H202101848 Doc 2.pdf

Briefing
Draft Cabinet paper: February 2021 update on the COVID-19
Immunisation Strategy and Programme

Date due to MO:  15 January 2021
Action required by:
18 January 2021  1982
Security level:
SENSITIVE
Health Report number:  20202320 Act
To:
Hon Chris Hipkins, Minister of COVID-19 Response
Hon Andrew Little, Minister of Health
Hon Dr Ayesha Verrall, Associate Minister of Health

Contact for telephone discussion
Information
Name
Position
Telephone
Dr Ashley Bloomfield
Director-General of Health
S9(2)(a)
Official
Caroline Flora
Acting Deputy Director-General, System
Strategy and Policy
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Minister’s office to complete:
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☐ Approved
☐ Decline
☐ Noted

☐ Needs change
☐ Seen
☐ Overtaken by events
☐ See Minister’s Notes
☐ Withdrawn

Comment:

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Briefing: 20202320

Draft Cabinet paper: February 2021 update
on the COVID-19 Immunisation Strategy
and Programme
Security level:
SENSITIVE
Date:
15 January 2021
To:
Hon Chris Hipkins, Minister of COVID-19 Response
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Hon Andrew Little, Minister of Health
Hon Dr Ayesha Verrall, Associate Minister of Health
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Purpose of report
1.
This report provides you with a draft Cabinet paper February 2021 update on the COVID-
19 Immunisation Strategy and Programme, for your review and Ministerial consultation,
that responds to Cabinet’s invitation for a report back on several issues related to the
COVID-19 Immunisation Strategy and Programme. It also seeks your agreement to
several of the policy issues included in the draft Cabinet paper.
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Summary
2.
This report attaches a draft Cabinet paper, to update Cabinet on 2 February 2021 on the
COVID-19 Immunisation Strategy and Programme, for your review and Ministerial
consultation. It includes proposals on a number of outstanding policy issues, including:
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a. Out of Scope
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b.
c. the proposal to expand eligibility for COVID-19 immunisation to everyone in New
Zealand, which would help us to maximise uptake of the vaccine. This would help
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reduce the risk of harm from COVID-19 and, over time, help us work towards
population immunity.
3.
Our advice on these issues is outlined in further detail in this report. We seek your
decisions on these issues to ensure the draft Cabinet paper accurately reflects your
position.
4.
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5.
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Recommendations
We recommend you:
Hon Chris
Hon Andrew  Hon Dr Ayesha
Hipkins
Little
Verral
Cabinet paper process
1    Note the attached draft Cabinet paper to respond to
Yes/No  Yes/No
Yes/No
the request for a report back by 2 February, which
includes our recommended advice on a number of
outstanding policy issues
2    Agree to provide the draft paper to relevant Ministers  Yes/No  Yes/No
Yes/No 1982
for Ministerial consultation, with feedback due by
midday 22 January 2021
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Out of Scope
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Eligibility to publicly funded COVID-19 immunisation
10    Note that enabling everyone in New Zealand,
Yes/No  Yes/No
Yes/No
regardless of immigration status, to access to publicly
funded COVID-19 immunisation:
10.1 would support our goal of working towards
population immunity over time, and
10.2 can be absorbed within existing funding under
current border settings
11    Note that to expand eligibility, the Minister of Health
could establish a Ministerial Direction under section 32
of the Public Health and Disability Act 2000 (the Act),
which requires consultation with DHBs
12    Agree in principle, subject to consultation with
Cabinet and DHBs, that eligibility to publicly funded
COVID-19 immunisation either:
Yes/No  Yes/No
Yes/No
12.1 Option one (not recommended): aligns with
the existing Eligibility Direction 2011
OR
OR
OR
OR
Yes/No  Yes/No
Yes/No
12.2 Option two (recommended) expands to
include everyone in New Zealand regardless of
immigration status
13    Agree that, as required under section 32 of the Act, we  Yes/No  Yes/No
Yes/No
begin consultation with DHBs in January 2020 on a
Direction to expand eligibility to publicly funded
COVID-19 immunisation to everyone in New Zealand.
under the Official Information Act 1982
Dr Ashley Bloomfield
Hon Chris Hipkins
Director-General of Health
Minister for COVID-19 Response
Date:
Date:
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Hon Andrew Little
Hon Dr Ayesha Verral
Minister of Health
Associate Minister of Health
Date:
Date:
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Draft Cabinet paper: February 2021 update
on the COVID-19 Immunisation Strategy
and Programme
The next update to Cabinet on the COVID-19 Immunisation Strategy and
Programme is due early February 20201
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6.
On 7 December 2020, Cabinet considered advice on the COVID-19 Immunisation
Strategy and Programme. It agreed that the purpose is to support best use of COVID-19
vaccines, which upholding and honouring Te Tiriti o Waitangi obligations and promoting
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equity [CAB-20-MIN-0509 refers].
7.
The Prime Minister’s office has requested that you report back to Cabinet on the COVID-
19 Immunisation Strategy and Programme on 2 February 2021.
We have attached the requested draft Cabinet paper for your discussion
and feedback, which includes advice on several outstanding policy issues
8.
The attached draft Cabinet paper incudes advice to respond to the requested report-
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backs. It includes proposals related to the following outstanding policy issues:
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b.
c. eligibility for COVID-19 immunisation.
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[Pages 5-8 withheld as out of scope]
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Expanding eligib
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Zealand will help us maximise uptake
37.
Immunisation is publicly funded for eligible people specified in the Health and Disability
Services Eligibility Direction 2011. In general, this would include al :
a. children
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b. New Zealand citizens (including people from Cook Islands, Niue and Tokelau) and
permanent residents
c. refugees and protected persons
d. Australian citizens or permanent residents who have lived, or intend to live, in NZ for
two years or more
e. people with a valid work visa who wil  be in NZ for at least two years.
38.
This means adults on temporary visas or who are Australian citizens that will be in NZ for
less than two years, or people who are in NZ unlawfully, would not be eligible for a
publicly funded COVID-19 vaccine at present.2 Our estimates suggest this could include
approximately up to 280,000 people.
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39.
As was seen with the 2019 Measles Outbreak, community transmission of infectious
diseases can occur among groups who are not normally eligible for immunisation,
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potential y putting the individuals, their whānau and their community at risk. Maximising
uptake of the COVID-19 vaccine wil  be essential if we are to reduce the risk of harm
from COVID-19 and, over time, achieve population immunity. It also enables us to
contribute to the global effort working to end the pandemic.
40.
Given this, we propose that everyone in New Zealand should be able to access free
COVID-19 immunisation. This includes people in New Zealand temporarily (for example,
Recognised Seasonal Employer (RSE) workers) and people in New Zealand unlawfully.
Appendix Three includes an options analysis of this proposal against the COVID-19
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Immunisation Strategy principles.
41.
This option is consistent with the draft advice from the National Ethics Advisory
Committee:
From an epidemiological perspective, all individuals living in a geographic area (such as
New Zealand) must be considered as part of the immunisation programme, regardless of
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their immigration status. This includes all non-residents currently living in, or unable to
leave, New Zealand.3
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42.
It is also consistent with access to COVID-19-related healthcare, which is available to
everyone in New Zealand.
43.
We did consider an option to limit the expansion in eligibility to only people “living in
New Zealand”, i.e. including people on work visas and student visas (and potentially
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Australians), but excluding people on visitor visas. We discounted this option for a
number of reasons:
a. It does not align with the COVID-19 Immunisation Strategy principles, in particular
equity, regional responsibility and equal concern.
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2 While there is a clause that enables the diagnosis or treatment of anyone suspected of having a quarantinable disease
immunisation is preventative and wil  general y not be given to a person “who has, or is suspected of having, and
infectious disease”.
3 National Ethics Advisory Committee, Ethics and Equity: Resource Allocation and COVID-19: An Ethics Framework to
Support Decision Makers (draft version, 2020).
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Wednesday 20 January  Feedback from agency consultation due
Midday on Friday 22
Ministerial feedback on Cabinet paper due
January
Wednesday 27 January  Final Cabinet paper for your approval
Thursday 28 January
The Cabinet paper is lodged by the Minister of Health’s office
Monday 2 February
Cabinet meeting
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56.
In addition to those who wil  attend the Ministerial meeting on 18 January 2021, we
suggest the updated Cabinet paper is provided to other relevant Ministers for their and
comment, such as the Minister of Immigration.
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57.
Given the tight timeframes, we are seeking feedback from Ministerial consultation by
midday on Friday 22 January. We will then incorporate any changes before providing
you the final Cabinet paper for lodgement on 27 January 2020.
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[Page 14 and Appendices One & Two withheld as out of scope]
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