The Immunisation Advisory Centre on preparing for a COVID-19 vaccine

Preparing for the eventual licensure and delivery of COVID-19 vaccine (or vaccines) is a big undertaking.  “It’s a huge responsibility - delivering a solution that will work for New Zealand’s team of 5 million”, says Dr Nikki Turner, Director of IMAC. “Each step from procurement to vaccine delivery needs to be carefully planned”.

Signing of MOU

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The Immunisation Advisory Centre (IMAC) has had an eventful and busy time during and after lockdown. Whilst heavily involved in the forward planning for a COVID-19 vaccine response, they’ve also been working hard to help support the current national immunisation programme so vital to protect our families and communities. 

Preparing for the eventual licensure and delivery of COVID-19 vaccine (or vaccines) is a big undertaking.  “It’s a huge responsibility - delivering a solution that will work for New Zealand’s team of 5 million”, says Dr Nikki Turner, Director of IMAC. “Each step from procurement to vaccine delivery needs to be carefully planned”.

Nikki is a member of the newly formed Vaccine Strategy Science and Technical Advisory Group (STAG) offering advice to the government for a COVID-19 vaccine strategy. IMAC is also assisting the Ministry of Health with their plan for COVID-19 vaccine distribution and delivery. 

Planning for a COVID-19 vaccine

Part of the plan requires a much larger vaccinator workforce. Loretta Roberts, National Manager of IMAC, rapidly put together a solution to address this need. “IMAC has developed an online vaccinator course to upskill a broader range of health professionals including nurses working in aged care, undergraduate midwives, paramedics, pharmacists and health science students such as third year student nurses and fourth year student doctors. To date, more than 1,100 have signed up to the course, with many more expected over the next 6--12 months”, she comments. “We traditionally would have a face-to-face clinical teaching element in most of our courses, but lockdown required a rapid transition to webinar-run clinical tutorials. I’m so proud of the way the IMAC education team adapted to the new normal.”

In this era of misinformation, it has also been important to provide a rational evidence-based perspective, when so many other voices have generated misplaced concern. IMAC works closely particularly with the Science Media Centre, NZ Doctor and the Ministry of Health communications team to assist in this area. To address concerns, Nikki and others in the team are frequently engaging with the media.

Supporting our communities

On top of this, the influenza immunisation programme commenced early during lockdown. For more than 10 years, IMAC has delivered the promotional campaign, clinical education and information resources for this annual event. Despite the challenges of lockdown, this year has seen the highest uptake ever and particularly for high risk groups where historically there has been notable equity gaps, particularly for older Māori.

Nikki explains that “immunisation services have to be relevant and accessible for those most in need. IMAC is taking steps to ensure that our mahi (work) has a strong focus on equity to close the gaps across the immunisation programme. New cultural advisory structures and memorandums of understanding with Hāpai te Hauora and Moana Research will help IMAC keep this equity focus front and centre.” The signing ceremony with Hāpai te Hauora was a great occasion, with UniServices CEO Andy Shenk signing the memorandum (pictured). 

So whilst it’s been a challenging time, and will continue to be so, there are certainly successes and achievements to be proud of. 

What’s next in preparing for a COVID-19 vaccine?

People are keen to know when a COVID-19 vaccine will be available. But it’s vital that expectations are managed and realistic. “A vaccine is not a cure for COVID-19 or a complete solution for border control. COVID-19 will enter the New Zealand community at some stage and we need to be ready”, Nikki observes. “Types of vaccines vary a lot. If it is a type of vaccine that can reduce or stop carrying the virus in the back of the nose and throat then we have a chance at stopping it spreading through the community (creating herd immunity). If the vaccine coverage is adequate, the New Zealand community may achieve that; however, we will continue to have COVID-19 coming in the border as we saw with measles last year. With the amount of COVID-19 in the world it is unlikely that New Zealand can maintain elimination. We will still need to continue long term with effective personal protection—(masks, handwashing, sanitising), social distancing, contact tracing and high rates of vaccination, with effective reach to the highest needs communities.”

If the early vaccines do not offer herd immunity, then they will be offered to front-line providers and high-risk groups first for protection. This will not stop COVID-19 spreading in the community.

What else is needed for success?

A successful COVID-19 immunisation programme needs much more than just a vaccine. This will include positive engagement with important higher risk communities including Māori, Pacific, refugee and migrant communities, as well as communities with low vaccination confidence and populations not enrolled with general practice. 

A system that works effectively at all levels to offer equitable services needs full enrolment at general practice level, good engagement with their communities, effective pre-call and recall systems backed up by adequately resourced outreach (community-based) immunisation services. Immunisation delivery needs to be accessible to all, including broadening opportunities to access vaccines such as broader use of pharmacies and venues and hubs that are easily accessible for diverse local communities.

Such a system is vital for all immunisation services, not just a COVID-19 response. 

Loretta, Nikki and the whole IMAC team will continue to work with local regional and central stakeholders to help put all the pieces of the system in place. “We are all passionate about helping New Zealand achieve high immunisation coverage across all communities” Nikki concludes. “When health professionals have the tools and knowledge to manage all aspects of immunisation service delivery, when all communities have confidence in, and ease of access to vaccines, then we will see the benefit that a truly successful immunisation programme can have”.

- Theo Brandt, IMAC Communications Manager.