People travelling overseas and returning to New Zealand should be prioritised for the Covid-19 vaccine - above the vulnerable and elderly - if New Zealand wants to continue its elimination plan of stopping Covid-19 at the border, a public health expert says.
The suggestion comes from Otago University associate professor Dr Ben Gray who acknowledges prioritising "privileged people who can afford to travel" might raise concern.
However, Dr Gray, who specialises in primary health care and general practice, says the community benefits to keeping Covid-19 out of New Zealand are greater than the controversy that comes with the idea.
But New Zealand Aged Care Association chief executive Simon Wallace said irrespective of what happens at the border, it was still critical that elderly people in care were prioritised because if Covid-19 gets into rest homes then people may die.
The Ministry of Health had advised the association that aged residential care staff and residents would be next in line for the vaccine following frontline healthcare workers, and this would start from April, he said.
Otago University epidemiologist Dr Michael Baker did not think vaccinating New Zealand travellers was high on the Government's list like it was Gray's or that there much support in general for Kiwis going overseas for holiday purposes.
However, he said it raised a good issue and specific policies on vaccinating travellers including vaccination passports would be something that needed to be addressed in the next few months.
Baker said after border workers and frontline health workers, he expected the Government would then start vaccinating people who were more vulnerable based on age, ethnicity and health conditions.
Gray, who also works at Otago University in Wellington, said the best way for New Zealand to protect the whole community including its old and vulnerable was to vaccinate from the border outwards which would provide extra protection to stop the spread from the border.
Gray has drawn up a more detailed list of the top four groups he thinks should get the Covid-19 vaccine providing New Zealand doesn't get any uncontrolled community spread.
The list is:
1. Any border or health worker likely to be exposed to cases of Covid-19.
2. Family/household members of these workers.
3. The communities within which these workers live such as South Auckland and other areas where there are MIQ facilities.
4. Any New Zealanders planning to leave on a return trip to Covid-19 endemic areas should also be prioritised.
"... What I'm suggesting is that the plan should be based upon strengthening our border control so the likelihood of it becoming a community case is diminished ahead of giving it to the vulnerable people in the community because the best way of protecting the vulnerable people in the community is to have a tight border control as possible and the vaccine can enhance that border control," he said.
"On the presumption that we continue to prioritise the border, it's not their age that makes the difference - the reason we are vaccinating them is not to protect them but to prevent extra spread."
Gray said that while some people may criticise these people travelling overseas in the first place it may be for a number of reasons including to see a dying relative and his priority list was more focused on the best way of eliminating Covid-19 which was the reason he supported them "queue jumping".
He said his longer list would then prioritise the older people in the communities closer to where the managed isolation quarantine facilities and airports were.
While he supported health workers being vaccinated - he said the priority was those in the communities with closer links to the borders.
"Health workers in South Auckland yes - health workers in Te Puia Springs less so."
Wallace said while NZAC supported border prioritisation, putting aged residential care near the bottom of the list was not right.
"We are dealing with a tricky virus here and as we have seen it can find its way into the population regardless of what happens at the border.
"Ultimately, this reinforces the urgency to get enough safe and effective vaccines into New Zealand and out to the population as efficiently as possible."