As part of the New Zealand COVID-19 response it is essential that all immunisation vaccinations continue to be delivered with a particular need for influenza vaccinations to be provided as rapidly as possible. There are several vaccination processes that have been amended to enable vaccinations to proceed and be given as safely and efficiently as possible. Please read about these changes in this Ministry of Health memo of 9 April 2020 (PDF).
In light of the COVID-19 pandemic, the Ministry of Health brought the start of the vaccination programme forward by two weeks. In this early phase the focus was on providing vaccinations for those who are most vulnerable.
Those eligible for early vaccination include:
The Ministry had previously stated that vaccinations should be provided only for these priority groups until 13 April, after which it would open up to the general population.
In order to ensure that everyone in the priority populations have had adequate opportunity to receive their vaccination, this date is being moved to 27 April.
We urge you to ensure Maori and Pacific communities are protected, as their immunisation rates have historically been significantly lower than those of the wider population.
If you have extra vaccines in stock beyond what you're likely to need over the next two weeks, the MOH expect you to be working with your immunisation coordinators and colleagues to make sure that the most vulnerable people in your communities are protected.
Vaccinations for everyone else will depend on the Ministry being confident that the priority groups have been vaccinated.
Influenza vaccine supply
We are aware that some practices have had difficulty with accessing vaccine supplies - the first 800,000 doses of influenza vaccine were distributed according to the usual first come first served basis.
In addition to this 100,000 doses of Influvac Tetra have arrived in New Zealand and distribution has commenced, with 200,000 more currently in transit.
The Ministry expect 1.768 million doses in total this season, 400,000 more than in any previous year.
To order influenza vaccine, please place your order with HCL through the normal process.Because this is a different brand of vaccine new orders will need to be made. All orders will be reviewed by the Ministry of Health and the DHB immunisation coordinators, or nominated delegate, for your region. This is to ensure that stock is distributed to where it is most needed.
Please ensure you record influenza vaccinations on the NIR
Wherever possible, please make sure you record influenza vaccination on the NIR. The NIR is the most accurate source of information for the Ministry about how many vaccines have been administered and how many are still likely to be in circulation and guides their decision making on this issue.
A reminder the Ministry of Health requests that once a patient turns 65 years of age, their flu vaccination claim must be categorised as 65+ years, even if they have previously qualified in other ways for the funded influenza vaccine (such as for other conditions). This ensures coverage of accurate data for the 65+ age group. Please also be sure to inactivate any old recalls for other flu codes, if you need assistance with this please contact your practice support person.
A reminder that when loading a vaccine such as influenza or Zostavax to the practice management software (PMS), nurses need to please put the GP name in the 'Provider' field (not themselves) and the vaccinators name in the 'Vaccinator' field. If this information is not recorded correctly, the vaccinations will not be counted on the National Immunisation Register and also effects payment. For more information contact Helen Ride, Waikato immunisation facilitator.
For nurses who are authorised vaccinators, administration of the seasonal flu vaccine to patients who do not fit within the national immunisation schedule requires either a) a standing order or b) the authorisation of the local medical officer of health. Please refer to the authorisation from the medical officers of health below for each Pinnacle MHN locality.
Waikato DHB medical officer of health, Dr Felicity Dumble, has given approval to all vaccinators within the Waikato region who have been authorised by her to administer the influenza vaccine to those ineligible for funded vaccine. This approval means that standing orders or prescriptions do not need to be used when the vaccine is being administered by an authorised vaccinator who has the appropriate knowledge and skills. Note a new clause has recently been added to the authorisation certificates.
Medical officer of health for Hauora Tairawhiti, Dr Osman Mansoor, has authorised all vaccinators within the Tairawhiti region to administer the influenza vaccine to those ineligible for funded vaccine, for vaccinations given in the practice. For outreach programmes, such as in workplaces, he asks to see the documentation that they have met the requirements of an outreach programme. Here is the full letter issued Dec 17 sent to authorised vaccinators.
Medical officer of health for Taranaki, Dr Jonathan Jarman, now gives "blanket approval to immunisation programmes where the vaccines are recommended but not funded in the most recent copy of the Ministry of Health Immunisation Handbook (exceptions are vaccines for people travelling overseas, and BCG vaccine which requires additional endorsement); and the authorised vaccinator follows immunisation best practice including complying with the Immunisation Standards and the requirements outlined in Appendix A4.3 of the Ministry of Health Immunisation Handbook."
"Vaccinators no longer need to tell me what vaccines they are administering and there is no need to fill in the template in Appendix A4.3 of the Ministry of Health Immunisation Handbook."
The medical officers of health have set in place a process to approve a local immunisation programme, which is valid for two years, for the administration of influenza vaccine (and other specified vaccines) to those ineligible for funded vaccines. Applicants need to complete the application template, attach a copy of all their nurses' current vaccinator approval certificates, Cold Chain Accreditation certificate and other specified copies and send to: email@example.com (attention Estelle Steinmann).
We also have a standing order template available for patients who do not fit within the National Immunisation Schedule and/or for administration of the vaccine by a registered nurse who is not an authorised independent vaccinator. The existing process for standing orders applies whereby there must be a standing orders policy in place and the standing order must be signed by all nurses whom it applies to. Please use this template to create a standing order template for your practice.
Contact nurse lead Hilde Mullins with any queries.
Visit the influenza website for all information relating to the 2020 influenza vaccination programme.
This Ministry of Health fact sheet sets out what you need to know about the reintroduction of the BCG vaccine (Bacillus Calmette-Guérin) in July 2018 after a longstanding global shortage.
The BCG vaccine is now available to order and this fact sheet includes information about vaccination orders, vaccinator endorsement, an online vaccination course and supporting resources. More information about the BCG vaccine can be found in chapter 20 of the Immunisation Handbook.