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The COVID-19 vaccination campaign is the best chance New Zealand has to protect our citizens’ health and will be a crucial activity for the health sector in 2021.[[1]] The procurement strategy for New Zealand started early and has been a dynamic process.[[1,2]]  However, there has been no evidence of large-scale and detailed operational planning at the level of district health boards (DHBs), drawing political comments that plans are ‘half-baked’ [[3]] and prompting an Office of the Auditor-General review. To have a successful vaccination program, New Zealand will need to learn from international experience, and it must include the participation of primary care.

New Zealand has been praised internationally for its response to the pandemic, and New Zealand has escaped other nations’ death rates.[[4]] One of the factors in our success has been strong leadership.[[5]] Communication has been effective, and we have had an excellent response from our team of five million.[[1]] Regardless of that result, the medium- to long-term success of New Zealand’s response overall will be determined by the success of the vaccine campaign. Communication with primary care will need to improve in New Zealand if we are to continue our excellent response.

The plans for the vaccination rollout seem to be evolving fast in New Zealand. A recent letter in the New Zealand Medical Journal expressed that border workers be vaccinated as a priority group, which the Ministry of Health (MOH) had not previously planned.[[6]] Yet, by the time the letter was published, the vaccine campaign for border workers was underway.[[2]] Detailed plans following the border force are not transparent or publicly available. The prioritisation of vaccination is a small part of the planning required. While that has now been established, the crucial ‘last-mile logistics’ [[7]] of the vaccination programme may be left to individual DHBs to coordinate vaccination for the health workforce and the wider public. [[2,3]]

International evidence highlights both general practice’s (GP) and community pharmacy's essential role in successful campaigns.[[8–13]] In the UK, 75% of the vaccinations delivered have been through primary care networks (including GP clinics) and only the remaining 25% in specially designated vaccination centres.[[14]] Israel has fully vaccinated more than 50% of its residents with the Pfizer vaccine in under six months,[[12]] and this was coordinated through the primary care health plans, where GPs commonly work in private clinics and are usually salaried by the health plans.[[12]] New Zealand has limited primary care involvement in the initial phases as the vaccine is targeted toward the most likely to be infected at the border. [[3]]

New Zealand should consider the Israeli campaign as a benchmark of success. The Israelis have had a few advantages that New Zealand could not replicate. For example, high population density. [[12]] Fortunately, New Zealand and Israel share a universal approach to health, well organised primary care, a national unique identifier system for patients, substantial investment in vaccine procurement and a centralised (rather than federalised) government. If the vaccine campaign is centred around the community through primary care providers, New Zealand may meet the projected targets that the government has set.[[2]]

The National Health Service (NHS) in the United Kingdom shares features with the New Zealand health system.[[15]] The NHS has primary care networks (PCNs), analogous to our primary health organisations (PHOs).[[16]] The NHS is also a universal system and is providing vaccination free to the population. In the NHS, mainly nurses (who are already qualified vaccinators) are doing the immunisation.[[14]] The NHS attempted to recruit a sizeable ancillary vaccination workforce, which has been less successful. Without additional workers, GP clinics are deferring other work to concentrate on the vaccine.[[17]] The NHS also considers incentive payments to PCNs to target priority and hard to reach populations. [[18]] Meanwhile, the New Zealand MOH is yet to indicate the payment structure for vaccine delivery, leaving primary care providers uncertain of their required level of involvement. New Zealand GPs are not protected by collective bargaining as they are under the NHS and the Israeli health system, and funding agreements are tortuous and often contested.[[22]]

Primary care will need to be well supported to participate in the New Zealand vaccine programme. The logistical considerations for transport to vaccination sites are daunting.[[19]] However, in practice in the UK and the USA and Australia, one of the most significant challenges has been coordinating patients to attend booked appointments.[[10,12,20]] The coordination is made difficult when there are supply uncertainties, and the short shelf-life once defrosted adds to the complexity of the Pfizer vaccine.[[10]] GPs in Australia have struggled with administration and logistical problems.[[21]] The logistical requirements are such that a coordinated approach through PHOs may be more efficient than individual practices undertaking the work.

The New Zealand health system is not optimally structured for rapid deployment of a whole-population vaccination campaign. The semi-autonomous DHBs are centred around local hospitals, with variable access to services across the country giving rise to ‘post-code lotteries’ regarding patient services and outcomes.[[16]] Systemic racism and inequity exist in every facet of the health and social support systems.[[22]] The New Zealand health system was under review before the pandemic, with the final report released mid-2020.[[23]] The government planned actions for the transition are not yet public, which is unsettling and will require MOH and DHB attention and may dismantle the PHOs that would be important in coordinating vaccine programmes, like the PCNs in the UK.

Despite the challenges in logistics, coordination and personnel outlined above, New Zealand can learn from international experience. Implementing those findings in our system’s milieu will require dedication and vaccination plans to be ‘fully baked’ and transparent to everyone. Logistical limitations are well explained[[19]] and anticipated. The vaccination programmes’ administrative requirements in the UK and Australia have been frustrating to GPs.[[10,11,21]] In contrast, Israel has efficiently mobilised the community health workforce through coordinated general practice and has stream-lined all the steps.[[12]] New Zealand should learn from those international experiences and provide an efficient vaccination campaign for our citizens.

Summary

The COVID-19 vaccination campaign is the best chance New Zealand has to protect our citizens' health and will be a crucial activity for the health sector in 2021. The procurement strategy for New Zealand started early and has been a dynamic process. However, there has been no evidence of large-scale and detailed operational planning at the level of district health boards (DHBs), drawing political comments that plans are “half-baked” and prompting an Office of the Auditor-General review. To have a successful vaccination program, New Zealand will need to learn from international experience, and it must include the participation of primary care.

Abstract

Aim

Method

Results

Conclusion

Author Information

Dr Vanessa Weenink.

Acknowledgements

Correspondence

Dr Vanessa Weenink

Correspondence Email

vanessaw@pmc.co.nz

Competing Interests

Dr Vanessa Weenink is Chair of the General Practitioners Council of the NZMA, Deputy Chair (Elect) of the NZMA and Director of Pegasus Health Charitable limited (the Primary Health Organisation).

1. Bloomfield A. COVID-19, 20, 21: lessons from New Zealand's 2020 response for 2021 and beyond. NZMJ. 134

2. Ministry of Health web page  [updated 10 March 2021. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-and-planning#strategy.

3. Mansh T. Government releases Covid-19 vaccine delivery schedule: elderly and people with pre-existing conditions to be prioritised. Stuff. 2021 March 10th 2021.

4. Huang QS, Wood T, Jelley L, Jennings T, Jefferies S, Daniells K, et al. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand. Nature Communications. 2021;12(1).

5. Dada S, Ashworth HC, Bewa MJ, Dhatt R. Words matter: political and gender analysis of speeches made by heads of Government during the COVID-19 Pandemic. BMJ Global Health. 2021;6(1):e003910.

6. Walls C, Gavaghan S, Gorman D, McBride D. Scheduling of COVID-19 vaccination for at-risk employees. NZMJ. 2021;134

7. Lee TH, Chen AH. Last-Mile Logistics of Covid Vaccination — The Role of Health Care Organizations. New England Journal of Medicine. 2021;384(8):685-7.

8. Freed GL. Actionable lessons for the US COVID vaccine program. Isr J Health Policy Res. 2021;10(1):14.

9. Harnden A, Lim WS, Earnshaw A. COVID-19 vaccination programme: a central role for primary care. Br J Gen Pract. 2021;71(703):52-3.

10. Mahase E. Covid-19: Logistical problems frustrate GPs ready to deliver vaccine in England. BMJ. 2020;371:m4849.

11. Majeed A, Molokhia M. Vaccinating the UK against covid-19. BMJ. 2020:m4654.

12. Rosen B, Waitzberg R, Israeli A. Israel's rapid rollout of vaccinations for COVID-19. Isr J Health Policy Res. 2021;10(1):6.

13. Volpp KG, Loewenstein G, Buttenheim AM. Behaviorally Informed Strategies for a National COVID-19 Vaccine Promotion Program. JAMA. 2021;325(2):125-6.

14. Baraniuk C. Covid-19: How the UK vaccine rollout delivered success, so far. BMJ. 2021:n421.

15. Gauld R, Horsburgh S. What motivates doctors to leave the UK NHS for a "life in the sun" in New Zealand; and, once there, why don't they stay? Human Resources for Health. 2015;13(1).

16. Gauld R. New Zealand's post-2008 health system reforms: Toward re-centralisation of organisational arrangements. Health Policy. 2012;106(2):110-3.

17. Iacobucci G. Covid-19: GPs can limit routine work to focus on vaccination, says NHS England. BMJ. 2021:n67.

18. Iacobucci G. Covid-19: GPs could get extra funding to boost vaccine uptake in hard-to-reach groups. BMJ. 2021:n548.

19. Holm MR, Poland GA. Critical aspects of packaging, storage, preparation, and administration of mRNA and adenovirus-vectored COVID-19 vaccines for optimal efficacy. Vaccine. 2021;39(3):457-9.

20. Mills MC, Salisbury D. The challenges of distributing COVID-19 vaccinations. EClinicalMedicine. 2021;31:100674.

21. Mannix L. Victoria's vaccines ready to roll - but some teething issues remain 2021 [22/3/21]. Available from: https://www.theage.com.au/national/victoria/victoria-s-vaccines-ready-to-roll-but-some-teething-issues-remain-20210321-p57cpf.html?utm_content=NARRATIVE&list_name=3C1D28D0-7E1E-4DC0-9DD3-A961CC5360DB&promote_channel=edmail&utm_campaign=am-theage&utm_medium=email&utm_source=newsletter&utm_term=2021-03-22&mbnr=MjA0MjIwNzg&instance=2021-03-22-06-38-AEDT&jobid=29297386.

22. Moewaka Barnes H, McCreanor T. Colonisation, hauora and whenua in Aotearoa. Journal of the Royal Society of New Zealand. 2019;49(sup1):19-33.

23. Simpson H. Health and Disability System Review Final Report. 2020.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

The COVID-19 vaccination campaign is the best chance New Zealand has to protect our citizens’ health and will be a crucial activity for the health sector in 2021.[[1]] The procurement strategy for New Zealand started early and has been a dynamic process.[[1,2]]  However, there has been no evidence of large-scale and detailed operational planning at the level of district health boards (DHBs), drawing political comments that plans are ‘half-baked’ [[3]] and prompting an Office of the Auditor-General review. To have a successful vaccination program, New Zealand will need to learn from international experience, and it must include the participation of primary care.

New Zealand has been praised internationally for its response to the pandemic, and New Zealand has escaped other nations’ death rates.[[4]] One of the factors in our success has been strong leadership.[[5]] Communication has been effective, and we have had an excellent response from our team of five million.[[1]] Regardless of that result, the medium- to long-term success of New Zealand’s response overall will be determined by the success of the vaccine campaign. Communication with primary care will need to improve in New Zealand if we are to continue our excellent response.

The plans for the vaccination rollout seem to be evolving fast in New Zealand. A recent letter in the New Zealand Medical Journal expressed that border workers be vaccinated as a priority group, which the Ministry of Health (MOH) had not previously planned.[[6]] Yet, by the time the letter was published, the vaccine campaign for border workers was underway.[[2]] Detailed plans following the border force are not transparent or publicly available. The prioritisation of vaccination is a small part of the planning required. While that has now been established, the crucial ‘last-mile logistics’ [[7]] of the vaccination programme may be left to individual DHBs to coordinate vaccination for the health workforce and the wider public. [[2,3]]

International evidence highlights both general practice’s (GP) and community pharmacy's essential role in successful campaigns.[[8–13]] In the UK, 75% of the vaccinations delivered have been through primary care networks (including GP clinics) and only the remaining 25% in specially designated vaccination centres.[[14]] Israel has fully vaccinated more than 50% of its residents with the Pfizer vaccine in under six months,[[12]] and this was coordinated through the primary care health plans, where GPs commonly work in private clinics and are usually salaried by the health plans.[[12]] New Zealand has limited primary care involvement in the initial phases as the vaccine is targeted toward the most likely to be infected at the border. [[3]]

New Zealand should consider the Israeli campaign as a benchmark of success. The Israelis have had a few advantages that New Zealand could not replicate. For example, high population density. [[12]] Fortunately, New Zealand and Israel share a universal approach to health, well organised primary care, a national unique identifier system for patients, substantial investment in vaccine procurement and a centralised (rather than federalised) government. If the vaccine campaign is centred around the community through primary care providers, New Zealand may meet the projected targets that the government has set.[[2]]

The National Health Service (NHS) in the United Kingdom shares features with the New Zealand health system.[[15]] The NHS has primary care networks (PCNs), analogous to our primary health organisations (PHOs).[[16]] The NHS is also a universal system and is providing vaccination free to the population. In the NHS, mainly nurses (who are already qualified vaccinators) are doing the immunisation.[[14]] The NHS attempted to recruit a sizeable ancillary vaccination workforce, which has been less successful. Without additional workers, GP clinics are deferring other work to concentrate on the vaccine.[[17]] The NHS also considers incentive payments to PCNs to target priority and hard to reach populations. [[18]] Meanwhile, the New Zealand MOH is yet to indicate the payment structure for vaccine delivery, leaving primary care providers uncertain of their required level of involvement. New Zealand GPs are not protected by collective bargaining as they are under the NHS and the Israeli health system, and funding agreements are tortuous and often contested.[[22]]

Primary care will need to be well supported to participate in the New Zealand vaccine programme. The logistical considerations for transport to vaccination sites are daunting.[[19]] However, in practice in the UK and the USA and Australia, one of the most significant challenges has been coordinating patients to attend booked appointments.[[10,12,20]] The coordination is made difficult when there are supply uncertainties, and the short shelf-life once defrosted adds to the complexity of the Pfizer vaccine.[[10]] GPs in Australia have struggled with administration and logistical problems.[[21]] The logistical requirements are such that a coordinated approach through PHOs may be more efficient than individual practices undertaking the work.

The New Zealand health system is not optimally structured for rapid deployment of a whole-population vaccination campaign. The semi-autonomous DHBs are centred around local hospitals, with variable access to services across the country giving rise to ‘post-code lotteries’ regarding patient services and outcomes.[[16]] Systemic racism and inequity exist in every facet of the health and social support systems.[[22]] The New Zealand health system was under review before the pandemic, with the final report released mid-2020.[[23]] The government planned actions for the transition are not yet public, which is unsettling and will require MOH and DHB attention and may dismantle the PHOs that would be important in coordinating vaccine programmes, like the PCNs in the UK.

Despite the challenges in logistics, coordination and personnel outlined above, New Zealand can learn from international experience. Implementing those findings in our system’s milieu will require dedication and vaccination plans to be ‘fully baked’ and transparent to everyone. Logistical limitations are well explained[[19]] and anticipated. The vaccination programmes’ administrative requirements in the UK and Australia have been frustrating to GPs.[[10,11,21]] In contrast, Israel has efficiently mobilised the community health workforce through coordinated general practice and has stream-lined all the steps.[[12]] New Zealand should learn from those international experiences and provide an efficient vaccination campaign for our citizens.

Summary

The COVID-19 vaccination campaign is the best chance New Zealand has to protect our citizens' health and will be a crucial activity for the health sector in 2021. The procurement strategy for New Zealand started early and has been a dynamic process. However, there has been no evidence of large-scale and detailed operational planning at the level of district health boards (DHBs), drawing political comments that plans are “half-baked” and prompting an Office of the Auditor-General review. To have a successful vaccination program, New Zealand will need to learn from international experience, and it must include the participation of primary care.

Abstract

Aim

Method

Results

Conclusion

Author Information

Dr Vanessa Weenink.

Acknowledgements

Correspondence

Dr Vanessa Weenink

Correspondence Email

vanessaw@pmc.co.nz

Competing Interests

Dr Vanessa Weenink is Chair of the General Practitioners Council of the NZMA, Deputy Chair (Elect) of the NZMA and Director of Pegasus Health Charitable limited (the Primary Health Organisation).

1. Bloomfield A. COVID-19, 20, 21: lessons from New Zealand's 2020 response for 2021 and beyond. NZMJ. 134

2. Ministry of Health web page  [updated 10 March 2021. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-and-planning#strategy.

3. Mansh T. Government releases Covid-19 vaccine delivery schedule: elderly and people with pre-existing conditions to be prioritised. Stuff. 2021 March 10th 2021.

4. Huang QS, Wood T, Jelley L, Jennings T, Jefferies S, Daniells K, et al. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand. Nature Communications. 2021;12(1).

5. Dada S, Ashworth HC, Bewa MJ, Dhatt R. Words matter: political and gender analysis of speeches made by heads of Government during the COVID-19 Pandemic. BMJ Global Health. 2021;6(1):e003910.

6. Walls C, Gavaghan S, Gorman D, McBride D. Scheduling of COVID-19 vaccination for at-risk employees. NZMJ. 2021;134

7. Lee TH, Chen AH. Last-Mile Logistics of Covid Vaccination — The Role of Health Care Organizations. New England Journal of Medicine. 2021;384(8):685-7.

8. Freed GL. Actionable lessons for the US COVID vaccine program. Isr J Health Policy Res. 2021;10(1):14.

9. Harnden A, Lim WS, Earnshaw A. COVID-19 vaccination programme: a central role for primary care. Br J Gen Pract. 2021;71(703):52-3.

10. Mahase E. Covid-19: Logistical problems frustrate GPs ready to deliver vaccine in England. BMJ. 2020;371:m4849.

11. Majeed A, Molokhia M. Vaccinating the UK against covid-19. BMJ. 2020:m4654.

12. Rosen B, Waitzberg R, Israeli A. Israel's rapid rollout of vaccinations for COVID-19. Isr J Health Policy Res. 2021;10(1):6.

13. Volpp KG, Loewenstein G, Buttenheim AM. Behaviorally Informed Strategies for a National COVID-19 Vaccine Promotion Program. JAMA. 2021;325(2):125-6.

14. Baraniuk C. Covid-19: How the UK vaccine rollout delivered success, so far. BMJ. 2021:n421.

15. Gauld R, Horsburgh S. What motivates doctors to leave the UK NHS for a "life in the sun" in New Zealand; and, once there, why don't they stay? Human Resources for Health. 2015;13(1).

16. Gauld R. New Zealand's post-2008 health system reforms: Toward re-centralisation of organisational arrangements. Health Policy. 2012;106(2):110-3.

17. Iacobucci G. Covid-19: GPs can limit routine work to focus on vaccination, says NHS England. BMJ. 2021:n67.

18. Iacobucci G. Covid-19: GPs could get extra funding to boost vaccine uptake in hard-to-reach groups. BMJ. 2021:n548.

19. Holm MR, Poland GA. Critical aspects of packaging, storage, preparation, and administration of mRNA and adenovirus-vectored COVID-19 vaccines for optimal efficacy. Vaccine. 2021;39(3):457-9.

20. Mills MC, Salisbury D. The challenges of distributing COVID-19 vaccinations. EClinicalMedicine. 2021;31:100674.

21. Mannix L. Victoria's vaccines ready to roll - but some teething issues remain 2021 [22/3/21]. Available from: https://www.theage.com.au/national/victoria/victoria-s-vaccines-ready-to-roll-but-some-teething-issues-remain-20210321-p57cpf.html?utm_content=NARRATIVE&list_name=3C1D28D0-7E1E-4DC0-9DD3-A961CC5360DB&promote_channel=edmail&utm_campaign=am-theage&utm_medium=email&utm_source=newsletter&utm_term=2021-03-22&mbnr=MjA0MjIwNzg&instance=2021-03-22-06-38-AEDT&jobid=29297386.

22. Moewaka Barnes H, McCreanor T. Colonisation, hauora and whenua in Aotearoa. Journal of the Royal Society of New Zealand. 2019;49(sup1):19-33.

23. Simpson H. Health and Disability System Review Final Report. 2020.

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

The COVID-19 vaccination campaign is the best chance New Zealand has to protect our citizens’ health and will be a crucial activity for the health sector in 2021.[[1]] The procurement strategy for New Zealand started early and has been a dynamic process.[[1,2]]  However, there has been no evidence of large-scale and detailed operational planning at the level of district health boards (DHBs), drawing political comments that plans are ‘half-baked’ [[3]] and prompting an Office of the Auditor-General review. To have a successful vaccination program, New Zealand will need to learn from international experience, and it must include the participation of primary care.

New Zealand has been praised internationally for its response to the pandemic, and New Zealand has escaped other nations’ death rates.[[4]] One of the factors in our success has been strong leadership.[[5]] Communication has been effective, and we have had an excellent response from our team of five million.[[1]] Regardless of that result, the medium- to long-term success of New Zealand’s response overall will be determined by the success of the vaccine campaign. Communication with primary care will need to improve in New Zealand if we are to continue our excellent response.

The plans for the vaccination rollout seem to be evolving fast in New Zealand. A recent letter in the New Zealand Medical Journal expressed that border workers be vaccinated as a priority group, which the Ministry of Health (MOH) had not previously planned.[[6]] Yet, by the time the letter was published, the vaccine campaign for border workers was underway.[[2]] Detailed plans following the border force are not transparent or publicly available. The prioritisation of vaccination is a small part of the planning required. While that has now been established, the crucial ‘last-mile logistics’ [[7]] of the vaccination programme may be left to individual DHBs to coordinate vaccination for the health workforce and the wider public. [[2,3]]

International evidence highlights both general practice’s (GP) and community pharmacy's essential role in successful campaigns.[[8–13]] In the UK, 75% of the vaccinations delivered have been through primary care networks (including GP clinics) and only the remaining 25% in specially designated vaccination centres.[[14]] Israel has fully vaccinated more than 50% of its residents with the Pfizer vaccine in under six months,[[12]] and this was coordinated through the primary care health plans, where GPs commonly work in private clinics and are usually salaried by the health plans.[[12]] New Zealand has limited primary care involvement in the initial phases as the vaccine is targeted toward the most likely to be infected at the border. [[3]]

New Zealand should consider the Israeli campaign as a benchmark of success. The Israelis have had a few advantages that New Zealand could not replicate. For example, high population density. [[12]] Fortunately, New Zealand and Israel share a universal approach to health, well organised primary care, a national unique identifier system for patients, substantial investment in vaccine procurement and a centralised (rather than federalised) government. If the vaccine campaign is centred around the community through primary care providers, New Zealand may meet the projected targets that the government has set.[[2]]

The National Health Service (NHS) in the United Kingdom shares features with the New Zealand health system.[[15]] The NHS has primary care networks (PCNs), analogous to our primary health organisations (PHOs).[[16]] The NHS is also a universal system and is providing vaccination free to the population. In the NHS, mainly nurses (who are already qualified vaccinators) are doing the immunisation.[[14]] The NHS attempted to recruit a sizeable ancillary vaccination workforce, which has been less successful. Without additional workers, GP clinics are deferring other work to concentrate on the vaccine.[[17]] The NHS also considers incentive payments to PCNs to target priority and hard to reach populations. [[18]] Meanwhile, the New Zealand MOH is yet to indicate the payment structure for vaccine delivery, leaving primary care providers uncertain of their required level of involvement. New Zealand GPs are not protected by collective bargaining as they are under the NHS and the Israeli health system, and funding agreements are tortuous and often contested.[[22]]

Primary care will need to be well supported to participate in the New Zealand vaccine programme. The logistical considerations for transport to vaccination sites are daunting.[[19]] However, in practice in the UK and the USA and Australia, one of the most significant challenges has been coordinating patients to attend booked appointments.[[10,12,20]] The coordination is made difficult when there are supply uncertainties, and the short shelf-life once defrosted adds to the complexity of the Pfizer vaccine.[[10]] GPs in Australia have struggled with administration and logistical problems.[[21]] The logistical requirements are such that a coordinated approach through PHOs may be more efficient than individual practices undertaking the work.

The New Zealand health system is not optimally structured for rapid deployment of a whole-population vaccination campaign. The semi-autonomous DHBs are centred around local hospitals, with variable access to services across the country giving rise to ‘post-code lotteries’ regarding patient services and outcomes.[[16]] Systemic racism and inequity exist in every facet of the health and social support systems.[[22]] The New Zealand health system was under review before the pandemic, with the final report released mid-2020.[[23]] The government planned actions for the transition are not yet public, which is unsettling and will require MOH and DHB attention and may dismantle the PHOs that would be important in coordinating vaccine programmes, like the PCNs in the UK.

Despite the challenges in logistics, coordination and personnel outlined above, New Zealand can learn from international experience. Implementing those findings in our system’s milieu will require dedication and vaccination plans to be ‘fully baked’ and transparent to everyone. Logistical limitations are well explained[[19]] and anticipated. The vaccination programmes’ administrative requirements in the UK and Australia have been frustrating to GPs.[[10,11,21]] In contrast, Israel has efficiently mobilised the community health workforce through coordinated general practice and has stream-lined all the steps.[[12]] New Zealand should learn from those international experiences and provide an efficient vaccination campaign for our citizens.

Summary

The COVID-19 vaccination campaign is the best chance New Zealand has to protect our citizens' health and will be a crucial activity for the health sector in 2021. The procurement strategy for New Zealand started early and has been a dynamic process. However, there has been no evidence of large-scale and detailed operational planning at the level of district health boards (DHBs), drawing political comments that plans are “half-baked” and prompting an Office of the Auditor-General review. To have a successful vaccination program, New Zealand will need to learn from international experience, and it must include the participation of primary care.

Abstract

Aim

Method

Results

Conclusion

Author Information

Dr Vanessa Weenink.

Acknowledgements

Correspondence

Dr Vanessa Weenink

Correspondence Email

vanessaw@pmc.co.nz

Competing Interests

Dr Vanessa Weenink is Chair of the General Practitioners Council of the NZMA, Deputy Chair (Elect) of the NZMA and Director of Pegasus Health Charitable limited (the Primary Health Organisation).

1. Bloomfield A. COVID-19, 20, 21: lessons from New Zealand's 2020 response for 2021 and beyond. NZMJ. 134

2. Ministry of Health web page  [updated 10 March 2021. Available from: https://www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-vaccines/covid-19-vaccine-strategy-and-planning#strategy.

3. Mansh T. Government releases Covid-19 vaccine delivery schedule: elderly and people with pre-existing conditions to be prioritised. Stuff. 2021 March 10th 2021.

4. Huang QS, Wood T, Jelley L, Jennings T, Jefferies S, Daniells K, et al. Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand. Nature Communications. 2021;12(1).

5. Dada S, Ashworth HC, Bewa MJ, Dhatt R. Words matter: political and gender analysis of speeches made by heads of Government during the COVID-19 Pandemic. BMJ Global Health. 2021;6(1):e003910.

6. Walls C, Gavaghan S, Gorman D, McBride D. Scheduling of COVID-19 vaccination for at-risk employees. NZMJ. 2021;134

7. Lee TH, Chen AH. Last-Mile Logistics of Covid Vaccination — The Role of Health Care Organizations. New England Journal of Medicine. 2021;384(8):685-7.

8. Freed GL. Actionable lessons for the US COVID vaccine program. Isr J Health Policy Res. 2021;10(1):14.

9. Harnden A, Lim WS, Earnshaw A. COVID-19 vaccination programme: a central role for primary care. Br J Gen Pract. 2021;71(703):52-3.

10. Mahase E. Covid-19: Logistical problems frustrate GPs ready to deliver vaccine in England. BMJ. 2020;371:m4849.

11. Majeed A, Molokhia M. Vaccinating the UK against covid-19. BMJ. 2020:m4654.

12. Rosen B, Waitzberg R, Israeli A. Israel's rapid rollout of vaccinations for COVID-19. Isr J Health Policy Res. 2021;10(1):6.

13. Volpp KG, Loewenstein G, Buttenheim AM. Behaviorally Informed Strategies for a National COVID-19 Vaccine Promotion Program. JAMA. 2021;325(2):125-6.

14. Baraniuk C. Covid-19: How the UK vaccine rollout delivered success, so far. BMJ. 2021:n421.

15. Gauld R, Horsburgh S. What motivates doctors to leave the UK NHS for a "life in the sun" in New Zealand; and, once there, why don't they stay? Human Resources for Health. 2015;13(1).

16. Gauld R. New Zealand's post-2008 health system reforms: Toward re-centralisation of organisational arrangements. Health Policy. 2012;106(2):110-3.

17. Iacobucci G. Covid-19: GPs can limit routine work to focus on vaccination, says NHS England. BMJ. 2021:n67.

18. Iacobucci G. Covid-19: GPs could get extra funding to boost vaccine uptake in hard-to-reach groups. BMJ. 2021:n548.

19. Holm MR, Poland GA. Critical aspects of packaging, storage, preparation, and administration of mRNA and adenovirus-vectored COVID-19 vaccines for optimal efficacy. Vaccine. 2021;39(3):457-9.

20. Mills MC, Salisbury D. The challenges of distributing COVID-19 vaccinations. EClinicalMedicine. 2021;31:100674.

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