine will be free for everyone with no private market supplies. It is Dr Nikki Turner’s understanding that the vaccine will be offered to anyone “with their feet in New Zealand” regardless of their immigration status and access to our healthcare system.
Other vaccinators
Medical and nursing students can be fast-tracked to become vaccinators. Provisional information is available on the Immunisation Authority Centre’s website (opens to PDF)