Those at high risk of Covid-19 in south Auckland and certain aged care facilities will be priorities for the vaccine
roll-out after border and frontline healthcare workers.
Following this group will be over-65s and people with underlying health conditions across the country. The vaccine will
then be distributed to the remainder of the population.
The SMC asked experts to comment on the roll-out plan.
Dr Collin Tukuitonga, Associate Dean Pacific, Faculty of Medical and Health Sciences, University of Auckland, comments:
“I think it’s fantastic that south Auckland is a priority in the vaccine roll-out. We’ve been lobbying for this to
happen for some weeks now. While we do this because we recognise the risk for the communities in south Auckland, they
are also adjacent to the airport, so there is a risk of an outbreak to everyone else in the country too. So prioritising
south Auckland residents with these conditions and ages will be good for everyone.
“The government have decided not to vaccinate all of south Auckland as a priority, which I consider is a pragmatic
response to limited vaccine supply. There are other priority groups as well – the government estimate 230,000 people
living in high risk environments.
“I think it’s a fantastic decision to allocate the 40,000 courses to Māori and Pacific providers to distribute to their
patients and families. I know from experience that Pacific medical providers have predominantly Pacific patients, so it
will improve the chances of the vaccine being delivered to those people that often have difficulty accessing health
services.”
No conflict of interest declared.
Professor Michael Baker, Professor of Public Health, University of Otago, Wellington:
“It is a remarkable achievement that only a year after Covid-19 first arrived in New Zealand that we are planning the
roll-out of a highly effective and safe vaccine to the entire adult population. It is also remarkable that because we
have eliminated transmission of Covid-19 in New Zealand that we can distribute the vaccine in an orderly way without the
pressure of being in the midst of an emergency with people getting sick and dying every day, which is unfortunately the
situation in much of the world.
“The vaccine prioritisation process is based on logical principles so contains few surprises. It is important to
remember that our top priority group of border and MIQ workers is very different to much of the world that has not been
able to eliminate the virus. In other respects, our focus on healthcare workers and the most vulnerable groups is very
similar to other countries.
“There are some questions that still need to be considered. In keeping with the high priority attached to reducing the
chance of future outbreaks it would be useful to consider vaccinating New Zealanders taking short to medium term trips
overseas, ie those leaving with definite plans to return. That would reduce the chance of them importing the virus when
they come back. It might also be useful to consider vaccinating everyone on arrival in MIQ facilities, though that is a
more complex decision as protection from the first vaccine dose would be only partial. It would of course be preferable
to vaccinate all returnees prior to their departure to New Zealand, though that is harder to arrange at present.
“The list of relevant underlying health conditions will almost certainly be fine-tuned. One group to consider includes
those who are obese, since we know that a high BMI is strongly associated with the risk of having a poor outcome from
Covid-19 infection.
“Children are still missing from the list for obvious reasons. We need data from trials that are underway at present to
confirm that the vaccine is safe and effective in that age group. Such results are expected shortly.
“One possible adverse effect of this vaccination programme is that it might add to the considerable complacency many New
Zealanders are showing in the face of this pandemic. The risk of importation and local outbreaks remains high.
Vaccination of border and MIQ workers will help to protect us. However, there is a lot more that can and should be done
to reduce the risk of importation of this virus and to prevent future outbreaks in this country.”
No conflict of interest.
Professor Nick Wilson, Department of Public Health, University of Otago, comments:
“The Government’s vaccine roll-out plan makes a lot of sense in how it combines enhanced border protection along with
protecting the older age groups. The plan is fairly consistent with the approach taken in New Zealand around
fully-subsidised influenza vaccination (ie. older age groups and those with various underlying health conditions.)
“However, the border protection part of the plan could have been improved upon by putting all the adult population in
the Counties Manukau DHB into Group 2 (rather than just the over 65s and those with underlying health conditions in this
area.) This is because this population is particularly exposed to border failures via the proximity to Auckland
International Airport and various MIQ facilities in south Auckland. Nevertheless, it is to be hoped that such border
failures will become less frequent with the vaccination of border workers – along with other refinements with MIQ to
reduce mixing of people in shared exercise and smoking areas etc.
“The rollout of this vaccination is a major advance in pandemic control – but there is still much work to do to both
improve New Zealand’s border controls (for travellers from high risk countries such as the US), while facilitating
quarantine-free travel for people from low-risk “green zone” countries like Australia (potentially with some testing
requirements.) Specific other improvements needed include phasing in mandated daily saliva-based PCR tests for all
border workers, mandated use of QR codes for high risk settings, and building higher adherence to mask wearing on public
transport.”
Conflict of interest statement: Nick Wilson has no competing interests. He gets no funding for any of the research he
does on Covid-19.
Professor Michael Plank, Te Pūnaha Matatini and University of Canterbury, comments:
“The plan released today sets out the timetable for vaccinating the New Zealand population. We have really strong data
that the Pfizer vaccine provides excellent protection against getting seriously ill with COVID-19. Although the
preliminary data is promising, it is less certain how much protection the vaccine provides against getting the virus and
passing it onto others. Therefore it makes sense to take a balanced approach like the one outlined in the plan.
Vaccinating our frontline workers will provide an extra buffer against COVID-19 getting out into the community.
Vaccinating older people and those with underlying health conditions will protect those at highest risk of getting
severely ill with COVID-19.
“It makes sense to prioritise at-risk people who are living in south Auckland as this region has the highest risk of
border-related outbreaks. This vaccination plan will help reduce the likelihood and severity of future outbreaks in
south Auckland. However, we should remember that cases of COVID-19 could appear anywhere, so eventually we will need to
see high vaccination coverage across the whole country.
“Māori and Pacific people have a higher rate of needing hospital treatment for COVID-19 after controlling for age. It is
a good start that the plan recognises this by prioritising older Māori and Pacific people. It will be important that the
government continues to work with Māori and Pacific providers to ensure that there are sufficient doses available for
these groups.”
No conflict of interest declared.
Dr Sarb Johal, psychologist, comments:
“Today we found out more about how vaccinations will be rolled out in New Zealand. This gives a helpful level of
predictability in what has been a very difficult year, filled with uncertainty.
“This is really encouraging news. For the vaccination messaging campaign, as well as talking about the risks of people
not taking up the vaccine in enough numbers, there is an opportunity to tell the story about the potential benefits that
are unlocked through vaccine uptake and continued public health measures adherence in the future.
“Telling New Zealand’s exit story of the pandemic and what needs to happen to get there becomes a story of pragmatic
hope, drawing a clear picture of what life might look like post-2021.”
Dr Sarb Johal is a clinical psychologist and author. He has today published on his blog a psychological analysis of the NZ Govt comms campaign so far, and how this could evolve now the vaccination pathway is
clearer.
No conflict of interest declared.