Five months after signing a million-dollar contract to set up its own childhood immunisation service, Whānau Āwhina Plunket has vaccinated fewer than 100 babies.
A progress report on the Plunket pilot, which was leaked to RNZ, revealed that just 53 children had been vaccinated by March 17, following its “soft launch” in December, attended by then Health Minister Shane Reti.
While one of the programme’s main objectives was to focus on “tamariki not enrolled or engaged in primary care”, only one child did not have a GP.
However, Whānau Āwhina Plunket chief executive Fiona Kingsford said she was proud of the progress made since signing the contract in October with the National Public Health Service (NPHS).
“We’re learning a lot in terms of setting up and working with [the] NPHS to ensure we’ve got the right systems and processes and equipment and processes in place and things like that. So we’re pretty confident that as we start to move forward, the progress will speed up.”
There were now five sites operational – in Whangārei, Kaikohe, Taumarunui and Hamilton (where there are two) and plans to open five more by the end of June – in Whanganui, Paeroa, Taihape, Te Awamutu and Masterton.
Six “cold chains” had been established to deliver vaccines safely, eight nurses had been trained and 33 were in training.
Kingsford said more than 76 children had now been immunised – but the actual number was not the point.
“This is a pilot, we’re learning by doing, so we’re identifying which models work. So we don’t have direct figures of what we need to hit, it’s about being able to track that, and seeing what is working in each community,” she said.
“The point here is that we are trying to focus on the 20% who are vaccine-hesitant, or who have chosen not to vaccinate in the past. So it is a challenging area to focus on.”
Health New Zealand Te Whatu Ora said the Plunket programme was about “expanding” the vaccinator workforce and reaching whānau and their pēpi (babies) who were not enrolled with a GP or were otherwise struggling to “access” immunisation.
However, Kingsford said the fact that all but one child vaccinated by Plunket before March 17 was enrolled with a GP did not suggest it was missing the mark – rather, it could point to its success.
“As we are working through with these immunisations, we are also promoting and ensuring that people are enrolled.
“So I’m not surprised by that stat.”
The goal of the vaccination is to fully vaccinate 95% of 2-year-olds by 2030, but the programme is falling short. Photo / 123rf
The Government target is for 95% of 2-year-olds to be fully vaccinated by 2030, with an interim target of 84% coverage by June 2025.
In the three months to the end of December, it was 77% – and lower still for Māori (63.5%) and Pacific babies (68.8%).
Plunket has previously been criticised for falling short on providing services for Māori, Pacific and disabled communities.
Kingsford said 9% of Māori babies had dropped out of the service by the age of 2, compared with 5% overall – most commonly to transfer to another service.
“Plunket sees 45,000 babies each year, and within that we see nearly 60% Maori and 77% of Pacific, so we do definitely have a strong market connection,” she said.
“We are really committed to ensuring we’re delivering services in a culturally appropriate and relational way, and have worked to boost the rate of Maori and Pacific nurses and kaiawhina [helpers] in our workforce.”
However, Plunket was not a kaupapa Māori service, she said.
“There are 60 other providers of Well Child services and there should be choice, so we help to facilitate to make sure that transfer happens.”
Plunket’s aim with the immunisation pilot was to support and complement the work of other providers, she said.
“We know we’re not ‘the solution’ but for us, it’s every door is the right door for whānau.
“If we’ve got a trusted relationship with those whānau and we can work with them to become immunised, that’s a win/win for everybody.”
Kingsford said the country’s largest Well Child provider aimed to have 20 immunisation sites running by the time the pilot finishes at the end of June next year.
“We’re really proud of the fact we’re stepping into this space, immunisation rates are far too low and we all need to be working together to address this.”
The $1 million contract was awarded to Plunket under a special exemption to the Government procurement rules – which meant it did not go through an open tender process.
Pilot in ‘early stages’ – Health NZ
In a written response to RNZ, the National Public Health Service deputy director, Matt Hannant, said the pilot was “still in its early stages”, but with over 400 clinics nationwide, Plunket was well-placed to provide childhood immunisations.
“We are tapping into their already existing infrastructure and trust in communities right across the country,” Hannant said.
“It is the only Well Child provider with this size and reach, which enables the flexibility required to work collaboratively with Health NZ to assess and adapt services to where they’re needed.”
There would be regular monitoring of progress, which would give a better idea of uptake as more sites were established.
“Given Whānau Āwhina Plunket’s existing infrastructure and trust in communities right across Aotearoa, we do expect to see more infants and children able to access immunisations through their Whānau Āwhina Plunket nurse. The focus will be on those who aren’t enrolled and/or accessing immunisations through primary care,” Hannant said.
The Immunisation Taskforce recommended increasing the vaccinator workforce and enabling Well Child Tamariki Ora providers to vaccinate, so Plunket’s proposal “aligned” with that, he said.
In fact, Plunket was one of the few Well Child Tamariki Ora providers that was not already funded to do immunisations.
Immunisation Advisory Centre medical director Dr Nikki Turner is in support of the immunisation. Photo / RNZ, Angus Dreaver
Support from expert
Immunisation Advisory Centre medical director, Dr Nikki Turner, said it made “good sense” for Well Child providers like Plunket to offer immunisations, as successive reports had recommended over the years.
“The problem is these things take a long time to set up, to embed, to change and they do take a lot of money,” Turner said.
“So I absolutely support this initiative and we should continue.
“On the other side, we absolutely need to support the existing services alongside that.”
In December 2023, the Government also committed $50m over two years for Hauora Māori providers to help lift immunisation rates.
