PHARMAC proposing to add to national immunisation schedule

November 7, 2013

PHARMAC proposing to add rotavirus, varicella vaccines to national immunisation schedule

A vaccine for the gastric infection rotavirus and protection from varicella for the most vulnerable people are among proposed changes to the national immunisation schedule that PHARMAC is seeking feedback on.

Rotavirus and varicella vaccines are not currently funded, says PHARMAC’s Medical Director Peter Moodie. Already 14 vaccines are funded in New Zealand and PHARMAC is managing the national contracting process for the first time, including looking at options for widening access to existing vaccines or listing new ones.

New Zealanders would have added protection from infections in the community if the proposals were implemented, says Dr Moodie.

“New Zealanders’ access to funded vaccines would continue to improve under these proposals,” says Dr Moodie. “In many cases vaccines offer our best defence against infection in the community, so this is an important process for people to be involved in. Having put together this proposal, we now want to hear from people what they think.”

Rotavirus is a significant illness in young children leading to many children ending up in hospital, says Dr Moodie.

“We estimate that, based on available data, as many as 1200 fewer hospitalisations of young children would occur each year, as a result of funding this new vaccine.”

Features of the proposals include:

· Rotavirus vaccine would be added to the funded list, funded for all eligible patients

· Varicella (chickenpox) vaccine would be funded to protect the most at-risk patients – children with reduced immune systems (for example, because of chemotherapy). The vaccine would also be funded for people in direct contact with these children (`cocooning’)

pneumococcal conjugate vaccine (Prevenar 13 - Pfizer) would be listed for all eligible patients from 1 July 2014. PCV13 offers additional protection against Invasive pneumococcal disease, compared to the previously funded PCV10;

· Listing of improved versions of the current meningococcal vaccine, changing to a conjugated meningococcal C or meningococcal A, C, Y and W135 vaccine.

Another significant change proposed is expanding eligibility rules so that children whose immune systems are weakened, for example by chemotherapy, will be able to have further vaccine boosters funded. This would be for 10 vaccines.

Dr Moodie says the proposals follow PHARMAC receiving clinical advice from its expert immunisation subcommittee and PTAC, and running a competitive process among suppliers. The expert committees had looked closely at the clinical evidence for varicella, and recommended funding only for highest-risk groups.

“It is still possible that other vaccines could be added to the schedule outside the three-yearly contracting cycle,” says Dr Moodie.

“PHARMAC continues to be open to new information on vaccines and will use this to make any appropriate changes to access in future.”

Dr Moodie says PHARMAC expects further evidence will become available about the impact of varicella vaccine on zoster infection (shingles), which mainly affects adults. When new evidence becomes available, PHARMAC would seek the view of its expert clinical advisors at its earliest opportunity, he says.

Public submissions on the consultation can be made at www.pharmac.govt.nz and close on 20 November. If approved, changes to the Immunisation Schedule would take effect from 1 July 2014.

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