New frontiers in the Covid-19 vaccine rollout are opening up – vaccinating 5-11 year olds, and giving booster doses to protect against Omicron.
Cabinet will announce today whether to shorten the six-month wait for the third Pfizer dose to give the population better protection against the new Covid variant. Cabinet is still yet to decide the exact dates of the vaccine rollout for children, after Medsafe gave the jab provisional approval last week.
The SMC asked experts to comment on the considerations of these two vaccine rollouts.
Dr Jesse Whitehead, Health Geographer, Te Ngira Institute of Population Research, University of Waikato, comments:
"Provisional approval for 5-11 year olds is an important step in working towards high levels of Covid-19 vaccination coverage for the entire NZ population. It is essential that the childhood vaccination rollout actively focusses on equity and takes pro-equity measures to ensure high levels of vaccination for Māori, Pacific and socioeconomically constrained children. One component of this is around geographic targeting of vaccination services. While the adult rollout has created additional travel barriers for Māori, Pacific and rural populations, there are opportunities to remove these in the child rollout.
"Research we published in May 2021 highlights that running vaccination services from school sites would give good access to over 99.9% of the total population. Furthermore, prioritising 'low-decile' schools in a school based rollout would improve access for many tamariki Māori, may potentially reach as-yet unvaccinated adults, and will likely provide better access to booster jabs for communities at the greatest level of risk from Covid-19 infection."
No conflicts of interest.
Dr Dianne Sika-Paotonu, Immunologist, Associate Dean (Pacific), Head of University of Otago Wellington Pacific Office, and Senior Lecturer, Pathology & Molecular Medicine, University of Otago Wellington, comments:
Boosters, Omicron, testing and borders
"A total of 22 Omicron cases have now been identified and confirmed in Aotearoa New Zealand. Although more information is still needed about the variant, and whether or not it causes more severe disease, hospitalization and mortality when compared with Delta, we have been warned that Omicron is more highly transmissible. This higher transmissibility can still lead to increased COVID-19 case numbers even though potentially associated with milder disease.
"Omicron in the community will still pose risk for the most vulnerable as was seen with Delta in the community. It is critical that OMICRON cases are stopped at the border, managed carefully and kept in MIQ. Reconsideration of Aotearoa New Zealand’s planned border openings and settings will also be needed.
"Early findings have indicated that immune protection against Omicron is much better with 3 doses of the Pfizer COVID-19 vaccine than with just 2 doses. Vaccine boosters will be critical to keeping everyone safe from COVID-19, and it will be just as important to get these rolled out as quickly as possible, with the appropriate prioritisation that takes into account the most vulnerable. Although vaccination levels have increased across the country which has been encouraging, vigilance is still needed. Areas remain in Aotearoa New Zealand where there is lower vaccination coverage and we are still dealing with a serious Delta outbreak, and now with Omicron’s arrival at the border.
"With the recent shift into the COVID-19 Protection Framework/Traffic Light system, more people will be interacting and getting out and about coming into close contact with each other, increasing risk that this could promote and accelerate spread – especially for those who are vulnerable, including our children.
"COVID-19 testing efforts must continue. Reported COVID-19 case numbers have been dropping in the Auckland Region, but they have been rising in other parts of Aotearoa New Zealand as Delta continues to spread around the country.
"There is still work to do if we want to keep everyone safe and protected from COVID-19. A maintained focus on vaccination, boosters, border controls and public health measures will be needed. People might also want to consider staying local over the holiday period and limiting unnecessary travel."
Vaccines for children
"5-11 year olds who are still waiting for access to the paediatric Pfizer COVID-19 vaccine, will be the most recent cohort to be added to the COVID-19 vaccination programme. This means they will have had less time than others across Aotearoa New Zealand to get the COVID-19 vaccine – an equity focus with appropriate prioritisation with the vaccination roll-out will be critical.
"Although children are more likely to have fewer and milder symptoms, and are less likely than adults to experience severe COVID-19, children can still get the virus and become unwell, end up with long Covid and those with pre-existing conditions can end up with severe illness and hospitalization.
"Of those affected by the current Delta outbreak in Aotearoa New Zealand, a total of 2,044 or 20% were children aged 9 years and under, were infected by the virus and ended up with COVID-19 – this also included babies and a 6-week-old. The hospitalization rate for children aged 9 years and under during the current Delta outbreak was 7% (of all hospitalisations). It was devastating to hear of the recent passing away of a child during this Delta outbreak – with sympathies and condolences respectfully extended to all family, whānau and kāinga at this time.
"In the meantime, we still need to keep our children safe and protected from COVID-19. To do this we need to make sure we’re vaccinated, and that those who come into contact with them are also vaccinated – and that we’re following the associated public health measures and guidelines such as mask wearing, scanning, ensuring ventilation etc. Importantly, we’ll need to support them to get vaccinated as well. "
Equity & prioritisation
"An equity focus with approaches that lowers barriers and builds trust for people, along with the appropriate prioritisation for the vaccination roll-out will be important and critical moving forward.
"Leaving any of our most vulnerable behind and unprotected, given the adverse health impact already seen for vulnerable groups in Aotearoa New Zealand, will have long-term consequences and impact.
"Vaccination is still key – please get vaccinated, tested, follow the rules and reach out to help others do the same. Stay safe this summer and keep others around you safe as well."
No conflicts of interest declared.