Covid 19 coronavirus: Shane Reti: Vaccine 'learnings' from previous campaigns

The 2019 measles outbreak had a raft of independently reviewed issues that we can learn from, says Dr Shane Reti. Photo / File

FROM PARLIAMENT

There is every indication that the coronavirus vaccine is having an impact on reducing coronavirus rates across a range of countries. There is every hope that we will add another layer of protection as we start vaccinating border workers first off the rank.

During the past five years there have been a number of immunisation and screening type projects that we must learn from to help the rollout of what is being described as New Zealand's biggest vaccination programme ever.

Here are some "learnings" from three such projects:

1. The bowel screening rollout a few years ago was significantly held up because of delays with the data register that records patient information.

I have already expressed my concern that data entry into the immunisation register may be a rate limiting step for the coronavirus vaccine rollout and I would encourage immediate and accelerated testing of the platform including whether the data can be shared with GP systems.

2. We must eliminate vaccine wastage. All vaccines are precious and the coronavirus especially so because there is extreme demand worldwide and they are hard to come by.

It is particularly disappointing this week then to find out from the minister that 246 meningitis vaccines for the 2019 Northland outbreak were allowed to expire.

These vaccines were also precious and could have protected 246 Northland children who were not eligible for the programme that was being offered.

A tight cold chain will also need to be vigilant for the coronavirus vaccine with real time temperature monitoring and alerting.

3. The 2019 measles outbreak has a raft of independently reviewed issues that we can learn from.

From a distribution perspective there was simply not enough measles vaccines in the right place at the right time despite what we were being told.

The messaging for who was eligible for the measles vaccine varied across the country and while we were strongly advocating for pharmacists to be vaccinators, it turns out a total of only 20 measles vaccines were given by pharmacists during the whole measles outbreak.

If we are not to relive flaws in just the measles outbreak then there are actions we need to take now. Vaccine procurement and distribution must align with demand and expectations and end to end distribution trial runs need to be undertaken.

There needs to be one source of truth for vaccine messaging. During the measles outbreak it seemed the Auckland Regional Public Health Service had one message while the Ministry of Health had another and local DHBs yet another.

We need a wide range of qualified vaccinators. To have our trusted and well qualified pharmacists give only 20 measles vaccines over the whole measles outbreak is an abject waste of skills.

To this end I am encouraged to hear signs of engagement with what is understood to be the thousands of vaccinators required for coronavirus.

Across these recent projects here are five basic "learnings" that could help the coronavirus rollout:

1. Coronavirus data entry register – test, test, test.

2. Vaccine wastage – let no vaccines expire.

3. Vaccine deployment – set real volume and delivery expectations and use technology for real time cold chain monitoring and alerting.

4. One communication message – one agency to be the source of truth.

5. Widespread vaccine access – develop a wide pool of qualified vaccinators.

• Dr Shane Reti is deputy leader of the National Party and a list MP based in Whangārei.