H202116597 Document 2 part 1.pdf

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INFORMATION
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Document 2
John Whaanga asked for clarity about susceptibility to adverse events, and particularly
whether this was distinguishable from people with underlying health conditions which are
actually one of our priority groups
David clarified that this group is distinct from people with underlying health conditions, and is
more focused on people who may have suffered from adverse events from vaccines in the
past.
Paper considered: CVIP OAG Performance Audit update
David gave an initial update on the OAG performance audit:
2.2
• OAG is in final stages of wrapping up their work, and today they issued a list of 14
questions which they want us to respond to within one week
• They will also go to a vaccination event next week to see how the whole process1982
flows. Details of this visit have already been organised
• OAG wil  look to get a draft report to Ministry by 19 April, we wil  then have 2-week
window to provide responses
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• Report will be finalised in mid-May before being tabled in Parliament
• The issues they are likely to call out are all issues that have already been discussed
by Steering Group, including: Programme ability to scale, programme structure and
accountability, and commentary around IT readiness.
Ashley provided a further update on this point based on a meeting with OAG earlier in the
day:
• Noting the timelines provided for final report, there is stil  around a month to address to
the greatest extent possible the issues raised.INFORMATION
• OAG has identified a number of key risks and issues, but none of them were issues
this Group would be unaware of.
• Programme complexity and unclear accountabilities: these issues should be
addressed by the ongoing restructure
• Level of certainty: OAG querying whether Ministry should be more transparent
about uncertainties in the programme and t
OFFICIAL  hings outside our control
• Critical path: ‘Just in time’ nature of Programme work delivery means it is difficult
for those in Steering or Governance roles to provide assurance
• Lack of contingency planni
THE  ng: Need to start thinking about how we would react to
events such as a new outbreak, or a large influx of supply.
• Primary care: Primary care providers need to be given more certainty around what
their role will be. This includes information around funding model. Additional
certainty for employers regarding their role would also be useful
• Equity: Questions ov
UNDER  er how fully embedded equity is within the Programme, as
well as when money wil  go out to providers. On the latter point, we do now have
more certainty.
• Technology: Issues raised around the national booking system and compatibility
with local systems. It appears that we do have these issues in hand now so should
just be about providing that assurance
• Comms: Some questions raised around when additional information wil  be given
to providers and around the timing of larger public campaign
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Dale noted that he has heard we are working towards having a population register by late-
June, and noted that population register has a very specific meaning
• Michael said that what was being worked on was having an additional layer above the
NHI that would enable us to run targeted campaigns and attach useful info around
individuals. The idea is to help us to use digital channels to better deliver population
health services. He wil  be doing some work to advance this in the coming weeks as to
some extent we already have this, but it just needs to be organised better

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•  Astrid stressed that this was never going to be a perfect tool, and particularly given
there are equity considerations around such a tool it can never be considered as the
only solution. However, it could be a very useful tool, amongst others.
Mat suggested that it would be worth considering whether Ministry aims to proactively publish
a full implementation plan around late-April or early-May. This would ensure that by the time
OAG report is tabled in Parliament there will be sufficient information available publicly on
how we are proceeding and addressing areas of concern.
•  Agreement reached to explore this idea in next Steering Group meeting
Maree also stressed that some risks wil  always be present in the Programme. This means as
a Steering Group we need to be aware of them while also acknowledging that not all of them
can be eliminated.
Action 1: Discuss proactive publication of full implementation plan at next Steering
Group meeting
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Programme progess and integrated plan strawperson (Mat and Matt)
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Paper considered: Straw person milestone plan and progress reporting
Mat noted paper circulated to group presents a high-level strawman and at next week’s
meeting wil  come back with additional information from
Once finalised there should be between 30-50 milestones, and this page, along with a section
highlighting recent successes, challenges and exceptions would be the parts needing to be
noted by the Group.
Action 2: Provide updated milestone plan and progress reporting, and embed in
programme ways of working
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Ashley asked for feedback from Rachel and Dale regarding the perception of GP utilisation.
Rachel provided an overview of the manner in which GPs are being used as providers of
community-based clinics, rather than in a traditional sense of GPs. Her sense of using all GPs
in the way they are for childhood immunisations would be something more likely for later
groups.
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Dale offered additional context, where they have gone out looking for initial Expressions of
Interest. They have received 15-20 responses, mainly from fairly large practices. A number of
PHOs are calling for a model where every GP is delivering vaccines, but some DHBs believe
there are issues with  there are issues
THE   with that model at this stage of the rollout.
Rachel added that one major reason this isn’t being scaled up is around accreditation.
4.   Standing item on science and technical advice through CV-TAG (Dr Ian Town)
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4.1  Chris provided an update on the approval process for the Janssen vaccine:

•  Expert advisory meeting wil  take place next Tuesday (April 13) with regulator decision

to be given on Thursday (April 15)

•  The decision on Thursday wil  either be Provisional Approval or Request for more

information

•  Chris would like to understand from Comms team what information might be needed
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in advance for the announcement around Janssen vaccine

Ashley noted that we wil  want to have clear messaging around Janssen vaccine as it is part

of a strong narrative confirming we have a backup (single dose) vaccine.

Chris offered additional updates on other two vaccines awaiting approval:

•  AstraZeneca: moving slower than expected due to a delay in receiving data and the

complex quality assessment. Probably looking at expert advisory meeting in early May

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•  Novavax. Formal application has started but Novavax haven’t provided their data yet.

Currently waiting to know more about their timeframe to send requested data,

approval decision wil  be further down the track, probably sometime in Q3

4.2    Alison discussed possible implications of Janssen vaccine approval:
•  An important step wil  be for Ministry to advise Ministers in relation to how we would
like to use this vaccine within current programme
•  There are interesting options available to use Janssen vaccine with specific groups or
delivery models
•  It is also a key tool to manage any supply risks with Pfizer
•  Over next 2 weeks Alison’s team will be talking to Immunisation team, as well as CV-
Tag and IIAG, about how we could optimise use of Janssen vaccine

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Action 3: Allison, Chris, and John Walsh to meet to discuss comms
strategy/requirements around Janssen vaccine approval announcement
5.
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Standing item on delivery over past seven days (Jo Gibbs)

Astrid provided update on initial analysis of DHB plans until end of June
•  Al  DHB plans have been received this morning and rapid assessment has been done
focusing on three components
•  1) Scaling and site planning: DHBs appear to have this in hand with some being
clearly ahead of others
•  2) Te Tiriti and equity: some comments pulled directly from report but further analysis
to be done with Jason Moses and team for next week
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•  3) Workforce: Main area of concern raised by most DHBs.
•  Jo’s team has already gone back to some DHBs for clarification or further info,
reflecting again the need for us to be clear in how we ask for information
•  The second at achment includes an analysis of DHB plans vs MoH model,
showing DHBs plans exceeding MOH model. However, for some DHBs the
forecasts look optimistic considering current performance.
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•  More work needs to be done on this to understand planning assumptions and be
confident about that before giving to minister
•  The next steps wil  be Jo w
THE  orking with DHB CEs and SROs to talk through all the
plans within next week.
•  There wil  also be a deeper dive with each DHB to look at operational issues,
underlying assumptions, and where we as Ministry can support and help
•  A framework is being developed to support monitoring and escalation of DHB
UNDER
plans

Action 4: Draft framework to support monitoring and escalation of DHB plans to be
brought through Steering Group next week

Group Discussion
•  Jo has agreed with all CEs that they are happy to share plans across DHBs so this
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should help some DHBs with smaller programme teams
•  Ashley highlighted that the main challenge wil  be the extent to which we can be sure
about delivery against their plans.
•  Jo said that by next week’s meeting there should have been one formal conversation
with each DHB and wil  be able to provide analysis of plans against actual delivery.
She should also be able to bring back a more detailed equity assessment

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•  John Whaanga raised the issue that current forms don’t allow staff to ask for ethnicity
of person being vaccinated, as there is an assumption this is being picked up from
NHI
•  DG asked for clarification on what other fields (if any) are assumed to be auto-filled
from NHI

Action 5: Jo to confirm which fields in vaccination form are assumed to be auto-fil ed
from NHI

Group Discussion
•  Mat noted that if DHBs do stick to these plans there would need to be almost no
wastage at all in order for supply to keep up with this
•  Dale confirmed that some DHBs have concerns around workforce and that anywhere
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an alternative workforce to DHBs could use would be advantageous.
•  Jo mentioned that currently we are averaging about 0.5 FTE for every vaccinator
trained
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•  Jo indicated that contracts with national occupational health providers wil  be signed
off by the end of the week. This workforce could be used in big centres, but numbers
will be small relative to overall goal. Training of unregulated workforce should be
starting in about 4 weeks, with the training being relatively straight forward
•  s 9(2)(g)(i)

, that they were open to idea of
developing something at national level that could be deployed to support DHBs (for
example over weekends), and they see a need to start planning for some large scale
events
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•  John Whaanga asked for an offline comms conversation with Jo and John Walsh

Action 6: John and John to have offline comms discussion 8 April
  •  Jo said that after Steering Group next week they should be able to provide a decent
summary to Ministers as part of the weekly vac
OFFICIAL  cination report to give a sense on what
DHBs are planning
6.   Programme structure update (Jo Gibbs, Mat Parr)
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Paper considered: Update on programme structure Steering Group 6 April
Jo highlighted key points in relation to the Programme Structure update
•  Overall programme gov
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•  The Design Authority has been renamed to Programme Leadership Group to
acknowledge that this is a forum for the whole group to work together
•  There wil  be a new Safety and Quality Commit ee, which is beginning to be setup now
to ensure we have adequate resources for Juliet
•  Regarding overall health sector governance there is a formalised co-design process
with SRO group. They have put in a placeholder for the accountability framework,
although t
RELEASED  here is a bit more work needed on this
•  The leadership team is now fully recruited with a lot of ongoing work to resource
underneath, and there have been some good sessions bringing whole leadership
team together
•  An announcement wil  be drafted to go out to all GMs to share with teams
•  There is also work being done on the mission statement to bring to the Governance
Group on Friday

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•  Mat highlighted that one challenge to be addressed was how to bring out in the
document our approach to Treaty obligations, as currently you would need to look
through to ToR and membership of dif erent Groups to find out this information
•  Jason will be important in this area, and this is one team where there isn’t a lot of
capacity yet, with getting an SME on mental health in that area being a key priority
•  Ashley expressed support of the updates and progress and approved for documents
to be taken to Governance Group on Friday
7.
Office of the Auditor-General performance audit expected findings and next steps (Mat
Parr, David Nalder)
Discussed alongside Agenda item 2.
8.
Comms and engagement update (John Walsh)
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Paper considered: Communication and engagement update 6 April
•  Three new staff have started within the comms team this week and recruitment
ACT is still
ongoing
•  Campaign progress is broadly on track with foundational info around efficacy and
safety being published from next week
•  The week of April 19th there wil  be a soft launch of the campaign and from the week of
April 26th the campaign wil  be fully underway with TV and letterbox content landing
•  They have created a new DHB engagement team and are working through with Fiona
and DHB managers to determine exactly what they want from this group
•  Today there was also first data release around vaccination which has resulted in large
number of media enquiries
INFORMATION
Group discussion
•  Ashley suggested that next Wednesday’s Select Commit ee appearance could be a
good chance to proactively release information. He also reflected on whether regular
standups would need to be reintroduced to share information
•  Mat highlighted other groups that wil  be key to engage with including TPK, MPP,
MSD, businesses and unions OFFICIAL
•  John said that both MPP and TPK are planning targeted campaigns which wil  sit
under and align with MoH campaign. He wil  bring more information on that to next
week meeting, but noted already
THE   that it is likely TPK wil come to MoH seeking funding
9.
Any other business
Funding paper has been provided for noting
Group discussion
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•  Rachel confirmed that the paper had landed in terms of total funding required and
what was now being discussed was a base price for contracting and commissioning,
noting that DHBs will expect to play rural and Māori providers a premium given extra
issues involved
•  Ashley stated that this issue needs to be landed within the next week
•  Shayne asked to discuss document of line with Ashley to address concerns around
lack of clear process for payments within the document
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Action 7: Ensure that base price for contracting is agreed and an update provided to
Steering Group next week.

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Action 3 relating to local clinical governance arrangements
•  Mat noted that there is a new clinical oversight structure built in as part of Programme
restructure. Full documented assurance not yet in place but wil  be once the
Accountability Framework is finalised
•  Ashley stressed the need to have at least an interim arrangement in place
Action 4 relating to CV-TAG advice on vaccine use
•  Caroline noted that this has been completed, that the topic was rediscussed at CV-
TAG today and no further advice would be coming on this
Action 5 on the proposal to put out science publicly
•  Sue wil  report back on this item as stil  work ongoing to confirm if all the previous
science updates would be published
Action 7 regarding ring vaccinating
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•  Mat noted that a paper on this topic previously considered by Steering Group was
tabled at recent SRO meeting
•  SROs asked for more detail on the reporting template provided so further information
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wil  be given to DHBs this week and they have commit ed to updating the Ministry by
next week
•  The template is quite light but has been requested from all DHBs rather than just
Auckland as one question inside is whether there is workforce available that could be
freed up for other DHBs
•  Caroline said that advice from CV-TAG is that there would be potential benefit of ring
vaccination in case of any new outbreak, but that this would need to be triggered by
public health advice at the time and ultimately what is needed is the agility to be able
to react
•  Jo suggested that a tabletop exercise should possibly be organised onc
INFORMATION e ring
vaccination plans are received from DHBs
2.
Risk summary report (Mat Parr, David Nalder)

Paper considered: CVIP Programme Status and Risk Summary - Steering Group - latest

David provided an update on Programme risks and on c
OFFICIAL  hanges to Summary document

2.1
•  A new page has been added to try to clearly delineate David’s role in running the risk

assessment process, and the role of Jo’s team in owning the actual risks
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•  There is also now a clear Risk and Action tracker to follow up

•  More work needs to be done with risk owners to address the additional mitigations that

need to be put in place to address each risk

•  The final two pages show a broader view of inherent risks across the Programme and
where they sit across the end-to-end process
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Jo provided a further update to risk management within the Programme
•  Real time internal programme assurance is being worked on, and work is also ongoing
to finalise embedding risk ownership with new Programme structure. David has
started to attend all programme meetings to be an independent observer of progress
•  Workforce remains a key risk but wil  be discussed under Agenda Item 5
•  There is currently no clear system to capture incidents like the wastage seen in
CCDHB, a
RELEASED  lthough as part of the root cause analysis we wil have clear view of how we
should report that going forward
•  Comms has been discussed at length in previous meetings, risks around this area
should change over the coming weeks with the mass campaign launch
Group Discussion
•  Sue noted that work was ongoing on critical path for Pacific Vaccine Programme to
ensure clear advice was provided to Ministers. An update wil  be provided next week
•  Stephen noted that at Governance Group the need to build an end-to-end assurance
plan had been discussed, and wanted to ensure it was also noted with Steering Group

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•  Jo said that the end-to-end assurance plan would be discussed under Agenda Item 6
•  Stephen pointed out that the other areas flagged as ‘Red’ related to overall
programme structure and asked Jo when she thought this area would stabilise
•  Jo replied that there was probably another two weeks until the weekly cadence would
be stabilised, structures bedded in, action trackers to be in place and there to be a
clearly documented and updated management of the programme
•  John asked for update on Equity analysis of DHB plans (Risk 7)
•  Jo said that Jason has been part of conversations with vast majority of DHBs. Jason
has also been focusing heavily on Minister Henare’s visits but by next week should
have a chance to put forward his views on how we structure feedback around equity
issues.
•  Jo noted that it would be useful to have John’s feedback on how legacy impacts such
as workforce and relationships with Māori providers could be measured
•  Ashley asked for an initial update next week regarding equity responsiveness. With
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planned DHB numbers being published tomorrow there may be a focus on how they
will deliver to priority populations, noting that if focus is put on boosting numbers by
reaching easy to access populations this could compound inequity
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Action 1: Megan to provide update to Group on critical path for Pacific Vaccine
Programme
Action 2: Initial feedback regarding equity approaches within DHB plans to be provided
to Steering Group
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Programme progress against milestones (Mat and Andrew)
Paper tabled: Milestone and progress reporting 13 April 2021
Andrew provided update on milestone reporting within Programme
INFORMATION
•  Work is ongoing to embed focus on upcoming milestones within Programme cadence
•  Considerable updates have been to the reporting document since previous Steering
Group meeting
•  Slide 3 charts critical path, starting from populations within cohorts and works through
to upcoming milestones that need to be met for the required service delivery model
•  The milestone view on Slide 4 is aligned with t
OFFICIAL his plan
Group Discussion
•  Ashley stressed that within one or
THE   two weeks there should be reporting against
milestones to ensure Steering Group can monitor progress
•  Stephen suggested document is shaping up well but that we need to make sure it
reflects the actual reality on the ground
•  Mat replied that in order to bring this document to life there wil  need to be a shared
view across teams int
UNDER ernally, as well as with SROs within DHBs to have consistency
across Ministry and DHBs
•  Ashley asked for explanation behind the disconnect around all early milestones being
either completed or on-track, but the operational target of 13,000 doses per day being
‘Behind Schedule’
•  Andrew suggested that the issue is that while readiness is reflected in model, there is
currently a lack of corresponding capacity/scale indicator. This wil  need to be built into
model in a better way moving forward
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•  Ashley suggested that additional use of the ‘unknown’ category could be good to
reflect lack of certainty on some items
•  In response to a question from Chris Fleming, Jo confirmed that information around
upcoming milestones (and their classification) would be shared with DHBs via RALs
and possibly through a Group involving regional CE representatives (TBC)
Action 3: Jo to work with Andrew Bichan to ensure communication channels between
Programme and Ministers’ Offices are clear

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Action 4: Need to ensure milestone view includes means to capture readiness to
operate at scale required to meet targets

Discussion on proactive publication of full implementation plan
To be discussed under Agenda Item 5
4.   Standing item on science and technical advice through CV-TAG (Dr Ian Town)

4.1  Caroline provided an update from CV-TAG in the absence of Ian

•  CV-TAG met this morning and received the first of future regular updates from

Independent Safety Monitoring Board

•  There were discussions at CV-TAG around the s 9(2)(g)(i)

, which Ian will follow-up on with Tim Hanlon
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•  CV-TAG also dicussed what role it might play in future situations similar to what has

occurred in Australia around AstraZeneca vaccine
•  CV-TAG also ratified two items which wil  come to Jo as Memos for implementa
ACT tion
o  Advice on at what point post-vaccination symptoms should be tested
o  Advice on what to do for people arriving in New Zealand who have received a
single dose of a non-Pfizer vaccine. Advice will be to administer only one dose of
Pfizer vaccine when they are eligible under sequencing framework
•  There wil  be a meeting tomorrow to discuss central clinical decision making for
programme as whole
Group Discussion
•  Chris James noted that Medsafe would be very much in support of active monitoring
INFORMATION
of adverse events, and would be keen to join any discussions on this with Tim
•  Mat noted there was a pilot trial out of s 9(2)(a)
GP practice trialling a text
message system. This was only done on small scale and never picked up for strategic
discussions on wider usage
•  Ashley asked for an update on this for subsequent meetings. As Dr Tim Hanlon is on
leave until the end of the week, a verbal update wil  be provided next week with a
paper to follow the next week.
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Action 5: Verbal update from Dr Tim Hanlon on active monitoring for Steering Group
THE
next week
Action 6: Full update on active monitoring of reporting adverse events at Steering
Group meeting on 27 April
5.   Standing item on delivery over
UNDER   past seven days (Jo Gibbs and Astrid Koornneef)

Paper considered: Vaccinator Workforce Plan_V3
Paper considered: COVID-19 A3 Vaccinations Dashboard April 11 2021 FINAL
a) Workforce
Fiona presented on the Vaccinator Workforce plan circulated to Group
•  Document has been prepared to provide Ministers with a simple view of where we get
workforc
RELEASED e from
•  The pools where workforce is drawn from wil  change over time. Just within last 24
hours Caroline has signed off on adding registered optometrists and dietitians to
potential pool
•  The plan is for this document to be included as an appendix for Vaccine Ministers
report on Friday, so open to feedback before then

Group Discussion

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•  Ashley asked how assurance could be given around the full vaccination team, not just
vaccinators
•  Fiona said that based on her conversations with DHB, finding the administrative staff
doesn’t seem to be major area of concern, although this could become problematic as
part of larger scale up
•  There was a general discussion around the line showing potential FTE and overall
consensus to remove that information, with possible exception of information on size
of NZDF and surge workforces
•  Sue suggested an update to document to reconcile differences between availability of
workforce versus their actual planned usage under service delivery model

Fiona provided broader update on workforce
•  There are now four workstreams around the non-regulated workforce, focusing on
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technical stream, training, recruitment, and employment relations.
•  Team is working very hard to meet ambitious deadline of having a product ready at
the end of month
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•  Fiona is currently exploring whether there is value in creating a type of national roster
to pick up people within surge database that have limited availability
•  There is a current bottleneck around training as pathway to IMAC has always been via
DHB employment. Exploring how to address this so that people who are eligible and
meet criteria could be trained even without DHB contract

Group Discussion
•  Chris Fleming highlighted that training of vaccinators not employed by DHBs should
be done in a way that doesn’t displace from training schedule people who are
INFORMATION
employed by DHBs
•  In order to address understaffing within Fiona’s team, Ashley suggested repurposing
the Regional Workforce Leads in shared agencies that are funded by Ministry
•  Fiona also noted that she has heard reports of registered nurses who are still doing
swabbing because they are paid more to swab than to vaccinate. This is something
she is looking into but not yet confirmed
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•  Fiona wil  update CEs on all the work her team is doing tonight, and it wil  be a
standing item at CEs meeting moving forward

THE
Action 7: Fiona to investigate availability of Regional Workforce Leads to offer support
to Workforce team

b) Cabinet A3 UNDER
Item passed over to ensure sufficient time to discuss DHB plans

c) Update on initial conversations with DHBs on plans to 30 June 2021
Astrid provided an update on the analysis of DHB plans until end of June
•  Since last week they have had calls with almost all DHBs (last few to be done
tomorrow) and have asked all DHBs to relook at their numbers against model in light
of the fact that we wil  be publishing planned volumes against actual from Thursday
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•  During these calls it was stressed that DHBs need to be able to deliver their numbers
and should be planning for a 7-day service
•  Once the final calls have taken place, her team wil  be updating the analysis document
from last week and adding in a RAG rating
•  There have been good discussions around what is being put in place to address
equity

Group Discussion

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•  Chris Fleming noted that if DHBs are able to meet targets there should also be
flexibility around the 7-day service to ensure they can give staff appropriate rest
•  Jo stressed that it is not just about meeting numbers, but also about being able to
reach priority populations which often requires out of hours availability. What most
DHBs appear to be doing is coming up with a pattern where not every site is being run
every day, but there is always some availability over weekends for example
•  Ashley asked the degree of confidence of DHBs being able to meet their plans after
these conversations
•  Jo stressed that DHBs have been informed this is public information and this wil  be
monitored in public domain weekly. SROs and CEs wil  be asked to sign off
specifically against their planned lines to document their agreement

c) Vaccine utilisation and wastage
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Astrid advised that root cause analysis is taking place into the wastage issue that occurred in
CCDHB over the weekend.
6.   Draft DHB and MOH accountability and planning framework (Mat Parr)
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Paper considered: Planning Accountability_Draft_08042021
Jo noted that there is an Agenda Item on this topic at CEs meeting this Thursday
Geoff provided an update on the drafting of the document
•  The three levels on Slide 2 emphasise the three key elements of a successful
framework:
o  Ministry must provide clear expectations around service delivery
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o  There needs to be clear information on how expectations can be met
o  Assurance must be provided that expectations are being met
•  Regarding the second item, it could be useful to provide DHBs with templates to work
off, particularly addressing risks and controls
•  It wil  also be important to have performance metrics to measure success, with a key
area for consideration being legacy metrics repo
OFFICIAL  rting on how system is stronger

Group Discussion
THE
•  Jo noted that roles and responsibilities are laid down in the operational guidelines.
There has been discussion of building in a RACI framework in order to have clarity
around who is doing what at each level
•  Stephen noted that the process by which operational guidelines are updated wil  be
crucial  UNDER
•  Jo stressed that the guidelines are updated and distributed on a weekly basis, that she
was confident in the current system for updating them, but that big updates wil  be
needed when moving through different Groups within sequencing framework
•  Colin expressed support for initial work done on Framework, although noted there was
a lot of work still to tie down
7.
Misinformation
RELEASED   and disinformation paper (Geoff Gwynn)
Paper considered: Misinformation memo for Steering Group [Updated recs following
subgroup DDG meeting]
Paper noted through without further discussion
8.
Standing item on communications and engagement update (John Walsh)
Paper considered: Communication and engagement update 12 April

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Karl was to talk to this point on behalf of John but had to leave meeting.
Ashley noted that the report would be taken as read, and that Comms activity was going to
scale up considerably from current moderate level
•  Jo added that there was a plan for Ashley to do a media briefing on Thursday in order
to give an “under the hood” view of the Programme
•  Jo also noted that DHBs had been approached to provide case studies to incorporate
into future briefings/comms material
9
Real time assurance update (Colin MacDonald and Stephen Crombie)
Paper considered: Real time assurance update 7 April 2021
Colin noted that the paper considered has already gone to Governance Group
•  This paper outlines a shift of some assurance activity to see the Programme take on
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more of a self-assurance role
•  Stephen and Colin wil  remain engaged on critical issues, such as Programme
structure, workforce, comms etc
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Stephen said that they have started a deep dive to look into booking system
•  The plans for this have been done very well, although there are some outstanding
delivery model questions to be answered such as the setup of a support cal  centre to
go along booking system
Astrid acknowledged the need for national call centre and said this is being worked on by her
team.
Ashley asked for this to be landed as soon as possible
Action 8: Setup of a national call centre to go alongside national booking sys
INFORMATION  tem to be
landed as soon as possible
10  Funding and commissioning update (Mat Parr)
Mat informed Group that an overall funding envelope has been communicated to DHBs,
signed off and noted.
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•  A standard base rate fee for service to be used for base contracting has now also
been agreed, with one rate for standard hours and one rate for after hours/weekend
•  There is a meeting happening at the same time as this one where this rate is being
THE
discussed with Sector Reps, although it has been made clear this rate is not up for
negotiation
•  The intention is to have this rate confirmed via DHB CEs this Thursday
11.  Any other business
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Jo noted that there was an idea to invite someone from primary care into the Programme to
act as a GP Liaison
•  A statement is being drafted to go out to Primary Care: worth noting conversation we
had today about primary care.
Ashley noted that primary care have expressed an interest in helping to design the system
that would be used to cater for any future involvement of primary care in vaccine rollout
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•  OAG recognises some information in the report may be out of date, so are happy to
engage over the next two weeks to ensure the most up to date information is included
•  They are aiming for report to be published in late-May
•  OAG wil  aim to write a balanced report, acknowledging the complexity of the
Programme and the successful work already done, while also making 6
recommendations for improvements moving forward:
1. Increase transparency around supply risks and potential impact on rollout
2. Develop more contingency plans against major risks (supply, workforce etc)
3. Improve guidance to DHB about specific scenarios in which it is acceptable
deviate from sequencing framework
4. Work with DHBs to make sure equity considerations are fully embedded in their
plans
5. Increased clarity for Māori/Pacific providers and other providers like GPs  1982
6. Improving comms planning to increase clarity around key events and how
Ministry is going reach specific vulnerable groups

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Group Discussion including OAG staff
•  In response to a question regarding current risk monitoring within Programme, Leanne
suggested that the report would note that the Programme is largely picking up on the
right risks and taking actions, while suggesting that some risks require additional
focus.
•  Leanne also stated that the aim of the report is not specifically to say whether the
Programme is performing well or poorly, but more to emphasise what needs to be
done to maximise the chance of reaching the publicly stated goals of the campaign.
•  Colin suggested that an important thing to contextualise within the report is the need
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for the Programme to increase not just its scale but also its reach into communities.

Internal Group Discussion [note discussion occurred at the end of the agenda]
•  David said that the report wil  be circulated tonight among the Programme Leadership
and Steering Group members. He wil  come up with a process to organise the
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response and ensure everything is provided back within the two-week timeframe.
•  The response wil  be put through Steering Group to ensure full Ministry oversight
•  Jo noted that the response from Ministry wil  need to include all the details that were
THE
not able to be picked up during OAG’s fieldwork, including conversations and emails.
•  Colin noted that how this report is responded to wil  be crucial in maintaining public
confidence.
•  Jo suggested that in parallel to preparing the response to the draft report, we wil  also
need to prepare the C
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messaging on what Ministry has been doing to address the recommendations.
•  Maree noted that we should also focus on benchmarks measuring the quality of the
Programme in addition to the speed.
•  Jo stated that the OAG report should remain as a standing Agenda Item until the
report is published.

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Action 1: David to circulate OAG Draft Report and coordinate Programme response.
Action 2: Response to OAG Draft Report to be brought back before Steering Group as
soon as possible.
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Risk summary report (Mat Parr, David Nalder)
Paper considered: CVIP Programme Status and Risk Summary - Steering Group 20 April

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David provided an update on Programme risks and on changes to Summary document Risk
summary report
•  The Key Decisions slide (Slide 3) is included to tie agenda items back to the
underlying risk and then to risk owner
•  This week a trend line for risks has been added to showing whether level of risk
seems to be increasing or decreasing

Group Discussion
•  Steve noted that given that the time pressure everyone is under, resources should be
prioritised on actions that can address multiple underlying risks (such as the
Accountability Framework)
•  Colin suggested to start distinguishing between risks and issues within the Risk
Summary report
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Action 3: Separate risks and issues within Risk Summary Report
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4.
Programme progress against milestones (Mat Parr and Andrew Bailey)
Paper considered: Milestone and progress reporting 20 April 2021 v2
Andrew provided update on milestone reporting within Programme
•  He has been working with Rachel to see how to bring DHB SRO’s group closer to this
and use it as a shared understanding of upcoming events.
•  Following on from a discussion at last week’s meeting, their team is working with
DHBs on developing criteria by which we can be confident that we are ready for rollout
to dif erent population groups. He wil  provide further updates to Steering Group on
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this as the work progresses.
•  They are also focusing on aligning deliverables to the major population milestones,
with Slide 4 showing what we think wil  need to be in place per workstreams for the
different Tiers
•  A future challenge wil  be how to capture the dif erent performance across DHBs
within this framework

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Group Discussion
•  Deborah asked how it was pos
THE  sible to be confident for the rollout to all the Population
cohorts while having many unknowns in the Deliverables section
•  Andrew agreed that perhaps for the later Tiers, particularly Tier 4, the indicators could
be updated to reflect uncertainty. He also noted that some deliverables were less
critical and could be rated Amber while allowing overall objective to remain green.
•  A general discussion t
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key risks identified within risk register and OAG report.
•  Some refinement of the document was suggested in order to ensure that critical points
were highlighted and drawn to the attention of the Steering Group for awareness and
for actions to be taken.
Action 4: Updates to be made to milestone reporting document to enable critical points
to be identified and brought to attention of Steering Group
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5.
Update on large event planning (Richard Clarke and Jane Mason)

Mat provided an introduction, explaining that Richard and Jane were from Auckland
Unlimited, a large events company who are helping to develop a playbook for mass
vaccination events.
•  The goal is to have a first draft within the next couple weeks and then, vaccine stock
permit ing, looking at an event around late June, ideally in Counties Manukau

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•  Around late August there could then be potential to run additional large-scale events
when general population is fully eligible for vaccine
Richard and Jane provided a brief overview of the work of Auckland Unlimited.
•  They wil  approach event to structure it around the medical team as the “performers”
•  They are looking at key workstreams required to carry out the event, as well as
analysing best practice internationally where mass COVID-19 vaccination events have
already occurred, while recognising such events in New Zealand would be unique in
that we are not facing active community transmission
Group Discussion
•  Responding to a question from Jo, Richard advised that the timelines for their work
would depend on the resources Ministry is able to allocate to this
•  Mat noted that the plan would not be a one-size-fits-all approach, and would be made
available to all DHBs
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•  Richard said Auckland Unlimited will initially focus on developing the guidelines, but
could also provide consulting services on any location around the country as well as a
delivery service if needed.
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•  Colin highlighted that we need to be very clear upfront about how we envisage this
model working. For example, is it something that wil  be stood up over a weekend or a
longer running event to deliver both doses.
•  Jo said that it would also be important for Auckland Unlimited to try to develop an
understanding of which parts of the population wil  respond to events like this, as there
could be trade-of s with other delivery systems.
•  Joe noted that there is a draft paper that looks at equity via dif erent delivery models
and that he would circulate this to Steering Group once it is finalised.
•  Jo noted that there wil  be a need to engage DHB SROs from the beginning of this
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process, although approach wil  probably not be suitable for all DHBs.
•  Colin noted that the big benefit of such an event would be if it could be run in a way
that is additive to existing activities, rather than drawing from existing resources and
becoming a substitution.
Action 5: Provide further clarity to Auckland Unlimited on structure of mass events
their planning should target.
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Action 6: Joe Bourne to circulate paper looking at equity impact of different delivery
models once it is finalised. THE
6.
Cook Islands and Polynesia update and rol out plan (Megan McCoy)
Paper considered: Polynesia vaccine roll-out for steering group 19 April
Megan provided an overview of current state of play for Cook Islands and Polynesian vaccine
rollout
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•  Documents have been prepared for the Vaccine Ministers meeting on Friday to give
an initial indication of when vaccine rollout could commence in Cook Islands
•  The chart shows the high-level steps that need to be done to meet an ambitious start
date of mid-May
•  The plan is broken down into steps by workstream, noting that the requirements of
the pharmaceutical companies is the step that wil  ultimately determine if rollout is
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possible or not.
•  In the Memo circulated it is proposed that Steering Group would need to provide
approval prior to the rollout in each of the six Polynesian countries
•  Depending on the updates from Pfizer and Cook Islands it may be possible within the
next few weeks to come to Steering Group for advice about Cook Islands rollout
•  In order for the activity to go ahead it wil  be essential to have a dedicated GM in
place

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Group Discussion
•  It was noted that rolling out the vaccine in Cook Islands and Polynesia at the same
time as scaling up in New Zealand would be a challenge, although the possibility to
start with the countries with smaller populations before building up to the larger ones
good reduce this pressure slightly.
•  Jo stressed that without a dedicated GM with operational experience the activity
couldn’t go ahead, and this message would need to be reiterated to Vaccine Ministers.
This has already been requested via NZDF but we are yet to receive any proposals.
•  Maree noted that as we are operating in an environment of resource scarcity, notably
around vaccine supply until end of June, the plan for this rollout cannot be considered
in isolation but must be considered alongside the plan for the domestic rollout
•  Megan noted that there may be a need to develop a small pool of deployable
vaccinators, possibly looking to draw on non-regulated workforce here who are 1982
qualified in the Pacific.
Action 7: Request for resourcing, including a GM for Polynesian vaccine rollout, to be
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reiterated at all levels
Action 8: Incorporate planning for Polynesian vaccine rol out into the overall
Programme planning
7.
Update on options for active monitoring of adverse reactions (Tim Hanlon)

Tim gave an update on active monitoring of adverse events.
•  The backbone of the safety system in New Zealand is passive monitoring via CARM
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•  The significant risk to the Programme around monitoring was initially whether CARM
could be scaled to the extent needed, although the ability for that scaling to take place
is now within touching distance
•  Active monitoring, such as via SMS, would not give extra safety signals but could
increase the dataset and therefore increase consumer confidence
•  This would be possible, but would require a lot of technical input and additional
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resourcing
•  The Group raised concern about possibly overstretching Programme, particularly if
active reporting wouldn’t addr
THE ess safety issues
•  Jo asked for a paper to be prepared over the next couple weeks to show what the
resource requirements could be, and how this could be done in a sustainable way.
•  Maree noted that the paper would need to include a comment on the overall
Programme impact
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Action 9: Paper to be prepared outlining resource requirements and possible
implications on Programme of an active monitoring system for adverse vaccination
event.
8.   Standing item on science and technical advice through CV-TAG (Dr Ian Town)

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Ian provided an update on the work of CV-TAG

•  A process has now been finalised for commissioning advice and getting that through

to Jo for sign of

•  Today the team has provided an update on questions around clotting from

AstraZeneca and Pfizer vaccines.

9
Standing item on workforce (Fiona Michel)

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Fiona acknowledged that workforce is a key area of work within the Programme, although
there is nothing crucial for Steering Group to be aware of this week.

10.  Standing item on logistics and distribution (Ian Costello)
Paper considered: 210419_Logistics Update
Item not addressed due to time constraint

11.   Standing item on communications and engagement update (John Walsh)
Paper considered: Communications update 19 April
Paper noted but item not addressed due to time constraint

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Sue mentioned that there is a new case of a border worker who is positive despite receiving
the vaccine.
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•  It wil  be important for clear communications around how this could happen and why
vaccination is stil  important.
•  Tim was asked to confirm that there were no adverse events noted for this person’s
vaccinations. He will follow this up of line with Sue.
12  Update on DHB equity plans (Jason Moses)
Paper considered: 20210419 DHB Plans and Equity Analysis
Jason provided an overview of his analysis of current DHB plans
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•  The pressure to increase volumes must not distract from equity considerations
•  The single biggest thing that can be done to remove barriers to access is to mobilise
delivery, rather than focusing on mass vaccination events that may not be accessible
to all
Jo noted that within the Accountability Framework it is being made that that DHBs are
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accountable for range of things, of which equity is the most important. Initial conversations
have also indicated possibly large gaps in relation to access for disabled people.
Action 10: ‘Next steps’ from Equity A
THE  nalysis to be actioned and reported on at next
Steering Group meeting.
13.  Real time assurance update (Colin MacDonald and Stephen Crombie)
No major updates this week.
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14.  Any other business
•  Sue noted that there was work to be done to find a channel for suggestions and offers
of assistance from other Agencies to reach where it needed to within Programme
•  Jo mentioned a previous idea from Ashley to invite in Regional representatives to act
as liaison for external Agencies, although this is yet to be developed further
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•  Maree noted that Agencies seconding people into Programme could also help provide
links
•  Jo said that she had provided feedback to PSC this morning regarding the lack of
traction received on outstanding resource requests
•  John Whaanga stated that he thought there were already SROs for regions across
government whose role is to coordinate roles across government
•  It was noted that Jo wil  be meeting tomorrow with someone who may have capacity to
act in this sort of liaison role.

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•  In response to a question from John Whaanga, Mat noted that there are two types of
contingency planning to be done. The first is the contingency planning around
vaccination if there is a new outbreak, and this work is well advanced.
•  The second is the contingency around the overall plan to scale, with these discussions
expected to happen once the DHB plans for July onwards have been submitted.
3
Programme progress against milestones (Mat Parr and Andrew Bailey)
Paper considered: Milestone report 27 April 2021
Andrew provided update on milestone reporting within Programme
•  Andrew will be meeting with Stephen/Colin on Thursday to prepare for the milestone
plan walk through with Governance Group
•  Upcoming milestones were noted
Group Discussion
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•  In response to a question from Deborah, Andrew noted that there are some
milestones which sit underneath the major milestones but cannot fit on the report due
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to space limitations
•  Jo suggested that this additional level of detail could be provided to Steering Group
next week but it may not be beneficial to go into this level of detail every week
•  Ashley asked for an update on the invitation strategy as it is due next week and
currently classified as ‘unknown’
•  Andrew advised that the discussions are ongoing with DHBs on this topic, and the
exact date this wil  be needed is to be confirmed depending on the model to be used
for Group 3 or Group 4
•  Andrew noted that Invitation Management Portals were flagged as orange not
because of technical limitations but because of the need to finalise the operating
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model that wil  support the tools
•  Jo suggested that for next meeting the team could prepare a brief status update on all
the milestones that aren’t green
Action 1: Additional level of detail underlying milestone view to be provided to Steering
Group next week.
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Action 2: Provide a short status update on any items that aren’t green in Milestone
report for next week’s Steering Group
THE
4
OAG Report update (David Nalder)
David provided an update on Programme’s response to the draft OAG Report
•  David noted that the process is underway to do a clause by clause response to OAG
report and he is confident we wil  meet the OAG’s deadline of next Tuesday
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•  A response is being put together showing what the Ministry has done/intends to do for
each of the six recommendations
•  There wil  also be Ministry comms published around the same time the final version of
the report is tabled
5.
Equity update and data trends for Māori (Mat Parr for Jason Moses and Luke Fieldes)
Mat provided a verbal update as the paper on the topic is awaiting peer review.
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•  An initial analysis on overall uptake in Tier 1a has been prepared
•  There has been an initial discussion about this at PLG meeting earlier in the day
•  There is a further workshop with PLG planned for tomorrow and intention to engage
with DHB SROs on the topic
•  Ashley requested to receive a copy of the paper as soon as it is finalised
Action 3: Copy of report on data trends for Māori to be shared with Ashley as soon as
possible

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6.
Communications and engagement update (John Walsh)
Paper considered: TPK Māori vaccination campaign funding memo 22_04_21
Paper considered: Pacific Communications Campaign Funding memo final
John Walsh provided update on Comms campaigns being run by TPK and MPP
•  Both campaigns have been developed in close col aboration with Health
•  Both TPK and MPP have substantially funded their own campaigns but are looking for
additional funding support from Health
•  The Ministry’s own campaign is progressing well and wil  be moving today towards the
focus on the benefits layer (‘The stronger our immunity the greater our possibilities’)
Group Discussion
•  Following group discussion, Ashley approved the funding for TPK
•  Funding for MPP was agreed in principle, subject to sign of  from Pacific Health 1982
Action 4: Proposal for funding for MPP comms activity to be shared with Gerardine
Clifford-Lidstone within Pacific Health team before final sign-off
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7.
Measuring success of the COVID-19 immunisation programme (Al ison Bennett)
Paper considered: Measuring Success of the COVID-19 Immunisation Programme_22 April
Alison provided an overview of the paper circulated
•  The main proposal of the paper is that we should set the national goal to vaccinate “as
many people as possible”
•  One reason for this is that we stil  don’t know enough about the individual vaccines to
have a population immunity target
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•  Given that not everyone is eligible for Pfizer vaccine, if almost every adult who is
eligible chooses to be vaccinated it would equate to roughly 76% vaccine coverage of
the New Zealand population
•  The paper also focuses on how to showcase the success of the programme as a
positive view of component parts (such as equity, sustainability, efficiency) rather than
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Group discussion
•  Discussion centred on the need t
THE  o have a clear narrative established
•  Although there is not yet sufficient evidence to determine population immunity targets,
it was stressed that ambitious goals need to be set nonetheless, noting that 95%
target is used for many of the childhood vaccines
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8.
National booking operational processes (Astrid Koornneef)
Astrid gave an update on the work being done on the national booking operational process
•  Team is currently working with DHBs to understand exactly where they are with
current booking processes
•  There is the need to be very clear around who is responsible for what within
operational process, all the way down to details. Michael has secured some additional
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resources which are being used to work on this
•  The aim is to have the plan available for Governance Group next week, with
something coming to Steering Group next week in interim
Group Discussion
•  Michael noted that the booking system is being demonstrated today with ADHB and
could be starting to use from tomorrow
•  Once the detailed operational design is completed then could move forward with more
advanced tools such as sending out invitations

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•  Ashley noted on the milestone tracker that the Booking System going live nationally
was currently categorised as ‘unknown’ and asked Michael to let Steering Group know
if at any point he is worried about delivery or needs additional support

Privacy impact assessment update (Geoff Gwynn and Fiona Wakefield)
Fiona provided an update on the Privacy Impact Assessment (PIA) being done around the
booking system:
•  Once national booking system goes live, if there are privacy issues this could result in
loss of public confidence in the wider Programme
•  Current mitigation measures include the incremental development/rollout to ensure
that complexity is only added when possible
•  A PIA has been done and is currently with the Ministry’s Chief Privacy Of icer for
comments/sign-off
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•  Additional PIAs wil  be done at each new stage of the process
Action 5: Geoff to provide Steering Group with copy of Privacy Impact Assessment
once signed off by Chief Privacy Officer
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9.
Accountability framework update (Geoff Gwynn)
Geoff gave an update on the progress around preparing the Accountability Framework
•  The goal is to have a draft to Programme Leadership Group and DHB SROs by Friday
in order to receive comments and provide updated draft at next Steering Group
•  If all goes to plan it could then be presented to Governance Group and DHB CEs next
Friday
•  The framework looks at detailed roles and responsibilities under each of the eight
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steps in our process from the Operational Guidelines, what controls are in place that
support those roles, and where details on the controls can be found.
Group Discussion
•  Jo noted that CEs wil  be expected to sign of  to say they agree to the framework, and
will also be expected to sign off their vaccination plans for July-December and submit
these plans against each criteria.
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•  Deborah offered to have an offline discussion with Geoff to provide insights gained
from other immunisation programmes.
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Action 6: Draft accountability framework to be presented to Steering Group next week
10.  Incident reporting (Astrid Koornneef)
Paper considered: s 9(2)(ba)  incident 15yr old vaccination briefing for Steering Group - v0.1
(ii)
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Paper considered: Vaccine wastage RCA HVCC DHB FINAL DRAFT
Astrid gave a brief summary of the work done on two recent incidents and the papers
provided:
•  The recommendations coming out of the s 9(2)(ba)  root cause analysis (RCA) still
need to be confirmed and wil  be reported ba
(ii) ck to Steering Group
•  The RCA report for the HVCC wastage incident is still a draft, but attention was drawn
to page 8 w
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•  The team is progressing on setting up a safety framework that gives clear
responsibilities throughout the vaccination process
•  They are also working with DHBs to ensure there is a clear way for issues to be
monitored and managed as they arise
•  Work is also ongoing to setup a national clinical governance forum for the whole
programme

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11.   Standing item on science and technical advice through CV-TAG (Dr Caroline McElnay for

Dr Ian Town)

Caroline said there was nothing particular to note from CV-TAG this week
12.  Standing item on workforce (Fiona Michel, Andi Shirtcliffe and Sonia McFetridge)
Paper considered: Workforce Non Regulation Trained Vaccinator Approach FINAL 27 April 21
Fiona provided an update on progress in Workforce stream:
•  Number of trained vaccinators is increasing well and people can now register directly
for training
•  One of the agencies used for contract tracing is going to be cleaning surge database
•  Development of the training for non-regulated workforce is advancing well with first
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pilot expected on 13/14 May
•  The paper circulated today focuses on the technical aspect of this workstream, and
includes the recommendation to make a COVID-19 specific regulatory change, to
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ensure this workforce can be active as soon as possible
•  The proposed regulatory change would allow this workforce to administer vaccinations
under supervision
•  This change would address the short-term need for COVID-19 vaccinators, with
additional work required to consider how to make this workforce eligible vaccinators in
a permanent sense to deliver legacy benefits
•  It was noted that preparation and delivery of the training course could progress in
parallel to the regulatory changes being made, although the workforce couldn’t carry
out any vaccinations until the regulatory changes were finalised
Decision
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•  Steering Group approved the proposal to progress with Regulatory Changes
13.   Standing item on logistics and distribution (Ian Costello)
•  Jo said that Ian was unable to attend today’s meeting but has commit ed to providing
a paper for next week’s Steering Group as a nu
OFFICIAL  mber of key logistics milestones are
falling due shortly
•  Michael noted that the decision has been taken not to rollout previously commissioned
inventory management softwar
THE  e (Colossus and Netstock) in order to focus on the
national rollout of the inventory management portal
Alison provided a brief update on vaccine supply
•  AstraZeneca have verbally agreed to allow donation to Pacific nations so there may
be a public announcement around that this week
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•  She wil  provide an update as soon as possible regarding the delivery schedules for
Pfizer vaccine for July
Action 7: Paper providing update on Logistics and Distribution key milestones to be
prepared for next week’s Steering Group
14.  Real time assurance update (Colin MacDonald and Stephen Crombie)
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•  Colin noted that the planned walk through with Governance Group to provide surety
around how all the pieces fit together
•  Mat noted he could contact Chair of Governance Group to see whether as many
members as possible could be physically present for that meeting
•  Stephen suggested that a dry run on scale events prior to any planned pilot event in
June could be useful
Action 8: Contact Chair of Governance Group to request physical presence of as many
members as possible for Governance Group meeting next Friday (7 May)

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15. Any other business
• Jo noted that additional follow-up had been done with PSC regarding resourcing for
the Programme and a number of CVs were received towards the end of last week

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