COVID-19 Vaccine and Immunisation Programme - Update - Dr Joe Bourne Emergency Medicine Conference
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COVID-19 Vaccine and
Immunisation
Programme – Update
Dr Joe Bourne
Emergency Medicine Conference
12 March 2021
VACCINATIONS ARE UNDERWAY
Lynette Faiva receiving the first dose of Pfizer-BioNTech
vaccine in NZ, at Jet Park Hotel MIQ facility on 20 Feb
From Mon 15 Mar, our focus will shift to Dose 2
vaccinations for border and MIQ workers
2
PROGRAMME OVERVIEW
COVID-19 VACCINE & IMMUNISATION PROGRAMME COVID-19 VACCINE & IMMUNISATION PROGRAMME
WORKSTREAMS ENABLERS
Purchasing and Approvals Patient Experience
Population Definition and Equity
Sequencing
Distribution and Inventory Clinical
Management
Digital
Health Workforce
Data
Service Design
Policy
Post Event
Comms & Engagement
3
POPULATION & SEQUENCING
https://covid19.govt.nz/updates-and-resources/latest-updates/covid-19-vaccine-rollout-plan/
4
VACCINE PURCHASING & APPROVALS
The Pfizer-BioNTech vaccine received Medsafe approval. It has been shown to be about
95% effective at preventing symptomatic infection.
Four shipments have arrived in NZ, with weekly deliveries planned.
Vaccinations commenced on 20 Feb with high-priority border and Managed Isolation and
Quarantine (MIQ) workers, and their household contacts being vaccinated. 18,000 NZers
have now received their first dose of the Pfizer COVID-19 vaccine.
Total Pfizer order now 10 million doses. The original agreement was for 1.5 million
doses. An advance purchase agreement has now been been signed by Government for
additional 8.5 million doses.
Enough for 5 million people to get two shots needed to be fully vaccinated against
COVID-19.
Every New Zealander has access to same vaccine. Remaining 8.5 million doses of vaccine
are expected to arrive in NZ during the second half of 2021.
5
DRAFT – IN CONFIDENCE
DELIVERY PROCESS FOR PFIZER
Distribution &
Purchasing & Population Data
Phase 1: Tier 1 and Tier 2 (Border, MIQ, Frontline Health workers, Household contacts,
Programme Inventory
Approval & Sequencing
Management
other frontline staff (e.g. Police, Defence) ~225k courses
Registration,
Provider
Health Workforce Appointment & Post Event
Engagement
Immunisation
Pre Event Immunisation Event Post Event
Vaccine sent from 2 ULT storage centres Inventory manually recorded in spreadsheets, sent to Run More vaccine and consumables
to all vaccination locations
Physical elements
Team to update master inventory list ordered based on consumption
Vaccine
Purchased,
Medsafe and
Cabinet
approved for use Vaccines and
Vaccine arrives in Demand at each
Service delivery consumables Vaccine supply continues to be sent to match
AKL and CHCH site confirmed
mechanisms and transported to demand requests throughout the first
and stored in and orders placed
physical sites are vaccination sites at immunisation cycle, informed by demand
established National storage 2° - 8°C (daily) (bookings) and daily stocktakes at sites
centre at -70°C
Population
data
prepared
Employers and DHB’s organise vaccination Vaccinations conducted at workplace and CBAC’s Customer returns for their
booking schedule by existing vaccinators second dose
Customers
I learn about the Informed of appointment by my employer for Attend vaccination site, Wait 20 mins to Receive event Identify potential If adverse Receive reminder of
vaccine through an immunisation (in line with testing cycles) confirm identity, provider ensure no adverse receipt and book in Household (HH) reaction occurs 2nd vaccination and
my employer *for HH contacts, DHB will make contact to consent; receive info about effects for 2nd vaccination Contacts* offsite, consult attend appointment
confirm appointment vaccine
Administer Healthline or GP
vaccine
~750 vaccinators trained and mobilised by IMAC for the Vaccinators immunise border workers and Vaccinators monitor adverse reactions and
Pfizer vaccine and use of the CIR record the event in the CIR input into CIR if required
Vaccinators
DHB’s supply daily Vaccinators deployed Vaccination team Vaccination team Vaccination team Vaccinator reports Vaccinator disposes Site coordinator performs
DHB’s and IMAC trains vaccinators
schedule of attendees to workplaces or on- prepares dosages enters vaccine monitors patient for any adverse of used supplies daily stocktake and
providers confirm
which is loaded in CIR site healthcare staff ready to be drawn information into any adverse affects reaction in CIR and consumables orders more stock if
service delivery
allocated COVID-19 required
model
Immunisation Register
NB: The process for immunising utilises a number of current state processes. The key point of difference to current state is on the physical good and storage and distribution of the Covid vaccine. As we ramp up the number of
vaccinations taking place, the mode for customers being communicated to and booking into getting a vaccine will change.
DISTRIBUTION
Once a dose of the vaccine is warmed above -70 degrees, it expires in five days. Once
removed from fridge it must be mixed within two hours, then used within six hours.
Ensuring we have people on hand to be vaccinated is important – which is not always
easy coordinating the many agencies and employers.
The large box is what is delivered to vaccine
providers.
The smaller boxes contain the vaccine vials
which will need to be stored in usual cold
chain.
The boxes will come with 5, 15 or 195 vials.
7
WORKFORCE
Planning for extra 2,000 – 3,000 full-time (or equivalent) vaccinators to be
trained and available. Registrations via Surge Workforce database. At 11 Mar,
4,928 people registered.
Partnered with IMAC to deliver education, training and support for COVID-19
vaccinators. Training commenced 10 Feb. As of 11 Mar, 989 vaccinators had
completed training.
Training is currently available to nurses and pharmacists to do generic
vaccinator training – required before commencing the COVID-19 Vaccinator
Education Course (Pfizer/BioNTech vaccine training and CIR training)
Training will be opened to primary and community care workforce in next
few weeks.
8
WORKFORCE CAPACITY
How many vaccinators do we need?
• 650 FTE by early April 2021
• 1,800 June
• 2,000 – 3,000 full-time (or equivalent) August-November 2021
Strategies:
Vaccinator workforce – 14,000 people
COVID-19 Surge Workforce – individuals who are willing to be vaccinators.
This includes retired health professionals or others not currently in the health
workforce. DHBs/providers will be able to access this pool as required.
Use of other regulated workforce who may be able to vaccinate with little or
no change to scope of practice, e.g. paramedics, phlebotomists, anaesthetic
technicians.
Upskill kaiāwhina to ensure an expanded, diverse and sustainable health
9
workforce
PROVIDER ENGAGEMENT
10POST EVENT – ROLE IN COVID-19 VACCINE ROLLOUT Monitor, evaluate and report on adverse events, effectiveness and coverage of the CVIP Three sub-pillars of work: ■ Vaccine safety ■ Vaccine effectiveness ■ Population protection Adverse Events Following Immunisation (AEFI) reporting Existing system: Medsafe and Centre for Adverse Reactions Monitoring (CARM) ■ Increased capacity for CVIP, including enhanced reporting mechanisms ■ Reporting through CIR and CARM website Establishment of COVID-19 Vaccine Independent Safety Monitoring Board ■ Panel of experts from clinical medicine, microbiology, epidemiology and biostatistics to support assessment of AEFIs and COVID-19 vaccines ■ Recommendations and advice to CARM, Medsafe, CVIP and Ministry of Health Initial reports received for Pfizer-BioNTech (Comirnaty) have generally described anxiety reactions. We are now starting to get reports of injection site reactions and systemic reactions (reactogenic reactions), these are expected for all vaccines.
DRAFT – IN CONFIDENCE
EQUITY & CVIP – OUR WORK SO FAR
1 Timeline for Equity & COVID-19 Vaccine and 2 From engagement and feedback came 3 Team Structure
Immunisation Programme the strategies and plans
Equity
Governance for the COVID-19 Vaccine Lead - Tamati Shepherd-Wipiiti / Ana Bidois Supported regionally
and Immunisation Programme (CVIP) Support – TBC by..
Oct – Dec 2020
Community Iwi
Treaty o Waitangi and Equity Māori Pacific Disability
guidance delivered to the
programme Lead – TBC Lead – TBC Lead – Ray Finch MSD DHB’s
Support – Tia Ashby & Support – Ali Ajmal Support – TBC
Te Ropu Smith
Dec 2020
TPK Regions
End to end process developed and operational
guidelines drafted
ACC TPK Office of Ethnic Communities MSD MPP
Jan 2021
Māori Pacific
Shakedown
Shakedownofofend
endtotoend
endprocess
processand
and
Operational
Operationalguidelines
guidelines • Phase 1: MDT that must include (Kaiawhina / WO) • Phase 1: MDT
• Phase 2: Kaiawhina trained as vaccinators • Phase 2: Pacific Teams
Workforce • Workforce Sequencing
Feb
Feb2021
2021
• DHBs /Hospitals/Community Pop- ups • DHBs
Feedback
Feedback • Primary Care • Primary Care
Māori
MāoriIIAG
IIAGmembers
members and Hauora
and Te Hau O Ora o • Pharmacies • Pharmacies
Service Delivery Hauora (partner with GP Response) Pacific Health Providers
Ngāpuhi
Ngāpuhi provided
providedadvice onon
advice changes
changesto to • •
Whanau Ora Commissioning Agency and Te Putahitanga Pasifika Futures (Whānau Ora)
end
endtoto
end process including shifting
• •
end process including shifting
‘Why’
‘Why’statement
statement and
andimproving
improvingendend
to end
to
outcomes for Whanau.
end outcomes for Whanau. • 140 Vaccination Navigators • 60 Vaccination Navigators
• 70 Vaccination Coordinators (regional) • 30 Vaccination Coordinators
KEY • 35 Vaccination Support Network • 15 Vaccination Support Network
Māori Support • 140 Champions • 60 Champions
PacificCOMMUNICATIONS & ENGAGEMENT
Integrated approach including; paid advertising, media, stakeholder
engagement, events, and development and distribution of collateral to
inform New Zealanders about the vaccination programme
To date, communications have been channelled directly to those who will
be receiving the vaccination in the first stages
Within the next week a paid media campaign will start that will inform
New Zealanders on the vaccination plan
As the vaccine programme rolls-out, the advertising campaign will gain
momentum with a focus on encouraging all of Aotearoa to get vaccinated
We will be working with a range of agencies to ensure the campaign
resonates with different audiences
We will be directing people to covid19.govt.nz to find out more info
13COVID-19 VACCINATION & IMMUNISATION TECHNOLOGIES
Dashboards,
Consumer reporting Contracting
channels & data & payment
(May) systems
Digital Adverse
National Health Terms &
quantities Event Report
Index
Covid-19 (9 March)
Immunisation Register
Identity &
demographics
Adverse Event
Report
Centre for
Border
Border worker household adverse Event
employer contacts portal monitoring
systems
systems
GP notifications
(9 March)
Sector
Vaccine forecasting GP practice
booking Invitations
report (9 March) management
& scheduling
systems
systems Vaccinator
on-boarding
National Distribution
booking system & inventory
KEY (May) management
Immunisation
Advisory Centre
Sector systems
learning systems
New systems Portals & interfacesDRAFT – IN CONFIDENCE
CX
Consumer experience
A high level view of the consumer experience work CX
The outputs of the CX discovery are 4 artefacts that
inform our digital design
This leads on to our
Co –Design work with
Maori, Pacifica
communities and
disability cohortsQUESTIONS
Any questions?
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