Document 1
Minutes/ Actions
IIAG Special Meeting
Date:
Tuesday 2 March 2021
Time:
12:00pm – 1.15pm
Location:
Teams
Ana Bidois, Api Telemaitoga, Angela Ballantyne, Carl Bil ington, Denise Mackay, Dr
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Rawiri McKree Jansen, Keriana Brooking, Loretta Roberts, Michael Dryer, Nikki
Attendees: Turner, Rhonda Sherrif , Taima Campbell, Te Puea Winiata, Wendy Il ingworth,
Casey Picket , Nicky Birch
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Item
Agenda Item
1.
Introduction
• Wendy opened explaining that there are two pieces of advice that the Programme is
working on this week; a process for alert level decisions and what they mean for the
immunisation programme, and a paper on what the current outbreak means for
sequencing scenarios.
• Casey explained the current situation and a view of next steps. Cabinet wants
reframed advice on the Sequencing Framework with a strong link
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elimination strategy. The team is updating the paper this week, which wil include
options for responding to the current outbreak in South Auckland.
2.
Open discussion
• There was some consensus from the group that mashing scenario 1 and 2 is
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problematic. Casey clarified that changes in early February talked about a relentless
focus at the border, which is why there is an option to bridge scenarios 1 and 2, as
the border isn’t finished yet.
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• Mat noted that from the MOH Covid Directorate point of view, we should stay in
Scenario 1 because the cluster is controlled. However the team is also thinking about
South Auckland and is undertaking operational planning to speed up delivery. There
is potential for a large scale vaccination centre in South Auckland next week.
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• Rawiri suggested that if Auckland stays at level 3, it wil be hard to argue against
going to scenario 2. If Auckland moves to level 4 we need to focus only on South
Auckland. This could include one dose for everyone and drive-through vaccination
centres.
• Keriana noted the difference between urgent and important. It wil be important we
don’t lose sight of all the different strategies e.g. from an equity perspective, at what
point do we stop feeling ok about the data?
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Action 1: Nikki Birch requested a direct contact for iwi in each region as they don’t
know who to work with and don’t want to miss opportunities.
3.
Clarification of actions for IIAG
• Mat clarified that the discussion landed in two places:
1. MOH requested a consolidated position from I AG on which sequencing scenario
to operate under next week. This wil be copied into the Cabinet paper.
2. The agenda for IIAG on Friday wil focus on the design of the programme,
including success criteria and tolerances, and workforce issues and options
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Action 2: The MOH team requested a consolidated position from I AG on which
sequencing scenario to operate under next week.
4.
Closing comments
• Rawiri requested that MOH be really direct on what they’re expecting from DHBs.
• Te Puia requested updates from MOH on a daily basis
Action 3: Mat Parr to come back to the group with update on daily comms to IIAG.
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Document 2
IIAG Minutes/Actions
Date:
5 Poutū-te-rangi/March 2021
Time:
1:00 pm – 4:00 pm
Chair:
Keriana Brooking
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Attendees: Dr Rawiri Jansen, Nikki Turner, Loretta Roberts, Beth Williams, Rhonda
Sherrif , Kevin Pewhairangi, Silao Vaisola-Sefo, Dr Tristram Ingham, N
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Birch, Vince Barry, Angela Ballantyne, Taima Campbell, Apisalome
Talemaitoga, Mathew Parr, Carl Bil ington, Michael Dreyer, Tamati
Shepherd-Wipiiti, Te Puea Winiata, Al ison Bennett, Fleur Keys, Mat Parr, Jo
Bourne, Ray Finch
Apologies:
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Item
Agenda Item
1
Introduction and welcome
• Opened with a karakia.
• Minutes from the last meeting and the special meeting on 2 March were
confirmed.
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2
Conflicts of interest register – any updates
• No conflicts of interests were registered.
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3
Programme update
Mat Parr (Programme Director) provided an update about the programme
• Mat noted that in response to the special meeting on scenarios for the
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sequencing framework, MOH is looking to send a letter directly from IIAG to
Minister Hipkins. The group supported the letter and this approach.
• The Sequencing Framework has been lodged for Cabinet on Monday.
• Mat noted that there are multiple important components that are starting to
come together to create and overarching strategy for the programme.
Discussion:
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• The group noted that they are interested to see how everything is coming
together and would like to have a view across the programme. The group would
also like updates on how the programme is going.
Action 6: Mat Parr to share daily reporting with the group and ask Jo Gibbs to give
an update at the next meeting.
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Success framework
Al ison Bennett and Fleur Keys (Policy) provided an update about the vaccinator
workforce
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• Al ison explained that this framework responds to Ministers’ interest in targets
for the Immunisation Programme. The framework aims to help decision-making
within the programme and provide clarity around the different aspects and
trade-offs that need to be thought about.
Group feedback:
• General consensus that the concept is good, but lots of suggestions for
refinement. For example:
o Disabilities should be added to the equity section.
o There shouldn’t be public measures about hesitancy as this could
exacerbate the problem.
o Need a separate box to represent Te Tiriti – the partnership in itself wil
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be a very important measure of success
o There is a need to have a sophisticated monitoring programme
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alongside this framework and decide whether it wil be done from inside
the programme or outside.
• The group suggested other measures that could be included in the framework:
o High quality data, as well as denominators for what we can measure
e.g. ethnic groups, rural communities
o Sustainability of the programme e.g. training new workers and providing
ongoing opportunities.
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o Health literacy
o Avoided hospital admissions
o Link to other immunisation programmes
• The group noted that there are so many dif erent things that can be measured,
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but they would like to be involved in deciding on priorities for monitoring.
Action 7: Al ison and Fleur to refine the framework and return to the IIAG with a
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second iteration.
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Workforce update
Fiona Michelle provided an update on the vaccination workforce.
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• At the time of reporting, there were 851 vaccinators.
• Data this week suggests that not as many vaccinators are needed as
originally thought; now 1200-1500 instead of 2-3000 but this is early data.
Group discussion:
• Fiona not
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through training. MOH is currently looking into options for the non-regulated
workforce. In response to this, Kevin noted that he thinks Pharmacy
insurance covers technicians.
• There was a discussion about whether more people should be put through
the training now. IMAC explained that there is technically no limit but they
are focussing on an information module about vaccines this week. The
group noted that they would like to be involved further in discussions about
training numbers.
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Auditor General advice update
Mat Parr noted that the Auditor General is conducting an audit on the vaccine and
immunisation programme to provide independent advice to parliament. This wil
involve a series of interviews, including with IIAG members. Mat suggested that
IIAG wil have a valuable view, seeing as they have been involved in the
programme since the beginning.
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Service Delivery Models
Joe Bourne (GM, Event Pillar) presented an update on service delivery models.
• Jo ran presented MOH’s work on service delivery models. The goal of this
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work is to ensure every site is safe, makes the most of existing processes,
and manages constraints and trade-offs. Joe also noted that MOH is
focussed on creating partnerships with stakeholders in the event design
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work, to ensure that people have trust in the programme to meet their
needs.
Discussion:
• The group raised the fact that they haven’t seen all the documents as a
whole and would like to see alignment across the whole programme.
• The balance between DHBs and MOH managing the immunisation
programme was raised. Jo mentioned that he is doing a lot of thinking on
this point and there are positives and negatives with both.
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• A question was raised about whether anyone can receive the same services
in any region e.g. a person with disabilities. Jo explained that the idea with
the dif erent service delivery models is that there wil be underlying
consistency across the programme, but the partnership approach means
that DHBs wil be responsible for ensuring that everyone in their region has
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the ability to get vaccinated.
• The issue of monitoring was raised again with a request for a central point
for all the information to feed back to.
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Te tiriti and equity framework
Tamati Shepherd-Wipiiti and Ray Finch provided an update on the equity
strategies.
• Last week a set of
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was approved by the Governance Group and by Ministers.
• Tamati explained that there is a cross-agency equity team that is being led
by MOH in partnership with other agencies that work with specific
populations e.g. OEC, TPK, MSD, MPP
• The goal of this work is to line up all of the support, regardless of where it
comes
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the country. There wil be a monitoring framework next week that explains
how these outcomes can be measured.
• Ali gave an update on the Pacific strategy, explaining that it is on track and
embedded into the governance of the programme. A focus at the moment is
working with MPP on community fonos.
• Rae provided an update on the disability strategy, including that a disability
subgroup of IIAG is being set up.
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• Tamati explained that the Māori strategy is separate from the other equity
strategies to honour te tiriti.
Discussion:
• The Asian elderly population was raised as a vulnerable group and should
be considered in the equity approach.
• Hesitancy was raised. It wil be important that the system does a good job of
informing people and making the process easy.
Action 8: Tamati to fol ow-up on start dates for Māori and Pacific communications
plans.
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9
Technology update
Michael Dreyer (Group Manager, National Digital Services) presented an update on
the technology landscape.
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• Michael presented a diagram of the technology landscape.
• The CIR is working well and later in the year everything from the old NIS wil
be migrated to create the new NIR. At the moment the CIR captures
everything that’s critical to the campaign and includes online training so
vaccinators can use it on day 1.
• Michael explained that the immunisation programme is a national campaign
that is being delivered locally, so it is important that the technology can see
what is happening at both levels and has an end-end view.
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• The national booking system is underway. It wil be an extension of the
covid tracer app and wil have a consumer channel for people to book, see
their vaccination status, report an adverse reaction, learn about vaccines,
and update personal information e.g. iwi, disability.
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Discussion:
• The group asked whether it would be possible to see RAG ratings for the
different tech component
THE s at the next meeting. It would be useful to see
how the system is tracking as a whole.
• The group asked Michael what was worrying him and he noted that getting
the booking system delivered nationally is a big task and is essential to
scaling later in the
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Action 9: Michael Dreyer to provide RAG ratings for the technology components to
the group.
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Communications and Engagement
Carl Bil ington presented an update on communications and engagement.
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• The team is reclarifying roles in comms and engagement and Carl will share
new responsibilities with the group.
• The team is looking to pick key messages back up going forward, which will
be shared with the group.
• Rachel from DPMC provided an update on the campaign which is being run
under the broader “unite against covid brand”. Rachel noted that they are
starting with a low-level media campaign to begin with focussing on the fact
that people need to remain vigilant. They don’t want to go out too early and
create demand for vaccinations we can’t meet, however they are balancing
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this with the need to reassure people that the vaccines are safe and there
are enough for everyone.
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Closing/Karakia whakamutunga
Action Tracker 5 March
Item
Action
Lead
Due Date
01 Share daily reporting with the group and ask Jo
Mat Parr
19 March
Gibbs to give an update at the next meeting.
02 Refine the success framework and return with a
Allison
19 March
second iteration.
Bennett
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03 Follow-up on start dates for Māori and Pacific
Tamati
19 March
communications plans.
Shepherd-
Wipiiti
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04 Provide RAG ratings for the technology components
Michael
19 March
to the group.
Dreyer
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Document 3
IIAG Minutes/Actions
Date:
19 Poutū-te-rangi/March 2021
Time:
1:00 pm – 4:00 pm
Chair:
Keriana Brooking
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Attendees: Dr Rawiri Jansen, Nikki Turner, Loretta Roberts, Beth Williams, Rhonda
Sherrif , Kevin Pewhairangi, Dr Tristram Ingham, Nicky Birch, Vince Bar
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Angela Ballantyne, Taima Campbell, Apisalome Talemaitoga, Mathew Parr,
Carl Bil ington, Michael Dreyer, Tamati Shepherd-Wipiiti, Te Puea Winiata,
Al ison Bennett, Fleur Keys, Mat Parr, Joe Bourne, Ray Finch
Apologies: Silao Vaisola-Sefo
Item
Agenda Item
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1
Introduction and welcome
• Tristram opened with a karakia.
• Minutes from the last meeting confirmed.
2
Conflicts of interest register – any updates
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• No conflicts of interests were registered.
3
Communications and engagem
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John Walsh provided an update about the comms programme
• John is leading the comms programme out of DPMC for the next 3 months.
• The tentative overarching position of the campaign is “the stronger our
immunity, the greater our possibilities”
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• There are three tasks for the comms campaign:
o Inform people
o Help people to understand their role and plan for it
o Share the notion of possibilities from immunisation
• John wil send a plan to the group next week for discussion at the next meeting
• The advertising campaign could begin in early April
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Rachel provided an update on the “soft launch” last weekend
• A press ad and radio ad went live last week and wil continue until April 11.
• The social media campaign started on Wednesday
• The campaign is based around “safe, effective, free” messaging
Group discussion:
• There were questions about how the general campaign relates to the Māori
comms campaign. General consensus from the group was that the overarching
campaign doesn’t work for Māori and isn’t moving quickly enough. Māori and
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Pacific groups and agencies (including MPP and TPK) are moving ahead with
their own comms campaigns.
• Concerns were raised about IIAG’s role in providing advice as the group doesn’t
feel like their advice has been listened to. There was also concern raised about
Ministers leading a health programme and Mat Parr agreed to pick this action
up with a briefing to Ashley.
Action 1: Gabe to share Mahi Tahi videos with the group
Action 2: Carl to bring back a report on “soft launch” campaign and who it has
reached
Action 3: Mat Parr wil send a briefing to Ashley on Monday about role of IIAG.
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Workforce training
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Loretta Roberts provided an update about vaccinator training
• Over 4000 people have gone through provisional training and close to 100 have
completed peer assessments.
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• The Train the Trainer module has been delivered in some regions and wil be
rolled out in additional regions over the next two weeks.
• The programme for GPs and information course is on hold due to clinical
changes.
• Regular webinars are being held for GPs and primary care. Any healthcare
workers wil be able to do the general course on the website from next week.
Group discussion:
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• There was discussion about deciding to only use Pfizer and the group not being
consulted on this. Mat Parr explained that the Pfizer purchase didn’t preclude
the other vaccines being used at some point / for some parts of the programme.
• There was concern raised about DHBs acting as gate keepers for vaccine
training. There is potential for the group to write a piece of advice on this.
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• Tristram requested that disability information be collected from the vaccinator
workforce. Michael Dreyer and IMAC will pick this up.
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Action 4: Michael and Loretta to organise the collection of disability information for
vaccinator workforce.
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Sequencing Framework update
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Wendy Il ingworth provided an update on the sequencing framework.
• Wendy explained the process for deciding the sequencing framework
• While the framework has been agreed by Cabinet, there wil be a pragmatic
and flexible approach to delivery.
Group discussion:
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• The group raised concerns over information flows from the Ministry of Health.
For example, IMAC found out about the sequencing framework from the press
release and then had to adapt the vaccinator training. Carl took this as an
action.
• Concerns were raised about policy decisions not following science and
Ministers needing to be clear that this presents risk for the programme.
Action 5: Carl to ensure IIAG is looped into significant decisions / progress in the
programme.
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Service delivery models
Joe Bourne gave an update on service delivery models, explaining that they are a
work in progress so there is time for the group to provide input. While the plan is to
have national consistency, there wil also be variability and flexibility for what DHBs
need for their regions.
Group discussion:
• The group raised that marae centres wil need to be a relationship building
exercise with iwi.
• Taima asked how Māori providers are linked to DHBs. Tamati explained that
there are multiple avenues but we need to manage communications between
them. This is a work in progress.
• Concerns were raised about providers obligation to abide by the standard
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operating model e.g. how much vaccinators are being paid differs across
providers. MOH acknowledged this is an issue that is being worked through and
a paper is going to Steering Group next week.
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Tech update (Michael Dreyer)
Michael Dreyer provided a technology update.
8
Programme update including ops (Luke Fieldes)
Luke provided an update on the programmes reporting.
Group discussion:
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• Need to also provide public facing reporting for transparency
• Agree with iwi data being collected predicated on having Māori data sovereignty
and Māori data governance in place, and using standardised iwi data sharing
protocol
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Closing/Karakia whakamutunga
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Action Tracker 19 March
Item
Action
Lead
Due Date
1
Share Mahi Tahi videos with the group
Gabe Para
2
Bring back a report on “soft launch” campaign and
Carl
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who it has reached to next IIAG
Billington
3
Send a briefing to Ashley on Monday about role of
Mat Parr
IIAG.
4
Organise the collection of disability information for
Michael
vaccinator workforce.
Dreyer &
Loretta
Roberts
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5
Ensure IIAG is looped into significant decisions /
Carl
progress in the programme.
Billington
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Agenda items for next meeting:
• Comms update for Māori, Pacific, Asian and
Disabilities
• Logistics of the programme
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Document 4
IIAG Minutes/Actions
Meeting - Friday 14 Haratua 2021
Date:
14 May 2021
Time:
1:00 pm – 4:00 pm
Co-Chairs:
Te Puea Winiata, Keriana Brooking
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Members
Dr Angela Ballantyne, Nicky Birch, Taima Campbell, Dr Tristram Ingham,
attending
Rhonda Sherrif , Kevin Pewhairangi
MoH
Jason Moses, Mat Parr, Carl Bil ington, Joe Bourne (item), John Harvey
Attendees: (item), Fiona Michel (item), Petrus van der Westhuizen (item), Tamati
Shepherd-Wipiiti
Carol Hinton (Minutes)
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Apologies: Dr Helen Petousis-Harris, Loretta Roberts, Dr Apisalome Talemaitoga,
Dr Nikki Turner, Silao Vaisola-Sefo
Item
Agenda Item
1
Introduction and welcome
• Keriana Brooking opened with a karakia.
• Mat Parr noted that the Director-General of Health, Dr Ashley Bloomfield, was
unable to attend this I AG meeting but was keen to in the future.
• Mat Parr apologised that due to a change of timing for the weekly Vaccine
Ministers’ meeting, he could only attend part of the IIAG meeting.
• No conflicts of interest were registered.
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Terms of Reference (ToR) refresh
Context
• Te Puea Winiata acknowledged Keriana’s contribution in the expression of the
concerns of the group over past weeks.
• This meeting was an opportunity regroup and review the ToR.
• Keriana felt the group would be happy to put forward its thoughts but leave
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Te Puea to work with the Ministry to refresh the ToR. She also acknowledged
that some may not wish to continue their membership.
Role of IIAG
• Te Puea noted the Director-General’s letter confirmed IIAG was the principal
advisory group helping to design the overall programme, and assured us that
the Group has been influential, with many recommendations moving into
Cabinet papers.
• Members want to feel there is a point to the amount of time and advice they wil
be giving going forward. Being advised in a more timely way when the Group’s
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advice is incorporated into advice to Ministers and Cabinet would be helpful.
They would also like a ‘whole system’ understanding - how advice that is
subsequently accepted translates into action ‘on the ground’ at DHB level.
• The group noted it incorporates an ‘equity’ lens into its advice, but did not
delineate this, considering it an integral part of ‘doing the right thing’.
Action 1: MoH (Mat Parr) to consider how best to provide ‘whole system’
advice to IIAG so that it is clear what advice is incorporated into policy
advice, and what then moves into decisions and implementation.
Group discussion
Keriana invited members to share their reflections:
• Nicky Birch: felt the group had potential to make a significant difference to both
policy planning and delivery, and noted her disappointment that the group had
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not had the impact she had expected.
• Taima Campbell: asked what had changed over the interim period in terms of
consideration of IIAG advice. The CVIP Programme does not have good
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access to ‘grass roots local provider’ level insights and needs to ensure DHBs
have the right information. As a provider she directly experiences the impact of
disconnect and mixed messaging from DHBs.
• Kevin Pewhairangi: Focus on vaccination rollout through pharmacies. Noted
that prior communications and engagement with Māori communities is essential
for effective rollout. Misinformation is a constant challenge.
• Angela Ballantyne: Felt the advice of the group had not made a substantive
impact outside of the programme, for example, to equity and fairness. Happy to
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move forward but had some reservations that the Director-General’s letter
responding to the IIAG’s concerns did not acknowledge all the substantive
issues raised.
• Rhonda Sherrif : Also concerned about disconnect between IIAG and delivery
‘on the ground’. There is a disconnect between DHBs and providers.
• Tristram Ingham: Committed to seeing the gr
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have value. However he does have concerns and suggests that comms and
engagement needs to be strengthened, and certainly for the disability sector.
Suggests something like a ‘dai
THE ly digest email’ from the Ministry could help with
this.
Action 2: MoH to consider how best to provide regular updates on
programme progress to IIAG members.
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3
Operational Update (John Harvey/Joe Bourne)
• DHB vaccination planning to end June is agreed. As at 9 May, we were at
107% of plan. Need to monitor carefully due to constrained supply of Pfizer to
end June.
• Establishing a national Quality and Safety framework, including defining
minimum standards, to support delivery of the programme and to provide
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assurance about the quality of delivery and vaccination.
• Will also establish a national clinical network across a provider backdrop to
monitor planning and development of quality assurance for the programme.
Group discussion
• Keriana noted the A3 operational update and asked if this could be more
detailed so that it could be provided to the groups that members represent.
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• Taima asked if the vaccine supply constraints related to supply as a whole, or
were simply about sequencing, and whether there would be opportunities to be
involved on the safety and quality network.
• Mat Parr said that confirmed DHB plans to end June required 1.161 mil ion
vaccines against 1.25 mil ion supply. He confirmed that New Zealand had
enough vaccine in hand to deliver to these plans but needed to manage
distribution and storage carefully to avoid wastage. We expect confirmation of
ongoing supply in the new few weeks and are in daily contact with Pfizer. He
also noted that DHBs were expected to have a strong equity focus when
prioritising distribution of any unused vaccine.
• Keriana asked if DHB plans were available to IIAG members (in particular the
plan relating to a member’s DHB). Mat will follow up on this.
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Action 3: MoH to consider how the information in the A3 can be enhanced to
include more information which Members can circulate more widely.
Action 4: MoH to follow up re membership of safety and quality network.
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Action 5: Mat Parr to consider if I AG members can receive the rollout plan
for their own DHB.
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Service delivery/rollout sequencing (Joe Bourne)
• Joe noted findings of a recent research article re large scale vaccination sites
across Europe. Large sites are best suited to those who are keen to be
vaccinated and do not have provider preference. NZ rollout planning must
consider groups who are not comfortable in that environment and who want a
trusted local provider.
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• Taima agreed, also noting that many people in her area are keen to be
vaccinated but nonetheless would not attend a large site. So mass vaccination
may address volume, but not equity.
• Te Puea endorsed she would like to see more DHBs working with providers to
do smaller bespoke events over the larger events. She also noted that the
group had no visibility over funding streams, in particular for disability support
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for community service providers.
• Mat Parr advised that Vaccine Ministers have been clear with the Ministry, and
the Ministry has in turn been c
THE lear with DHBs, that funding should not be a
barrier to maximising uptake. Funding is only partially ‘fee for service’. There is
also a significant amount of money for targeted high needs services including in
rural and whanau settings and the Ministry’s expectation is that this money is
available over and above the ‘fee for service’ amount.
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• Taima noted that funding issues in her region have meant that both DHBs and
providers had expended their own resources to deliver vaccination services,
and she was pleased this appeared to be on track to be resolved.
• Taima noted she had been asked to set up a large vaccination centre with little
advice or guidance. She asked if guidelines are available.
Action 6: Mo
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vaccination centres.
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Focus on equity
• Te Puea invited Jason Moses to update the Group.
• Jason introduced himself as the vaccine programme’s new Group Manager
Equity. He confirmed that Ministers had a very strong focus on equity for the
rollout programme.
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• Members discussed what equity might look like. Some members suggested
population-based parameters. Nicky saw the requirement for DHBs to work
with Māori as a Treaty issue.
• Getting comms and engagement/the invitation strategy right was reinforced by
members as critical to prompting people to come for vaccination.
• Funding certainty and payment disparities are big issues. Many clinics have
started vaccinating based on goodwil .
• MoH wil be seeking equity ‘targets’ from all DHBs. Members noted the
importance of not confusing rights and obligations with targets, and the
importance of considering desired outcomes. Keriana cautioned that we don’t
want to ‘hit the target but miss the point’.
• Mat confirmed that IIAG advice re sequencing had been incorporated into the
sequencing decision paper to Ministers.
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• Tristram noted his aspirational targets for vaccination for people with
disabilities, being that everyone who wanted to wil be fully vaccinated. He also
noted the importance of measuring customers’ positive vaccination
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experiences.
• Tristram also noted national level data limitations. Tristram noted he was on an
NHI disability project current in scoping mode, which aimed to cover groups
currently not in the Socrates database.
• Members noted their appreciation for the data and discussion provided by
Petrus van der Westhuizen, noting an emerging gap between Māori and non-
Māori, and for Pacific peoples not returning for second vaccine. Petrus
cautioned about the impact of Group 1 and 2 sequencing in interpreting this,
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however.
Action 7: MoH to provide IIAG with regular updates for equity and
disability progress within the CVIP programme rollout.
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Workforce training
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Fiona Michel provided an update about vaccinator training.
• There are 5,025 trained vaccinators, 1,826 of whom are active or have been
active under the programme
THE .
• We need about 1,600 vaccinator FTEs for peak delivery - about 6,000 people.
• Maori representation is at 10%. Pacific representation very low at 3%. Working
to improve this representation. Need to understand DHB planning at more
granular level to understand exact requirements and ensure the right settings
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are provided.
• Working with IMAC and Careerforce to look at the non-regulated workforce for
the ‘vaccinator assistant’ role to build skil sets and language to better recognise
the cultural needs of whanau being vaccinated. These people will operate
under supervision. Consultation generally supportive with some concerns from
NZ Nurses Organisation. The Minister has agreed to seek Cabinet approval for
the neces
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[NB: since the IIAG meeting the new role has
been renamed “COVID-19 vaccinator.”]
Group discussion
• Several members noted strong support for this initiative, noting its value-add to
whanau experience of vaccination, and also noting that it can be incorporated
into several roles already in existence.
• Tristram Ingham thanked Fiona and team for their work and support, saying this
new role was also significant as it reduced barriers to entry into the health
sector workforce and increased the work opportunities for many. In particular,
he saw increased opportunities for people in the disability community.
Document 4
• Members were also very positive about the future opportunities this new role
could provide beyond COVID-19 vaccination. Fiona confirmed this was a
longer-term goal of the Ministry, noting further legislation change would be
needed.
Surge workforce
• Tristram asked if disability data could be incorporated into the surge workforce
database.
• Fiona confirmed that the recent refresh of the database meant that MoH is now
asking those registering on the database for this type of information.
Closing/Karakia whakamutunga - Te Puea Winiata
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INFORMATION
OFFICIAL
THE
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RELEASED
Document 5
IIAG Minutes/Actions
Meeting - Friday 28 Haratua 2021
Date:
28 May 2021
Time:
2:30 pm – 4:00 pm
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Co-Chairs:
Te Puea Winiata, Keriana Brooking (apology)
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Members
Dr Angela Ballantyne, Taima Campbell, Dr Helen Petousis-Harris, Rhonda
attending
Sherrif , Kevin Pewhairangi
MoH
Mat Parr, Al ison Bennett, Joe Bourne, Luke Fieldes, Fiona Michel (item),
Attendees: (item), Tamati Shepherd-Wipiiti
Carol Hinton (Minutes)
Apologies: Nicky Birch, Dr Tristram Ingham, Loretta Roberts, Dr Apisalome
INFORMATION
Talemaitoga, Silao Vaisola-Sefo, Jason Moses (MoH)
Item
Agenda Item
1
Introduction and welcome OFFICIAL
• Te Puea Winiata noted that co-Chair Kereana Brooking would be late or unable
to attend due to an unexpected delay.
• Taima Campbell then opened t
THE he meeting with a karakia.
• The minutes of meeting held 14 May were accepted with a correction to record
Nikki Turner as an apology rather than being in at endance.
• Te Puea advised that Nikki Turner had submitted her resignation from the IIAG
due to her workload. Nicky had advised she wil , however, be able to provide
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input as may be requested from time to time. Te Puea thanked Nicky for her
support during her time as a member of the Group.
• No conflicts of interest were registered.
2
Matters arising from the previous Minutes
Te Puea invited Mat Parr to update on progress re the actions from the 14 May
meeting, noting members’ desire to receive regular updates on progress across the
RELEASED
programme:
• Re actions 1-3, Mat advised that:
o the meeting’s agenda contemplated substantive discussion on the ‘success
framework’. The IIAG’s advice would then be incorporated into a paper for
the Steering Group and Cabinet in the next fortnight. This discussion
would be important to help shape how the future success of the programme
wil be defined and measured.
o MoH is considering how the A3 (COVID-19 Immunisation Programme
Update – paper 2) can be enhanced to bet er inform the IIAG.
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• Re action 4, Mat confirmed he had sent through a paper on the Quality
Framework mid-morning and indicated that a paper is about to go to the
Steering Group. He looked forward to discussion at the meeting and would also
put Safety and Quality on the next meeting’s agenda.
• Re action 5, Mat advised that DHB plans had only just been received and they
had not been analysed. He wil advise the IIAG in between meetings re how
they can each receive information relevant to rollout by their respective DHBs.
• Re action 6, Mat advised that operating guidelines for large vaccination centres
is being incorporated into guidance for Mass events.
• Re action 7, the IIAG wil receive regular updates on equity across the
programme rollout.
Finally, Mat confirmed that it had been helpful to receive an advance list of
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questions from Taima Campbell, as this had helped develop the agenda. He also
confirmed that members of the MoH team are always available to discuss matters
outside of the meeting schedule.
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3
Operational updates
3.1 Service rollout – strong focus on primary care (Mat Parr/Joe
Bourne/Astrid Koornneef)
Joe Bourne advised that DHBs are placing a strong focus on vaccination service
delivery through primary care settings. DHB planning shows 700-800 sites spread
across GPs, pharmacies and other sites. The Canterbury, Nelson/Marlborough
and Auckland Metro DHBs in particular are actively engaging with GP practices as
INFORMATION
part of a suite of delivery options.
Vaccine delivery is likely to start from early July, however, Joe noted that it takes
some time to bring a GP or pharmacy on board. Early delivery wil therefore have
regard to the population being served and vaccination vulnerability. Likely to move
to more distributed models later in sequencing.
OFFICIAL
3.2 Changes to Pfizer vaccine storage
Medsafe has approved that the P
THE fizer Comirnaty vaccine can be stored at 2-8oC for
31 days. This now means it can be treated similarly to many other vaccines and
has considerable implications for rollout planning in terms of GP storage, ordering,
and the interface with the booking system.
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Astrid Koornneef noted the new storage approvals mean we need to review the
quality and safety arrangements. A consultation document including CVIP
programme standards and considering their alignment with the wider Quality and
Safety framework has just been finalised. This wil be sent to members in
anticipation of discussion at the next meeting. Taima Campbell agreed she would
be keen to see these.
RELEASED
Action 1: Send consultation document on Quality and Safety Framework and
performance standards to IIAG members. [Mar Parr]
3.3 Accreditation for cold chain storage
IIAG members asked for clarity around the extent to which providers were or were
required to hold additional accreditation to store the Pfizer vaccine. Joe Bourne
indicated that the objective is to work within the existing frameworks so that most
providers wil simply apply their existing cold chain accreditation. MoH is engaging
with relevant professional bodies (Royal College of GPs, Immunisation Advisory
Centre) to confirm this. Providers using more mobile facilities may need to
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implement some new practices. Joe encouraged these providers to apply to IMAC
for adjustments to their accreditation as soon as possible so that they don’t impact
on their starting date.
Finally, Joe confirmed that MoH wil provide guidance to help all sites know exactly
what they have to do to be ready for their ‘day 1’.
Group discussion re accreditation for cold storage
Te Puea Winiata and Kevin Pewhairangi strongly endorsed the approach outlined.
Kevin noted that additional accreditation would impose a significant burden on
providers and Te Puea noted her service already held three different forms of
accreditation.
Taima Shepherd asked if it was correct that only DHB personnel could supply the
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vaccine to sites. Joe Bourne confirmed this was correct currently, however, the
model under development for Group 3 rollout has a main hub in each island, and
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the hub wil supply directly to accredited vaccination sites. DHBs wil be able to see
where the vaccine is being delivered.
Joe also advised that, as long as there is assurance about managing the cold chain
during transportation, there wil be no reason why a staff member from the
vaccination service provider cannot collect directly from the DHB.
IIAG members endorsed this model as taking a common sense approach.
3.4 Workplace vaccination (Mat Parr)
INFORMATION
• A workplace vaccination model is under development. CVIP needs to work out
which businesses/ workplaces wil be able to have a vaccinator on site and how
to apply a pro equity approach.
Action 2: Provide ‘high level project update’ to next IIAG meeting and
OFFICIAL
discuss the service design for delivery of vaccination through businesses
and workplaces – issues include how we take a pro equity approach to this.
[Mat Parr].
THE
3.5 Funding
• Fee for Service model is in place for DHBs - $500 mil ion.
• Additional money wil be paid for higher needs vaccination – for example mobile
services.
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• CVIP is monitoring DHBs to get more clarity on costings for their dif erent
vaccination service provision models.
Group discussion – funding model
Te Puea Winiata agreed that a ‘fee for service’ model works for scenarios such as
rest home ca
RELEASED re. However there were challenges in being able to adequately
describe a service provision model (and therefore a funding model) adequately for
more remote/rural areas such as in the Far North, and for delivery to Maori and
Pasifika communities. Therefore flexibility is also required.
Several members of the group noted their ‘on the ground’ experiences of service
provision and current funding arrangements could usefully inform the funding model
discussion going forwards:
o Te Puea’s organisation had operated five dif erent mobile facilities, and had
experienced some frustrations with the funding model.
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o Taima Campbell’s organisation was keen to work collaboratively with
pharmacists but was hindered as pharmacists wanted funding up front.
o Taima also sought clarity from the Ministry/DHBs about how consumables
were to be funded, and payment expectations for vaccinators and others
working weekends.
Mat Parr agreed that the CVIP programme would work with the IIAG to formalise a
position (acknowledging that high level funding commitments provide the wider
parameters) and provide advice to the Steering Group.
Action 3: Draft a position for IIAG on the adequacy of the ‘fee for service’
funding model and circulate to members, before providing final IIAG
comments back to the Steering Group.
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Group discussion – funding flows
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Tamati Sheppard-Wipiiti noted delays in funding flows e.g. to Whānau hauora
providers who are providing many vaccination-related services on trust while they
wait for funding. Much of this work goes unrecognised. The expected guidance
from MoH and consumables from DHBs have not yet eventuated. However,
providers wil not sign up staff to vaccinate to roster/weekends without a formal
agreement mechanism in place.
Action 4: Tamati Sheppard-Wipiiti and IIAG members wil meet to discuss the
challenges they face, and form a position to take discuss with DHBs to
INFORMATION
progress this.
3.6 DHB planning for readiness for rollout (Astrid Koornneef/Jason Moses)
• Astrid advised that the current focus areas ahead of Group 3 rollout are the
booking system (see below), the Quality and Safety framework for the CVIP
OFFICIAL
programme, and ensuring DHBs have appropriate plans for their delivery over
July to October. Al plans have now been received.
• Jason Moses advised that MoH had worked closely with DHB CEOs and Senior
THE
Responsible Of icers during development of their regional plans for operating at
scale, and reinforced the importance of them having an equity focus at the front
end. Some plans are excellent and all show a significant increase in their
equity focus.
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Group discussion
Taima noted that her organisation would like direct access to vaccine supplies for
their Maori providers to support to give them confidence about their ability to scale
up. Te Puea endorsed that having to order through a DHB introduced an
uncertainty. Tamati Sheppard-Wipiiti agreed there was a disjunct with supply
RELEASED
management and he was aware of cancellation of some orders. This is difficult
when vaccination clinics have been planned and bookings have already been
accepted.
Action 5: Astrid Koornneef and Mat Parr to look into mechanisms to provide
direct access to the COVID-19 vaccine for providers.
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3.7 National Booking System (Astrid Koornneef)
• The National Booking System has been piloted in Christchurch and in Auckland
wil be rolled out to all sites managed by DHBs over the next six months. It
represents a significant change to current processes and allows New Zealanders
to engage with the process. Taranaki and Wairarapa DHBs wil be first to ‘go
live’ – both scheduled for early June.
• CVIP is stil considering how the booking system might be used in other settings
e.g. settings that wil take family or group bookings, or specific settings that are
not available to other members of the public.
Group discussion – National Booking System
Taima Campbell noted that her Waikato-based organisation uses its general practice
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system to book appointments for both the flu and COVID-19 vaccine. They
understand this system. It is reliable. It generates reminders. Taima wondered
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about the ‘add value’ of introducing a duplicatory system for COVID-19 vaccination,
noting that many of those in Group 3 are people who are unlikely to use the booking
system.
Astrid Koornneef and Mat Parr acknowledged that primary care providers may have
a preference to use existing systems and agreed that CVIP is mindful of the need to
not to create confusion. They agreed that the national booking system was one
conduit only, and confirmed that decisions have not been made about its use by
primary care providers. A real benefit of the booking system was in supporting
INFORMATION
bookings for mass vaccination sites, which wil be essential to achieve the volume
required by Group 3 rollout. It can also provide a consistent single focus from a
‘public communications’ perspective.
Wider discussion across all attendees agreed that the most important thing was to
get people to come for their first vaccine as they a
OFFICIAL re then recorded in the
Immunisation Register (CIR) and wil automatically get second dose follow up. Joe
Bourne noted that he was noting the points raised to feed into a paper he was
preparing on the national booking s
THE ystem.
3.8 Workforce and skil s (Fiona Michel)
• Fiona Michel advised that the changes to regulations to allow for the
establishment of the C
UNDER OVID-19 Vaccinator role had been gazetted that week.
The Minister was likely to make the announcement.
• There are now 6,293 trained vaccinators, of whom 2,320 are/have been active in
CVIP. However, 62% of these people are not being used in the programme.
Fiona said she is working with DHBs to ensure that those who have taken the
effort to train for the programme were in fact used for that purpose. She
expected the final total of trained vaccinators to be about 8,000.
• The refreshed
RELEASED surge database is now live (weblink below) and available in
English, Te Reo, Samoan and Tongan. Fiona noted this is a list of people with
required skil s, and their availability to assist with rollout workforce requirements.
However, with only about 6% of registrations from Māori, and 2% Pasifika, we
need to look more widely to address workforce equity issues.
Surge database website:
https://customervoice.microsoft.com/Pages/ResponsePage.aspx?id=JMfOIyBt0Uuf6dxER-
3R-rPtHQW4g5dMvLRp5o2K1E1UN1Y3WkxBTUxLUTVDVFgyNk8yN1QxRFY4Ri4u
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Group discussion – Workforce and skil s
Taima Campbell noted that there were some issues with the requirement for a
person who has completed the COVID-19 vaccinator training to then be
independently assessed before being able to start practising. For example,
assessors were not available in some areas, or there may not be anyone available
to be vaccinated for the assessment.
Fiona advised that there was flexibility to do assessment in a variety of ways,
including online, or demonstrating injection technique another way. She would raise
this with IMAC and report back to IIAG.
In response to a question from Rhonda Sherrif , Fiona advised that there was no
target for the size of the new workforce. However, the DHB rollout planning means
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that the workforce wil be more nuanced (workforce ethnicity mix, clinic location etc.)
to meet community needs.
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Te Puea thanked Fiona and congratulated her on the progress made.
Action 6: Advise on how timely access to independent assessment of newly
trained COVID-19 vaccinators can be achieved. (Fiona Michel)
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Quality (Success) Framework (Al ison Bennett/Luke Fieldes)
• Alison first reflected on the value of the IIAG’s input provided in March 2021 on
an early draft of the Success Framework, which is now called the “Quality
Framework”. This new iteration of the framework evolved from that feedback.
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• The Framework focuses our attention on priorities; this means we are
transparent about what we are delivering and how we then transparently assess
performance against this.
• Al ison spoke to a presentation showing the six components of the Framework,
and noted that none operate in isolation:
o Effectiveness (strong focus on clinical
OFFICIAL quality and safety)
o Equity
o Experience (both provider and consumer)
THE
o Efficiency
o Te Tiriti o Waitangi
o Sustainability/legacy (support health system as a whole and into the
future).
• Luke Fieldes said there
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up a picture of the overall success, however, a high score is not necessarily a
good thing if it has significant negative impacts elsewhere in the framework.
• Al ison and Luke agreed that noted the challenge now is to present the
framework for ‘easy consumption’. They sought the views of IIAG on both
content and presentation.
• It is intended that the Quality Framework be owned by the whole programme, not
just the Mini
RELEASED stry of Health. Ultimately it wil go into a Cabinet paper for final
agreement by Ministers. It wil be publicly available.
Group discussion –Quality Framework
• Taima Campbell suggested indicators could be weighted. She also noted the
importance of building in accountability.
• Dr Helen Petousis-Harris suggested ‘sustainable active vaccine safety
monitoring’ as a potential success indicator.
• Some members indicated that they were happy to be contacted separately to
discuss the framework further.
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• Al ison confirmed that it was intended to be a ‘living’ document as rollout wil
provide valuable information that wil feed back into the framework.
• Joe Bourne noted that the intention is to use current reporting as much as
possible when assessing performance against the Quality Framework. A ‘low
touch’ approach wil avoid burdening providers.
Action 7: Send copy of the draft Quality Framework to IIAG members for their
consultation comment (Mat Parr, Allison Bennett)
Action 8: IIAG members who so wish to provide comments on the draft
Quality Framework back to Mat Parr and Al ison Bennett.
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Focus on equity – disability communities
• Tamati Sheppard-Wipiiti noted that obtaining reliable data on the disability sector
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is a significant issue hindering identifying and reaching disability communities,
even though we know these groups form a significant part of the population.
DHBs share this problem. It is not solely an issue for COVID-19.
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• Tamati noted he wil be meeting with Dr Tristram Ingham (who is an apology
from this IIAG meeting) and others early in the following week to try to work this
through in respect of the COVID-19 vaccination rol out. Some research wil be
required. However, leveraging local relationships wil be critical to ensure people
are not missed.
• Te Puea Winiata agreed that this was something Dr Ingham had raised with the
IIAG at an early stage and said that his support and networks wil be critical. She
saw that mobile support and home visits, combined with whanau vaccination
bookings wil be the key things in reaching members of the disability
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Closing/Karakia whakamutunga – Kevin Pewhairangi
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Document 6
IIAG Minutes
Meeting - Friday 25 Pipiri 2021
Date:
25 June 2021
Time:
1:00 pm – 3:30 pm
Co-Chairs:
Te Puea Winiata, Keriana Brooking
Members
Dr Angela Ballantyne, Nicky Birch, Taima Campbell, Dr Helen Petousis-
attending
Harris, Loretta Roberts, Rhonda Sherrif , Kevin Pewhairangi
MoH
Andrew Bailey, Carl Bil ington, Joe Bourne, Geoff Gwynn, Rachel Mackay,
Attendees: Fiona Michel, Jason Moses, Mathew Parr, Petrus van der Westhuizen
Apologies: Dr Tristram Ingham, Dr Apisalome Talemaitoga, Silao Vaisola-Sefo, Luke
Fieldes (MoH), Tamati Sheppard-Wipiiti (MoH)
Format:
Most attendees at this meeting attended online. However, to ensure
compliance with the Alert Level 2 in place in Wellington on 25 June, those
present in the meeting room maintained appropriate social distancing.
Item
Agenda Item
1. Introduction and welcome
• Te Puea Winiata welcomed members.
• Jason Moses opened with a karakia timatanga.
• The minutes of meeting held 28 May 2021 were confirmed. The deferral and
subsequent cancellation of the meeting scheduled for 11 June was noted.
• No conflicts of interest were registered.
Matters arising from the previous Minutes
• Mat Parr advised he would report back after the meeting on the mechanism for
sharing DHB production plans.
• COVID-19 vaccinator assessments: Fiona Michel said that Loretta Roberts
had confirmed the pathway for simulated assessment. The assessment can be
arranged through the regional co-ordinator or directly through IMAC.
2. Strategy for Transition to BAU (Mat Parr)
• Focus over the second half of the year is driving uptake for New Zealanders,
acknowledging that some wil require more proactive effort to achieve this. We
need to balance this activity against the need to transition COVID-19
vaccination into future BAU.
• The Ministry wil be preparing advice for Cabinet. Mat emphasised that nothing
was written as yet and that ‘blue sky’ views of IIAG members were sought on
where the system should be directed, including:
o Access – ensuring the vaccine gets to those it is intended to reach.
What vaccination settings are sustainable – what is the balance
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between primary care, GP, pharmacies, after hours services? Input
sought on locations, sites, providers.
o What wil the workforce look like – where will it be?
o Incentivisation – does New Zealand need to follow international
approaches?
• Also need to think about what 2022 might look like. Planning parameters
include:
o Recognising that the science and technology wil continue to evolve
(e.g. number of doses and frequency of vaccination);
o Identifying the impacts of this on purchasing/supply;
o developing the immunisation programme.
• Noted that Pfizer is currently the most expensive of the COVID-19 vaccines
available. Cost per dose is nearly double that for the flu vaccine.
• Objective is to make best placed decisions early, but be flexible enough to
change if required.
• There is a considerable Legacy component to identify what will carry over into
the new Health system.
Group discussion
Members endorsed the early thinking being given to this, noting the significant
impacts on the workforce and on funding flows for planning. Views expressed
(no
priority implied) included:
• This is a new behaviour being introduced into New Zealand. Several members
said that creating demand and ensuring access are key, so focus on raising
awareness and visibility first. Māori simply may not know about the issue –
with consequent impact on uptake.
• Are there any broader learnings – including internationally – about behaviour
change to promote wider uptake to vaccination that can be drawn from?
• The concept of an annual vaccination is good. Links with current approaches.
A joint vaccine (flu/COVID-19) would facilitate uptake but is unlikely to be a
possibility in the foreseeable future. Many members preferred “Pfizer, one
dose, once a year” as a future scenario.
• Ensure flexibility in the booking system so that people have choices.
• Workforce – significant future opportunities through the new COVID-19
vaccinator training. Important to continue to consider how broader workforce
can be deployed if required (UK model cited as example) . Some concerns
noted around DHB vaccination service provision. Noted that a skil ed
(vaccination) workforce must always be available in a DHB, however, some
members understood that some contracts were being terminated for periods
when not required. Potential impact on skil sets.
• COVID-19 is an epidemic. While we are currently low risk, we need to get
New Zealanders ready for having COVID-19 in the community because it is
unlikely we can keep it out forever.
• If it is found that the Sydney traveller (Wellington community case, June 2021)
was less contagious because he had had one vaccination, can that messaging
be used to promote community benefit? This is the sort of situation that
potentially could build confidence in vaccination.
• To what extent wil government fund ongoing vaccination?
• Group members emphasised a point discussed at the previous meeting, being
that vaccination service providers (and Māori providers in particular) would
benefit from direct relationship with the vaccine distributor, avoiding DHB
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• distribution channels and the potential supply disruption they have seen in the
past.
• The Co-Chair summed up that from an equity perspective, 2020 saw the best
ever response to immunisation. Evaluation of workforce and service settings
could provide opportunities to help achieve equity objectives for COVID-19
vaccination roll-out.
Action 1: Ministry to consider doing a Horizon Scan for research and
published articles on the international experience to create demand for
vaccination and make vaccination accessible.
Action 2: Keep IIAG updated on the thinking about funding for COVID-19
vaccination into the future.
3. Equity Programme overview (Jason Moses and Mat Parr)
Considerable work under way to promote equitable outcomes for Māori, Pacific
and disability communities during the vaccination delivery phase:
• To help improve uptake, the Ministry is providing funding for targeted support
that is culturally appropriate and meets the needs of specific communities.
Noted that five marae sites are already delivering vaccination services.
• Further research has been undertaken into vaccine hesitancy and the factors
preventing update by Māori and Pacific people. Results are encouraging.
Overall potential uptake (those already vaccinated and those likely to get a
vaccine), has increased to 80 per cent, up from 69 per cent in March 2021. Of
these:
o Māori potential uptake is now 75 per cent, up from 71 per cent in April;
o Pasifika potential uptake is steady at 78 per cent, similar to 79 per cent
in April, but up from 59 per cent in March.
• The Ministry identifies Group 3 as the opportunity to take a pro equity approach
within the sequencing framework.
• DHBs now have agreed targets for Māori and Pacific people in their regions.
This is a ‘stretch’ target identified by using burden of disease study, and
information of underlying health conditions in regions. Targets were based on
NHI data, and not census data. This builds some ‘stretch’ in that fewer people
are known to identify as Maori in census data). (
See Paper 11.)
• DHB ‘letters of readiness’ provide assurance of the overall readiness of each
DHB to scale up. These letters are signed by DHB CEOs and have a specific
focus on equity and on service quality.
• The Ministry has appointed regional co-ordinators who work locally and engage
directly with providers in the regions as needed.
• The Director-General of Health is sending a letter to the DHB CEOs and to
CEOs of social service agencies that contract with Māori and Pacific health
providers, to see if there is opportunity to be flexible with these contracts
including postponing some deliverables. This will better allow providers to
target their resources to the COVID-19 vaccination programme.
• Equity is the key risk identified for scale roll-out. The Ministry is closely
monitoring the population breakdown for the first dose vaccination. This
provides a check on uptake across population groups. It was noted that Māori
have been tracking at 10 per cent of the population to date but for Group 3 this
figure was around 19 per cent.
• The Ministry would welcome the views of Group members on what more could
be done to support and promote equity.
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Group discussion
• Clarification sought around the basis of the 10 per cent vs 19 per cent
mentioned, noting that a ‘percentage of population’ measure would not support
equity, even if achieved. Some DHBs are currently achieving high vaccination
rates but are not meeting ethnicity targets.
• A target is more than just a target. It represents a measure of what we value
and starts to shift public service thinking about what equity is, and what it is not.
Māori are twice as likely to die if they contract COVID-19 than are those in
other population groups. Targets need to acknowledge and reflect the risk rate
of any group.
• Acknowledged that roll-out to Groups 1 and 2 did not have an equity approach
and that Group 4 provides the real opportunity. However, expressed a hope
that progress would start to be seen quite promptly.
• Suggested that the words ‘vaccine hesitancy’ could be replaced by ‘vaccine
acceptance’.
• Noted some concerns about Māori providers being required to expand their
services considerably, but not being aware of the funding that is available to
support them or how they access this. Aware that some money is paid to
DHBs to pay to providers but this can create delays
. (See also section 8b.)
• In terms of promoting uptake by individuals, be clear about the possibility of a
reaction within 2-3 days after being vaccinated and normalise this through
comms on ‘what to expect after your vaccination’.
4. Contingency Planning (Geoff Gwynn)
Paper 4, and papers 4a- 4e considered: CVIP Contingency Planning – Draft for
discussion - 21 June 2021
• Have identified six risk scenarios that would affect delivery of the national plan
and developed contingency plans for each of them:
o Community outbreak,
o Disruption to vaccine supply,
o Disruption to COVID-19 vaccination workforce,
o Unavailability of IT systems,
o Clinical safety issue,
o Significant privacy or security breach.
• Plans focus on response at first hour, first day and first week – identify triggers,
impacts and critical resources. New plan likely required from that point.
Group discussion
• Members noted that equity is not one of the areas identified for contingency
planning. Noting that under the Terms of Reference, IIAG advice is provided
within the context of honouring Te Tiriti o Waitangi, with a particular focus on
equity, members noted concerns that not achieving the equity objective for
COVID-19 vaccination would certainly reach the threshold for an event
requiring contingency planning.
• The Ministry agreed with this level of significance but clarified that equity was
not regarded as a “sharp shock” event (as were the six scenarios above).
Rather it is something that requires regular monitoring and adjustment (and
actions might be at a local or regional level). The intention was to ‘not wait’ until
there was a catastrophic failure but to take early action.
• The matter was discussed further, and the Ministry agreed with the IIAG’s
suggestion that the approach could usefully be clarified within the contingency
planning document.
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Action 3: Clarify in contingency planning documents that poor performance
against the equity objective is not regarded as a “sharp shock” event but is
something that requires regular monitoring and adjustment.
5. Approach to Workplace Vaccination (Rachel Mackay)
• Rachel noted she had just been meeting with Ministers and as a consequence
the papers circulated would need to be updated.
• The Ministry is trialling workplace vaccination at two worksites in South
Auckland, both of which have potential to contribute strongly to the roll-out
equity focus.
• A “blueprint” for vaccination at worksites has been developed. Both Equity
teams in the Ministry reviewed this.
• Participation criteria are established for participating employers and their
service providers. Focus is on larger employers with a large Māori or Pacific
workforce. Rural or outer urban factories. There is an opportunity to take a
whanau approach with vaccination service delivery.
• Care is being taken to protect and expand current employer relationships with
occupational health service providers. The DHB is accountable for delivery
under this trial programme so the Ministry will work with them over final
decisions.
Group discussion
• Noted that Māori providers could potentially be included service delivery for
workplaces that provide vaccination for COVID-19 under these arrangements.
Action 4: Presentation to be updated and distributed to Members of IIAG.
6.
Outcome measures (Petrus van der Westhuizen)
Paper 6 considered – CVIP Outcome Measures – 18 June 2021
• Objective of having outcome measures is to enable the programme to ask
questions. They dif er from the Success Framework, which is a tool to assist
decision-making.
• Measures are proposed for:
o Population acceptance
o Workforce
o Vaccine and consumables
o Technical Approach
o Access
– Location
• Vaccine consumption is a ‘good news’ story with current usage in the high 90
per cent measures.
• For population acceptance, the opportunity is likely to be those who are
‘unsure’ rather than those who say they are ‘unlikely’. We would appreciate
views on how we can that movement in perspectives.
• We wil do work to benchmark our outcome measures internationally.
• Consideration wil be given to how this could be made interactive so that users
can do their own reporting.
Group discussion
• Suggested give consideration to rural vs urban vaccination uptake and possibly
also age bands. Specific level data helps inform response.
Document 6
• Supported the concept of having input data made interactive. Asked if the data
would be publicly available? Strongly supported that public access would
support the legacy objectives of the CVIP programme.
Action 5: Co-Chairs and Mat Parr to discuss offline the extent to which
supporting data is widely accessible into the future as part of the CVIP
Programme “legacy’ activity.
7.
Communications (Carl Bil ington)
• The ministerial announcements on 22 June re Group 4 roll-out had created two
points of anxiety for the public:
o The perception that the start of Group 4 means the end of other groups.
o Perceptions re timeliness of contact re vaccination.
• Carl apologised that information on progress with roll-out had been publicly
released before the Ministry had had a chance to inform members of IIAG. He
acknowledged and thanked those members who had had media approach
them for comment and who had responded without any prior ‘heads up’.
• The Ministry is encouraging providers to contact their clients with advice about
their invitation.
• There is a focus on workers at the border as the requirements for vaccination
by this group are increased.
• Regular engagement established with the aged care sector. For Pacific people
there is considerable engagement with the Recognised Seasonal Employer
workforce.
Group discussion
• In response to a question, Carl advised that CVIP has had a lot of guidance
from IIAG member Dr Tristram Ingham and comms material is available in
accessible format. However, there is a gap in comms for Maori with disabilities
and Carl confirmed that he would be increasing the focus on this group.
• Key issues for comms and engagement with members of the disability
community include identifying ‘what consensus looks like’ and how those who
need support provide their informed consent. There are also barriers to
accessing early information about the vaccine and the vaccination process.
8. Other Business
8a. Planning for future engagement with IIAG
Co-chairs and Mat Parr agreed to book some time to discuss and agree a cadence
for how engagement with the IIAG would operate for the rest of 2021:
• Develop workplan (members can prioritise and plan),
• Update Terms of Reference (Ministry to do first cut),
• Co-chair representation at Steering Group (previously agreed – Ministry to
send invitations)
.
Action 6: Review the IIAG ToR to better recognise the advisory role of the
IIAG and to ensure IIAG as a group has visibility over consideration and
incorporation of its advice into policy development and ministerial/Cabinet
processes.
Action 7: Send invitations to Co-Chairs re CVIP Steering Group attendance.
Document 6
8b. Primary Care and funding for equity
As raised during the Equity discussion (section 3), Māori providers have had to
expand their services considerably, but are often not aware of the funding that is
available to support them or how they access this. Members of IIAG are aware
that money (additional to ‘fee for service’) is paid to DHBs to allow them to better
fund higher cost services e.g. in rural locations, requiring use of mobile facilities
etc. Many of these are linked closely to the equity objective. Members are very
concerned that this additional money is not getting through to the providers and
that its use is not transparent.
Action 8: Ministry to follow this up with DHBs. Ministry to identify extent of
funding passed on from DHBs to Mā
ori providers for COVID-19 service
provision.
Action 9: Include a ‘deep dive’ into Primary Care on the agenda for the next
meeting.
9. Closing/Karakia whakamutunga – Jason Moses
10. Next meeting – Friday 9 July 2021
Document 7
IIAG Minutes
Meeting - Rāmere 9 Hūrae 2021
Date:
Friday 9 July 2021
Time:
1:00 pm – 3:00 pm
Co-Chairs:
Te Puea Winiata, Keriana Brooking
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Members
Dr Angela Ballantyne, Nicky Birch, Taima Campbell, Dr Tristram Ingham,
attending
Dr Helen Petousis-Harris, Loretta Roberts, Rhonda Sherriff,
MoH
Andrew Bailey, Joe Bourne, Astrid Koornneef, Rachel Lorimer, Rachel
Attendees: Mackay, Sonia Marshall (for item), Rachel Mackay (for item), Jason
Moses, Mathew Parr, Dr Juliet Rumball-Smith, Tamati Sheppard-Wipiiti.
Apologies: Kevin Pewhairangi, Dr Apisalome Talemaitoga, Silao Vaisola-Sefo
INFORMATION
Item
Agenda Item
1. Introduction and welcome
• Te Puea Winiata welcomed members.
• The minutes of meeting held 25 Piripiri 2021 were confirmed, with minor editing
to bul et 3 of item 1.
• It was noted that Dr Apisalome Talemaitoga and Silao Vaisola-Sefo had
submit ed apologies for the 9 July meeting due to attending a Pacific Providers
meeting at the same time.
• No conflicts of interest were registered.
Matters arising from the previous Minutes
Members noted their appreciation for the action tracker, set clearly set out actions
and their status.
• Action 210625-01 – MoH confirmed that the horizon scan re articles on the
international experience re demand for vaccination has been commissioned
and wil be shared with IIAG once available.
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• Action 210625-08: Andrew Bailey wil contact Te Puea Winiata after the
meeting to begin this conversation.
• MoH noted other actions as pending.
Document 7
2. Modelling increased uptake (Mat Parr and Sonia Marshal )
Paper 3 considered – Vaccine roll-out (Pfizer only) – Sequenced population aged
12 years+
• Previous modelling to reach ‘scale’ has been based on 70 per cent uptake.
• Mat and Sonia advised on the modelling of the numbers of vaccines
administered and vaccinators required to achieve scale roll-out, noting that
modelling is now being done for a stretch target 85 per cent uptake.
• This compares well with international achievements e.g Canada is at 69 per
cent currently and Israel at about 60 per cent.
• Research in New Zealand by Horizon shows that 80 per cent of people are
wil ing to be vaccinated.
• A high uptake now helps with ‘future state’ for the ongoing programme.
• As per paper 3, international experience shows there is an eight week
window of working at peak before delivery starts to reduce.
• There are three settings possibilities to ‘push’ uptake:
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o Through primary care services (well established, trusted,
o Through mass events;
o Through schools (i.e. delivery to students, noting that school settings
are already being used by some DHBs for sequential vaccination).
• IIAG views were sought on the 85 per cent target, and the on balance of
delivery channels, in particular those we should maximise (in particular for
the eight-week peak delivery period).
IIAG perspectives and advice
INFORMATION
• Delivery to younger age group through schools needs to be pre-planned
around the school year. Identify what we need to be doing now for roll-out next
year or during school holidays.
• Think more widely about who uses school sites and how these groups can be
used to help (e.g. Al ied Health, providers with school contracts).
• School based vaccination could be seen as a family/whanau site. School sites
provide an accessible ‘focal point’ even during holidays.
• Consider how faith based and ‘character’ schools can help us to reach out
more widely to different ethnicities.
3. Quarter 3 Work Programme (Mat Parr)
Draft Paper: IIAG Work Programme to September 2021
• The IIAG considered a one-pager overview of the proposed Quarter 3 work
programme. Key areas on which IIAG advice wil be sought are:
o Primary care role and future COVID-19 vaccination
o Access to vaccine and options to increase uptake
o Leading indicators/outcome measures
o Equity monitoring
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o 2022 strategy and vaccine portfolio.
• Following recent decisions by Medsafe about COVID-19 vaccines, the Ministry
is developing advice to the Minister/Cabinet and will consult ‘out of cycle’ with
those IIAG members who are available:
o the use of Pfizer by 12-15 year olds, and
o the use of Janssen.
Ministry action 1: Send a draft of the advice to IIAG Members for comment as
soon as this is available. (Al ison Bennett)
Document 7
4. I AG Governance
4a. Revised I AG Terms of Reference
Paper 5 considered: COVID-19 Immunisation Implementation Advisory Group –
Terms of Reference
• Members considered the “Draft Version 2” of the IIAG Terms of Reference,
which had been updated to address issues raised previously by the Co-Chairs
and to better reflect the focus and role of the Group.
• A key new provision to ensure transparency over the Ministry’s consideration of
IIAG advice, is that the IIAG Co-Chair representing DHBs wil be invited to
attend weekly meetings of the CVIP Steering Group, and both Co-Chairs will
present to the Steering Group on at least a monthly basis.
I AG perspectives and advice
• Members indicated no major concerns. Due to the full agenda, the Co-Chair
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asked that members submit any comments they had to Andrew Bailey.
([email address])
Action 2: I AG members who wish to make comments on the Draft Terms of
Reference should submit these to Andrew Bailey of the Ministry.
4b. I AG meeting times
• The Ministry noted that the current Friday afternoon meeting timing clashes
with the weekly meeting of the seven Vaccine Ministers.
INFORMATION
• IIAG members were asked if the IIAG meeting could be moved to a Thursday
afternoon. This would also allow the Ministry to improve its flow of decisions
and actions through to updates to members and also to take advice from IIAG
and pass it to the CVIP Steering Group meetings on Tuesdays.
Ministry action 3: Ministry to conduct a ‘straw poll’ re a new meeting time.
(Mat Parr)
5. Safety and Quality Network update (Dr Juliet Rumball-Smith)
Papers 6 and 6a considered – CVIP Quality and Safety Framework and Actions,
and National Clinical Quality and Safety Forum Terms of Reference
• This update outlined the framework in place to promote delivery of a safe and
quality COVID-19 vaccination service. This aligns with the Health Quality
Safety Commission’s four ‘building blocks’ of effective clinical governance:
o Consumer engagement and participation;
o Clinical effectiveness;
o Quality improvement and patient safety;
o An effective, engaged workforce.
RELEASED UNDER THE OFFICIAL
I AG perspectives and advice
• Members asked that the importance of Equity be emphasised and given more
prominence.
Ministry action 4: Dr Juliet Rumball-Smith agreed that an inequitable
programme was neither clinical y competent nor safe. She wil amend the
framework and report back to IIAG once completed.
Document 7
5. Cont. (Safety and Quality Network)
• Members noted the importance of ensuring people knew how they could make
complaints should they need to. Ideally this should be a quick, likely local
process.
• Members asked if it was going to be possible to connect pharma-covigilance
data into epidemiology.
Ministry action 5: Dr Juliet Rumball-Smith and Dr Tim Hanlon wil meet with
Helen Petousis-Harris to discuss the connection between pharma-
covigilance data into epidemiology further and report back to the IIAG when
the matter has been discussed.
6. Equity Update (Jason Moses and Tamati Sheppard-Wipiiti)
Overview
There are 77 providers funded to support the programme. Some are currently
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supporting DHBs to deliver, but wil not commence direct provision until August,
depending on their DHB. Many using a whanau-based invitation approach.
DHBs have signed off on their accountability documents. These include equity
targets. The challenge is in the monitoring.
Promoting uptake by Mā
ori
The numbers of Māori who wil be vaccinated between July and October 2021 wil
INFORMATION
be significantly higher than the current numbers, due to sequencing. Target doses
per week for Māori is 20,000 during this period.
An update was provided on the Five Point Plan to increase Māori vaccine uptake.
This covered:
•
Promoting contract flexibility by CEOs of DHBs, Te Puni Kōkiri and other social
service agencies engaging Hauora and Pacific providers.
• Ensuring that
primary care providers are in the right settings and right volumes
to support vaccination in priority areas.
• Redistributing existing ‘yet to be used’ Māori communications funding to fund
readiness across a wider range of Maori providers.
• Providing f
unding to support rural vaccine delivery.
•
Ensuring Hauora providers know how they can order vaccine supplies directly
from the Ministry.
Promoting uptake by Pasifika
• 23 Pacific providers wil deliver the vaccine across the country.
• Key focus to promote update is in two DHB regions: Auckland Metro; and Hutt
Valley/Capital & Coast.
RELEASED UNDER THE OFFICIAL
• Also a focus on increasing the Pacific vaccinator workforce. This is about
3 per cent currently whereas the population composition is 6-7 per cent.
Promoting uptake by disability communities
• More work is needed to understand and address the needs of Māori disability
communities.
• Have met with Tātou Whaikaha to help gain a bet er understanding of issues
and responses and to better ensure accessibility at vaccination sites.
Document 7
• Ministry is looking at how it can influence and support DHB planning for
services to people with disabilities. There are also crossovers for Māori with
disabilities.
• Data collection and monitoring is a strong focus.
Ministry action 6: The Ministry will work offline with some IIAG members to
gain better insights into the provider perspectives on accessible service
delivery.
IIAG perspectives and advice
• Providing what are effectively ‘bespoke’ services for disability community
members takes time and effort. Care is needed to not also put volume
pressure on providers.
• Both equity target setting (which has to consider need and risk and access) and
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monitoring are key. There are issues and pressures here for DHBs with rural
communities.
• Aware that some regions are taking a ‘marae by marae’ based approach to
vaccination to meet rural needs.
• Some instances of ‘vaccination tourism’ have been noted.
• Emphasised the importance of people having a good vaccination experience as
they then pass this on to others.
• IIAG members thanked Jason and Tamati for the mahi that had gone into the
Equity focus.
INFORMATION
7. Primary care
7a. Primary care implementation plan
Paper 8 considered – CVIP Primary care playbook - Steps for setting up a COVID
vaccination site
• Astrid Koornneef and Dr Joe Bourne noted the Ministry was reaching out more
deeply into primary care to support vaccination roll-out. The discussion draft
“Primary Care Playbook” aims to provide assistance to providers set ing up
vaccination sites.
• As much as possible, the Ministry wants providers to have a smooth,
streamlined experience to ‘come on board’. Some need for local variation is
acknowledged.
• Aware that some providers wil not want to participate, but there are also many
who do but who need the assistance.
• The initial views of IIAG members were sought now, but there would be
opportunity for further input through sub-group conversations.
IIAG perspectives and advice
RELEASED UNDER THE OFFICIAL
• Agree that providers (e.g. community based social support groups) who want to
provide vaccination services but are not doing so currently wil need
considerable support to go through the establishment process. Many simply do
not have the resources.
• What are the opportunities for partnerships? Who is brokering these
relationships?
• Encourage PHOs to think differently and to collaborate – examples given re a
group of seven Pacific providers.
Document 7
• Links to the surge workforce – providers need to know how to access the
specialised workforces and skil sets.
• Can this document include an equity lens – e.g. what supported decision-
making looks like in practice? Not all providers understand this.
• Accreditation can be a significant burden. Can this be rationalised across
multiple sites? Some providers see the requirements and are reluctant to
provide the services. Fewer providers means higher dependency on those who
are willing.
• Funding issues – some providers are concerned that Māori providers are paid
to set up vaccination services but they are not. Are those providers who set up
for scale entitled to some of the programme development money also?
• Concerns that trained staff wil not stay with current employers but wil be
actively sought by other providers.
• A number of providers are doing this because they want to do the right thing for
their community.
• The name ‘playbook’ on the draft was queried, with members noting care was
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needed not to downplay the significant work that wil be needed by primary care
providers to provide COVID-19 vaccination services.
Ministry action 7: Hold further ‘sub group’ conversations with IIAG members
on particular issues relating to primary care vaccination rol -out as required.
7b.
Funding flows into primary care
Members noted their ongoing concerns that in some places, contracts for COVID-
19 vaccination-related services were not yet in place and that the fundi
INFORMATION ng flows
from DHBs into primary care were still very slow. Some providers have yet to
receive funding. This is impacting on provider wil ingness to provide vaccination
services.
Ministry action 8: Mat Parr advised that this matter had been escalated to the
Director-General, and direct conversations are being held with DHB SROs.
8. Environmental scanning of issues
• Noted that environmental issues had largely been raised in the discussion of
equity (item 6), and primary care provision at item 7.
7.
Communications (Rachel Lorimer)
• Will start promoting a COVID-19 Healthline shortly – nearly ready to launch and
wil let IIAG know in advance. Noted however that dif erent DHBs wil have
different capacity to answer specific questions.
• GPs are a ‘trusted place’ in a community and have an important role in
education.
Ministry action 9 – ensure IIAG members are advised in advance of the
launch of the COVID-19 Healthline.
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8. Other Business
8a. National booking system
An enhanced call centre opens on 17 July – wil support the new booking system
which wil be launched on 28 July. The booking system wil support whanau
bookings. Ministry is developing material and tool kits to support providers.
(Cont. over)
Document 7
IIAG Perspectives and advice
• Members noted some provider confusion in that the booking system is ‘live’ but
is not ‘launched’. Some DHBs are phoning GPs but advise they are not clear
on the processes from here.
Ministry action 10 - Astrid Koornneef wil work offline with Taima Campbell to
clarify and address this issue.
• Noted that the meeting was nearing its end time but disability communications
and the interface with the booking system needed active consideration. (There
are 1.1 mil ion people in New Zealand recorded as having disabilities. The
Ministry had data on only 40,000 of these people – those who receive disability
8b.
support funding.)
Ministry action 11: Astrid Koornneef wil work with Dr Tristram Ingham
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offline to clarify and progress this issue.
Privacy of information
• An IIAG member noted the importance of the Ministry ensuring its web page
commentaries are aligned about how personal data is stored and shared and
the basis for recording it.
• The point was made solely from a transparency perspective.
INFORMATION
Ministry Action 12: Ministry to check web content to ensure basis for
recording data is clear, and that commentary about how data is stored and
shared is consistent. (Rachel Lorimer).
9. Closing/Karakia whakamutunga – Nicky Birch
10. Next meeting – Friday 23 July 2021
RELEASED UNDER THE OFFICIAL
Document 8
IIAG Minutes
Meeting - Rāpare 22 Hūrae 2021
Date:
Thursday 22 July 2021
Time:
1:00 pm – 3:00 pm
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Chair:
Keriana Brooking
ACT
Members
Nicky Birch, , Dr Tristram Ingham, Dr Helen Petousis-Harris, Kevin
attending
Pewhairangi, Dr Apisalome Talemaitoga, Loretta Roberts
MoH
Andrew Bailey, Dr Joe Bourne, Astrid Koornneef, Rachel Lorimer,
Attendees: Jason Moses, Mathew Parr, Tamati Sheppard-Wipiiti.
Apologies: Dr Angela Ballantyne, Taima Campbell, Rhonda Sherrif , Silao Vaisola-
Sefo, Te Puea Winiata
INFORMATION
Item
Agenda Item
1. Introduction and welcome
• Keriana Brooking welcomed members.
OFFICIAL
• Nicky Birch opened with a karakia.
• The minutes of meeting held 9 Hūrae 2021 were confirmed.
THE
• Keriana Brooking advised that due to a prior commitment, she would need to
leave the meeting at 2.30 p.m.
• No conflicts of interest were registered.
• There were no matters arising from the previous Minutes.
UNDER
2. Environmental scan / issues being raised (Chair)
• It has been agreed that an IIAG Co-chair wil attend the CVIP Steering Group
meeting on a regular basis (meetings held weekly on Tuesdays).
• The Steering Group is the programme’s key decision-making body for
vaccination roll-out. It considers a wide range of matters, for example,
development of the booking system, matching of supply and demand. This
may include
RELEASED consideration of the approach taken by other countries.
• The Co-Chair noted she could see an end to the design and development
phase which had been such a strong focus until now.
• Noting the role of the I AG, papers to Steering Group would desirably reflect
consultation advice from IIAG, particularly from the perspective of operational
impacts. It was noted that some papers are developed at considerable speed
and this consultation has not been possible. The IIAG continues to reinforce
the benefits to the Steering Group discussion and decision-making processes
of considering papers that understand and articulate the operational impact of
their proposals.
1
Document 8
• Noted that the workforce has been stretched for some time and this may impact
on the ability of some DHBs to deliver COVID-19 vaccination.
• Hospital services are heavily loaded at this time. The same is also true of aged
residential care services. The Chair noted her own DHB was working closely
with service providers to ensure services continue to be delivered.
Ministry Action 1: The Ministry will provide a summary of the key issues
raised at this meeting to the Co-Chairs to support their attendance at the
CVIP Steering Group meeting on 27 July 2021. (Completed 23 July 2021)
3. Equity Monitoring (Jason Moses)
Paper 3: Monitoring and accountability measures to support DHBs in meeting
equity targets
• Several measures are in place to support DHB accountability on equity targets.
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These include equity production plans (which set out on a week-by-week basis
the number of Māori and Pacific people the DHB plans to vaccinate based on
their Māori and Pacific populations) and letters of readiness, which outline t
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DHB’s level of preparedness for vaccination roll-out.
Papers 4 and 4a DHB performance against equity production plans (12-18 July
and cumulative 5-18 July 2021)
• These tables show actual performance for the week and cumulative
performance since the start of Group 4 roll-out. Performance status is
highlighted by colour for each of Māori, Pacific and non- Māori/non-Pacific. If
DHBs achieve their targets the programme wil be on track with its equity
objectives.
INFORMATION
• At a national level, results are at 98 per cent. However, there are regions with
early flags, including three DHBs that have to date delivered well under their
planned services to Māori and Pacific. DHB overall delivery to Māori is at
58 per cent.
• These tables are shared with DHB SROs and the Steering Group each week.
OFFICIAL
• Ministers have a strong focus on equity of vaccination, although it is recognised
that sequencing means that Māori will not be vaccinated in volume until the
younger age groups.
THE
• Whilst it is still early in overall delivery, neither Māori nor Pacific people
featured as prominently in Group 3 as originally hoped (i.e. those with
underlying health conditions).
• There is a desire to move earlier than sequencing allows, however, it is easier
UNDER
to identify people by age band than it is by health status.
• The views of IIAG members are sought in helping to identify actions that can
help to improve vaccination delivery.
I AG perspectives and advice
• Members noted that Group 4 roll-out was at a relatively early stage and some
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people wil just be starting to make the transition to action.
• Members would like to be able to understand the issues underpinning the
variable performance. A cumulative graph and a ‘key points’ commentary
would be useful as roll-out progresses, particularly in relation to equity access
and coverage.
• Concern was expressed that this table was unable to reflect disability
vaccination performance.
• Members of ered support to the CVIP programme if local workforce or
education issues were identified as some offer local weekend training and have
other support mechanisms available.
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Document 8
4. Access to vaccine and options to increase uptake
4a. Paper 5: Disability vaccine uptake action plan
• A ‘Five Point Plan’ has been developed to increase disability vaccine uptake by
those people with disabilities. Key components are:
o Communications
o Accessible invitation and accommodations
o Ensuring processes are in place to support decision-making and
consent.
• Considerable from input has been received Tātou Whaikaha, chaired by
Dr Tristram Ingham. The Minister for Disability Issues, Hon. Carmel Sepoluni,
may be approached to lead public engagement for COVID-19 vaccination.
• It has also been noted that supported decision-making is not being
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implemented uniformly across the country so some additional training wil be
put in place.
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IIAG perspectives and advice
• Members noted the Five Point Plan, however, considered that ef ective
implementation wil need a culture change within the system to acknowledge
the problems that need addressing.
• Members acknowledged national data limitations but noted considerable
concern in relation to access to vaccination, and reporting, for people with
disabilities. Noted that Ministry’s record of those receiving disability support
services (about 30,000) provides a possible denominator for monitoring, even
INFORMATION
though this is a much smaller number than those reporting a disability in the
census (well over one mil ion).
• CVIP should be collecting disability information routinely as part of the
programme. The IIAG suggested that the Washington Short Set Questions
could provide a mechanism for the purposes of CVIP. This information could be
requested at the time of booking or vaccination.
OFFICIAL
Ministry action 2: Monitoring the uptake of COVID-19 vaccination by people
with disabilities will be raised a
THE t the next Steering Group meeting and the
programme’s position formalised back to IIAG.
4b. Papers 6 & 6a: Horizon Research – COVID-19 Vaccine – 25-30 June 2021
Key research results are:
UNDER
• Respondent sample showed 17.3 per cent of the population aged 16 years and
over has been vaccinated (i.e. 705,100 people). This is in line with figures
published by the Ministry of Health at 29 June 2021 (705,062).
• The number who state they wil ‘definitely’ be vaccinated has not changed from
May.
• The number who state they ‘intend’ to be vaccinated has gone down.
• The number who state they were ‘unlikely’ to be vaccinated is 19% (i.e.
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650,100 people).
Ministry comment
• The results include trends for Māori and Pacific peoples. Noted however that
the current sample size is not large.
• It was noted that as the number of people vaccinated increases, the proportion
of people who state they intend to be vaccinated wil drop (equity, invitation and
booking system).
3
Document 8
• The Ministry has commissioned a second Horizon survey into the perspectives
of Māori to track changes. This wil provide more indepth insights to guide
future engagement and communication.
4c. Group 4 Communications (Rachel Lorimer)
Paper 7: UAC-19 Vaccine – Group 4 Campaign Planning
• This is a flexible framework approach that wil apply to communications
surrounding the rolling age group announcements about access to vaccination.
• Objectives are to keep it simple, memorable, to have messaging that applies
across a range of channels, and to help to manage expectations.
• Those in older age groups have a greater risk of a poor health outcome if they
contract COVID-19.
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• However, age bands do not fit well with equity considerations. The Ministry is
keen to obtain IIAG views on how engagement wil best align with the whānau
approach also being promoted for vaccination (for example – which artists/
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personalities wil best resonate with Māori?)
I AG perspectives and advice
• Agreed that the age band approach does not translate well for Māori or Pacific
populations.
• Early involvement of key figures/role models is suggested.
• Media channels are different for Māori and Pacific.
• In terms of the Group 4 messaging, the “It’s your time to book” mes
INFORMATION saging may
not resonate with Māori and needs to sit alongside the idea of protecting
whānau.
• Some of the Group 4 comms concepts seemed a little “American”. Group
members would like to see more “Aotearoa”.
• Concerns were expressed that Group 4 bands continue to be rolled out while
OFFICIAL
Group 3 is not completed. This puts vaccination sites under pressure and
impacts negatively on delivery for equity.
• Members are keen to continue t
THE o be involved in this dialogue.
5. Advice about Primary Care and the future state of COVID-19 vaccinations
(Dr Joe Bourne and Astrid Koornneef)
• The ‘stretch target’ is for 85% population vaccination.
UNDER
• As roll-out continues, the intention is to push harder into primary care service
provision. Aim to have most of those who deliver the flu vaccine also delivering
COVID-19 vaccine by October 2021.
• Funding – the service price is set and DHBs do have the funding. There are a
few steps a vaccination service provider needs to go through to be
commissioned. The Ministry understands this can take about four weeks and is
trying to reduce this timeframe. The Royal New Zealand College of General
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Practitioners is keen for its standards to be accepted as being aligned with
programme standards. This wil work well where DHBs use a commissioning
model that has them accountable for the standards met by their providers.
• The Ministry requested views of IIAG about how the Ministry can best assist
uptake by this sector, noting that a level of national consistency is required to
ensure quality and safety standards are met.
(Cont. over)
4
Document 8
I AG perspectives and advice
• Members noted that at a pragmatic level, they are not turning away people who
present for vaccination.
IIAG’s advice covered a range of issues:
• Primary care providers are trusted providers. Many people do not want to
participate in a mass vaccination event and wil simply wait until they can go to
someone they trust.
• Caution was noted to not try to ‘over-manage’ too much of the roll-out to the
primary sector. Numbers of those vaccinated wil lift if GPs and primary care
are allowed to start vaccinating. A ‘just do it’ approach should be adopted and
IIAG encouraged the programme to push harder and faster into primary care.
1982
• Some providers are hesitant because they are worried that delivering COVID-
19 vaccination is logistically difficult.
• Cost is an issue. Ease of funding to providers is essential.
ACT
6. International Comparisons (Mat Parr)
Paper 8a: Percentage of total population vaccinated in OECD countries
• The table provided vaccination statistics for the 38 OECD countries.
• The OECD uses 140 day implementation period as the benchmark comparison,
being the shortest period of time that a country has been vaccinating.
However, most countries have been vaccinating for significantly longer than
this, with 20 countries at 200 days or longer.
INFORMATION
• New Zealand ranks at 37 for population fully vaccinated (with only Australia
being lower).
7. General Business
The following papers were noted:
•
Paper 9: COVID-19 Immunisation Program
OFFICIAL me Update – 18 July
•
Paper 10: IIAG work programme to September 2021.
8. Closing/Karakia whakamutunga
THE – Jason Moses
9. Next meeting
Thursday 5 July 2021
1.00 p.m. – 1.30 p.m. (IIAG member session)
UNDER
1.30 p.m. – 3.00 p.m. (Full attendance)
RELEASED
5
Document Outline
