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Extension of additional Covid-19 boosters from 1st May 2023 - updated 15May23

The additional COVID-19 booster is available for:

  • people aged 30 and over
  • people at higher risk of severe illness from COVID-19 aged 16 to 29
  • pregnant people aged 16 to 29 years
  • young people aged 12 to 15 who have health conditions that put them at higher risk of severe illness from COVID-19, with a prescription.
  • Boosters are especially recommended for:
  • all people aged 65 years and over
  • Māori and Pacific people aged 50 and over
  • people living in aged or disability residential care facilities
  • people aged 16 and over at risk of severe illness if they get COVID-19
  • pregnant people with health conditions that put them at higher risk of severe illness from COVID-19
  • people with disability with significant or complex health needs
  • people with serious mental health conditions
  • young people aged 12 to 15 who have health conditions that put them at higher risk of severe illness from COVID-19, with written consent and prescription
  • talk to your usual doctor, nurse, or healthcare provider about whether this is recommended and how to get a prescription.

Click here for full details

Additional messages:

  • To get an additional COVID-19 booster:
    • you must have had at least your first two COVID-19 vaccinations
    • it's recommended you wait at least 6 months since your last COVID-19 vaccine
    • it's recommended you wait at least 6 months if you have had a COVID-19 infection
  • The bivalent vaccine has replaced the Pfizer COVID-19 vaccine for boosters.
  • The Pfizer COVID-19 booster causes the immune system to create antibodies against both the original variant of SARS-CoV-2 and Omicron subvariants.
  • The vaccine used for the primary vaccination course is the Pfizer COVID-19 original vaccine. The Novavax vaccine isn’t recommended for pregnant people, please consult with a health professional.
  • We encourage everyone who is eligible, to get both their COVID-19 booster and flu vaccination to ensure that they are well protected ahead of Winter.

 Background key messages for additional booster dose:

  • To get an additional COVID-19 booster you must have had at least your first two COVID-19 vaccinations.
  • It’s recommended that you wait at least six months if you have had a COVID-19 infection. People at higher risk of serious illness can consider an additional booster from three months after COVID-19 illness.
  • After a COVID-19 infection your antibody levels will be high, giving you some protection. This gradually decreases over six months which is why an additional booster dose isn't recommended until six months after infection.
  • If you want to have an additional booster earlier than the recommended gap after your last COVID-19 vaccine, you should discuss this with your healthcare provider. You might not need a prescription.
  • If you are at higher risk of impact of Flu or COVID-19 illness, please consult with a health professional on the right time for you to get an additional booster dose, it may be earlier than 6 months.
  • Staying up to date with the recommended COVID-19 vaccinations will continue to protect you from the risk of serious illness, hospitalisation or death from COVID-19.
  • Novavax additional booster doses continue to be available for eligible people aged 18 or older, six months after their last vaccination or infection with COVID-19. Prescriptions are not required, however Novavax is not recommended for pregnant people.
  • You can book your COVID-19 vaccine or booster at BookMyVaccine.nz or by calling the COVID Vaccination Healthline on 0800 28 29 26 (8am to 8pm, seven days a week).

Additional messages specifically for the health sector:

  • Healthcare, aged care and disability workers who are aged 16-29 are not eligible to receive an additional booster unless it is prescribed. 
  • Those who wish to have the original Pfizer vaccine (if over 16) or Novavax vaccine (if over 18) as their additional booster dose can choose to do so when presenting for their vaccination. Note that Novavax is not available at every vaccination centre.
  • When considering an additional booster for young people aged 12 to 15 who have health conditions that put them at higher risk of severe illness from COVID-19, consult the Starship guidelines.
  • The dose interval is recommended at six months; however, an additional dose can be administered at a minimum of four months between booster doses; five months between primary and first booster; and from three months after COVID-19 infection.
  • The benefit of vaccination in the reduction of severe COVID-19 should be weighed against the small risk of vaccine associated myocarditis and pericarditis. The Pfizer booster is the preferred choice during pregnancy due to the lack of safety data for Novavax.

Change to HCL temperature monitoring device from 31 May 2023

HCL are standardising their temperature monitoring device to just one (the remote tracking system).

  • Deliveries from 31 May 2023 onwards will only contain Google Scout loggers.
  • Same positioning as current devices on top of vaccine packs in shipper box.
  • Google Scout logger light indicator on top section of device:
    • No light means temperature in range
    • Red light means breach may have occurred
  • Indicator legend for battery charging on side of device is for HCL use only.
  • If red light is displayed, quarantine vaccines and call NIP Logistics.
  • Device is left in shipper box for courier to return to warehouse as usual.

Please see this document for more information.

Authorisation Expiry for COVID-19 Vaccinator Working Under Supervision (CVWUS) 27Apr23

The COVID-19 Vaccinator Working Under Supervision (CVWUS) was introduced as response to the pandemic in June 2021 as a new class of vaccinators in New Zealand, to accelerate the expansion and diversification of the COVID-19 vaccinator workforce.

The Immunisation Advisory Centre (IMAC) introduced the CVWUS education programme, which resulted in a pathway for the non-regulated healthcare workforce to join the immunisation workforce and increased capacity of providers, particularly Māori and Pacific health providers and pharmacies to administer COVID-19 vaccine to their local communities. The programme ended in July 2022 and has been superseded by the Vaccinating Health Worker (VHW) pathway. A total of 517 CVWUS were authorised by Te Whatu Ora and their authorisation to administer COVID-19 vaccine will expire on 1 June 2023.

This means, if you wish to continue to administer COVID-19 vaccines beyond 1 June 2023, you must become an authorised VHW. In August 2022, VHW was introduced as a new class of vaccinators in New Zealand to provide a career progression pathway for authorised CVWUS to upskill and expand practice scope. This included the ability to administer additional vaccines under supervision including influenza, HPV9 and Tdap vaccines. Further upskilling will enable VHWs to administer vaccines to an extended age group and includes administration of the MMR vaccine.

Any CVWUS that does not transition to a VHW by 1 June 2023 will no longer be authorized to vaccinate and must stop vaccinating on this date.

The VHW education is offered by IMAC. To learn more about the education pathway and enrol into the VHW programme, visit the IMAC website.

To learn more about the VHW role and understand the employer responsibilities visit the Te Whatu Ora website.

• VHW Capability matrix
• VHW Information sheet
• VHW Supervisor information sheet
• VHW Employer information sheet

Click here for the PDF version

Temporary co-administration fee for pertussis and influenza in pregnancy

Antenatal immunisations for pertussis and influenza are a key priority of the Aotearoa immunisation strategy, as coverage remains low and wide ethnic disparities exist. 

From 1 April to 30 June 2023, the National Immunisation Programme will pilot a temporary co-administration fee when pertussis (as TDaP) and influenza vaccines are administered at the same time to pregnant people. This is a temporary co-administration fee paid in addition to the standard administration fee under the Integrated Community Pharmacy Service Agreement (ICPSA) or Primary Health Organisation Service Agreement (PHOSA) and will include back-dated payments.

Influenza and pertussis concomitantly administered to a pregnant person between 1 April to 30 June 2023

Baseline immunisation administration fee of $27.84 (exl GST) and co-administration fee of $19.54 (exl GST)

Total paid is $47.38 (exl GST)

This pilot is aimed at improving antenatal immunisation rates, one of the recommendations of the Immunisation Taskforce Report. Success of this pilot will determine if funding can be secured in the future to implement this co-administration fee permanently as part of a wider contract negotiations.

Flu Reimbursement Portal

The National Immunisation Programme will reimburse eligible employers of non-district health and disability workers to claim for the cost of vaccinating their staff against influenza via the Reimbursement Portal.

The reimbursement scheme will be available from 4 April 2023 to 13 October 2023.

Reimbursement is available for non-district health and disability sector employees, self-employed lead maternity carers, and carers employed under individualised funding arrangements who:   

  • provide a health and/or disability service
  • have direct patient/client contact 
  • are not eligible for a publicly funded influenza vaccine

People can self-register without having to go to the helpdesk. If they signed up and made a claim last year the log in details will be the same.

Further information can be found here Influenza – Te Whatu Ora - Health New Zealand at the bottom of the page there is a document with a set up guide for the portal as well.

Immunisation Handbook Update 17Apr23

The latest Immunisation Handbook has now been published. This large update includes the changes to the COVID-19 vaccine products and the additional of the Meningitis B vaccine to the schedule as well as other smaller updates.

https://www.health.govt.nz/publication/immunisation-handbook-2020

https://www.health.govt.nz/our-work/immunisation-handbook-2020

Please note: the Handbook is no longer available in print and only the online version should be used.

Reimbursement for employers of health & disability workers

Eligible employers of non-DHB health and disability workers can be reimbursed for the costs of immunising their staff against influenza. For the latest information, visit www.tewhatuora.govt.nz/for-the-health-sector/health-sector-guidance/diseases-and-conditions/influenza/

MenB Bexsero vaccine hot topics 6/3/2023

  • Don't forget to check the expiry dates on Bexsero if it's been in the fridge a while.
  • Bexsero vaccine can be entered into the PMS and claimed from 1 March (today). This will be slightly different for each PMS type and will be communicated to PMS users by PMS vendors.
  • The administration fee for Bexsero will be paid if it is administered with other scheduled vaccines or if it is administered on its own at 8 weeks and 4 months.
  • Opportunistic catch-up Bexsero vaccine administered to the eligible groups anytime from 1 March will be funded.
  • Resources and guidance are on our MenB Bexsero resources page

Comirnaty Grey Cap vaccines hot topics and updates

  • Open vaccine vials have a 12 hours expiry and should be stored in the fridge, as per best practice for all vaccines. This is part of the operations guidance. It can be drawn up and administered cold. Although we are aware that the vaccine is stable at room temperature for up to 12 hours once vial is open, this carries potential risks and is not advised.
  • Expiry in syringes: maximum expiry of 6 hours, or the use by time on the vial, whichever is soonest. Syringes can be stored either in the fridge or at room temperature. Clearly mark vaccines with type of vaccine and use by time.
  • Grey cap vaccine record sheets have been updated - the latest have red text on them.
  • Covid Vaccine screening guide has also been updated to v18 - so please use this one.
  • Spacing and eligibility for boosters, and guidance on spacing post COVID disease has not changed. You will be aware that there will be updated guidance around these issues, but changes only start from 1 April. We will share more information about this in the near future.
  • Resources and guidance are on our Comirnaty Grey Caps resources page.

Comirnaty vaccine changes

There are changes to the stock for those aged 12+ you should be using from Wednesday 1 March onwards

  • All COVID adult doses will now have a ‘grey cap’.
  • Any stock with a ‘purple cap’ should be taken out of circulation and destroyed.
  • At end of day 28 February, all Comirnaty (12+ years) Purple Cap Vaccine vials should have been disposed in the Interwaste vial disposal bins and recorded as wastage in the CIR inventory. 

We’re introducing a new formulation for adult booster doses – the bivalent vaccine

  • From 1 March, a new Pfizer COVID-19 bivalent vaccine will be available to eligible New Zealanders as a booster dose.
  • This will replace the existing Pfizer booster and is considered likely to be more effective against Omicron subvariants than earlier vaccines.
  • It will not replace the vaccines used for the primary vaccination course, which will be the original grey cap Pfizer COVID-19 vaccine or the Novavax vaccine.
  • Comirnaty 30 mcg (12+ years) Grey Cap Vaccine are now to be used for Primary doses and Comirnaty Original/Omicron BA.4-5 15/15 mcg Grey Cap Vaccine for Booster doses (16+ years if eligible).

There are no changes to who is eligible for a booster right now, but you can expect to see changes in early April

There are no changes to booster eligibility on 1 March 2023. If someone isn’t sure about their eligibility, they should visit https://covid19.govt.nz/covid-19-vaccines/covid-19-vaccine-boosters/#check-your-eligibility

If you want to learn more about these changes, IMAC have a set of resources for vaccinators. Visit https://covid.immune.org.nz/

For clinical advice contact IMAC on 0800 466 863.

WEBINAR LINK 

https://covid.immune.org.nz/news-insights/comirnaty-grey-caps-x2-webinar

This webinar covers:

  • differences between the vaccines
  • vaccine safety and effectiveness data
  • practical issues
  • resources. 

COVID-19 antiviral medicines – resources for healthcare providers

Te Whatu Ora - Health New Zealand is working with Manatū Hauora - Ministry of Health, Te Aka Whai Ora - Māori Health Authority, Te Puni Kōkiri - Ministry of Māori Development, and Ministry for Pacific Peoples to raise awareness that free antiviral medicines are available to people who are at risk of getting severely ill from COVID-19. We want eligible people to know about antivirals before they get sick, so they can get the medicines quickly if needed, and that the medicines are available directly through many pharmacies. We’re emphasising that people should stay home and isolate if they feel sick and call their pharmacist or usual healthcare provider for a phone appointment to talk about antivirals.

As our information campaign continues, you may get more questions about antivirals, so we wanted to remind you of key information and provide some useful new resources.

As you’ll be aware, antivirals are free for people eligible under Pharmac’s access criteria, which was expanded in September and now includes: 

  • Māori or Pacific people aged 50 years or older 
  • everyone aged 65 years and older
  • anyone aged 50 years or older with fewer than two COVID-19 vaccinations 
  • anyone with a severely weakened immune system 
  • anyone with Down syndrome 
  • anyone with sickle cell disease 
  • anyone previously in critical or high dependency hospital care from COVID-19 
  • anyone with three or more high-risk medical conditions.

To be eligible, a patient must have COVID-19 and be experiencing symptoms or be a household contact of someone with COVID-19 and be experiencing symptoms. We recently updated our clinical guidance on oral therapeutics for the treatment of COVID-19, which you can find on the Te Whatu Ora website. The COVID-19 Health Hub website has information on the criteria and high-risk medical conditions and is the best place to point the public for Manatū Hauora advice on what to do if you test positive for, or are exposed to, COVID-19.

Pharmacies may get more questions.
One of the campaign messages asks people to speak to a local pharmacy about their potential eligibility before becoming unwell, or phone a pharmacy for an assessment if they’ve tested positive, are having symptoms, and think they may be eligible.

If you’re a pharmacy that offers antivirals, we have developed a poster you can display to make people aware. You’ll find a link to this in the table below. If you don’t offer antivirals, either with or without a prescription, a reminder to please use Healthpoint to identify the nearest pharmacy that does and provide the patient with that pharmacy’s information. You may wish to save the following links:

Resources for pharmacies and general practices
We have developed the following resources for you to display, use or share as you see fit – with your patients and the local community.

Note: Most of these resources are available from the Unite Against COVID-19 online resource toolkit. If you’ve not used this toolkit before, you’ll need to register first - it's free and only takes a couple of minutes.

Resources for pharmacies and general practices

Karawhiua resources for Māori audiences

Unite Against COVID-19 resources

Pharmacy posters - these let people know you offer antivirals. Available in A3 and A4 sizes with a variety of images. Download and print.

 

If you are a RAT collection centre, download this flyer to distribute with RATs.

 

General Practice posters - these can be displayed in your practice. Available in A3 and A4 sizes with a variety of images. Download and print.

Factsheet – you can provide this to anyone with questions or an interest.

The Karawhiua website has a resources page with antiviral posters, factsheets in te reo Māori and English, and videos. It also has information on antiviral medicines and an antivirals availability map.

The Unite Against COVID-19 website (COVID19.govt.nz) has information on antiviral medicines in 27 languages.

 

The website also has accessible format resources, including Braille, large print, NZSL, audio and easy read.

 Thank you for supporting this rollout of COVID-19 antiviral medicines to people in your communities. We will continue to provide updates and resources as this mahi progresses. If you have any questions, please feel free to get in touch with the COVID-19 Care in the Community team: COVIDCareintheCommunity@health.govt.nz. 

Nuvaxovid update

Medsafe has extended the drug product in-use duration for Nuvaxovid from 6 hours after first puncture to 12 hours for up to 10 dose withdrawals of the vaccine from the vial when stored between 2°C to 25°C.

COVID-19 vaccine safety reporting

Updated results from the COVID-19 Post Vaccine Symptom Check (PVSC) are now available on the Medsafe website. For the first time, these results include people who received a second booster.

Results of the PVSC on the Medsafe website

The COVID-19 post vaccine symptom check survey results have been updated and also now include results from people who have received a second booster. 

  • Reporting of symptoms following a second booster was 25%, lower than any other dose to date. 
  • 319,136 people chose to participate to date. 

Based on the survey results, no new safety concerns have been identified for the Pfizer Comirnaty COVID-19 vaccine.  

MPOX Vaccinations

You will have received information from Te Whatu Ora explaining that mpox vaccinations are available for those who meet the criteria.

Please initially refer to this information from Te Whatu Ora.

If you have clients asking for the mpox vaccination, they can access the eligibility criteria via the Burnett Foundation website at www.burnettfoundation.org.nz

It is essential to have a booking for a vaccination, so clients should phone 0800 829001 for an appointment.

Mpox vaccinations are being delivered through the Rangiora Health Hub at the Fraser Cove Shopping Centre.

Ongoing supply of Shingrix

Pharmac have confirmed that Shingrix will continue to be the funded zoster vaccine for people who are 65 years age for the prevention of shingles. There will be no changes to the current eligibility criteria for Shingrix at this time

For more information about these changes please visit Pharmac’s website.

 

Widened access to Meningococcal B vaccine (Bexsero)

Widened access to Meningococcal B vaccine (Bexsero)
From 1 March 2023 Meningococcal B vaccine (Bexsero) will be funded as part of the childhood immunisation programme to protect against meningococcal disease in children up to 12 months of age.  It will also be funded for people aged 13 to 25 years who are entering into or in their first year of specified close-living situations. The National Immunisation Programme is working with Pharmac, IMAC and other key partners to prepare for this change.  Further operational guidance and detail will be provided early in the new year.

Planning is underway for a catch-up programme which will also be funded for:

  • children under 5 years of age, up until 31 August 2025
  • people aged 13 to 25 years who are already living in close-living situations such as boarding school hostels, tertiary education halls of residence, military barracks, or prisons, to 28 February 2024.

Please keep a look out for more information.

 

Measles

The risk of a measles outbreak remains high, please continue to offer MMR vaccinations at every opportunity.

 

MMR vaccines are administered at age 12 months and 15 months and to any children who have not received two doses. Please also prioritise the catch-up cohort, those born from 1989 to 2004, who do not have two documented doses.

Aotearoa Immunisation Register vaccinator portal is live, and see our top three FAQs below

The Aotearoa Immunisation Register (AIR) will replace the current National Immunisation Register (NIR) and supersede the COVID-19 Immunisation Register (CIR).  

The AIR vaccinator portal is now live, and we have commenced signing up pharmacy users. The AIR will replace Immunise Now from January 2023. More information on AIR is found here. Pharmacy facility managers can commence their sign up by contacting air.engagement@health.govt.nz.

Our top three FAQs asked during sign up are:
Q: How do I request to be a facility manager or a user at multiple sites?  

A: Once you complete your sign up for one site and can access the AIR, you will be able to request access to additional sites using the vaccinator portal. The AIR admin team will authorise requests for additional facility manager access. Approvals for access for all other roles are authorised by the facility manager for the site being requested.   

Q: I am signing up to the AIR as a facility manager, but I also need the role of vaccinator – how do I get both?  

A: You will only ever need one login to the AIR. Once you complete your sign up as a facility manager role and can access the AIR then you can request access to other roles at a site using the vaccinator portal. As the facility manager you will approve this access. For example, when you sign up as a facility manager, then once you get your access to the AIR, you can assign yourself a vaccinator role as well.  

Q:  I have signed up as a vaccinator, but I also need to be a facility manager – what do I do? 
A: You will need to contact the help desk to ask to have the facility manager role added to your profile. help@imms.min.health.nz 

Vaccine Errors

NIP advise that there continues to be incidents where the wrong vaccine has been administered. Please ensure that all vaccinations have two people check that the right vaccine has been selected and that the expiry and batch numbers are correct.

Accurate Data Entry

The latest ministry report on errors highlighted issues with incorrect data entry. Wrong batch numbers or dates are being selected along with incorrect vaccine e.g Pfizer selected instead of Paediatric Pfizer.

Please ensure that your data entry is accurate and this save a lot of work further down the track.

 

Spacing for Boosters

Please ensure that you adhere to the Operating Guidelines for spacing between booster shots.

Second boosters must be 6 months (180 days) after the 1st booster. Don’t include the date of the 1st booster vaccination.

Anything earlier than 180 days needs a prescription because it is off label use (not covered by the license).

The only situation that is an exception is someone who has turned up between 1 to 4 days early and is:

  • Unable to obtain a script or will be significantly disadvantaged by having to get a script
  • Unlikely to return to get their vaccination (live remotely, financial stress, whanau situation, have a disability)
  • Not vaccinating will likely increase the inequity of access to vaccine for Maori and Pacific Island peoples.

In this situation you must:

  • Contact IMAC and get their confirmation that it is safe to vaccinate this person up to 4 days early.
  • Discuss with your clinical lead that this person meets the criteria to vaccinate up to 4 days early.
  • Record on CIR that IMAC have been consulted and the reasons for vaccinating early.

No vaccination can be given more than 4 days early without a prescription. IMAC cannot approve delivery of a vaccine more than 4 days early without a prescription.

 

Guidance for Community Pharmacy Funding for COVID-19

Primary care funding for COVID-19 was last reviewed in February 2023 and continued to support the alignment of access criteria for COVID-19 anti-viral medicines with funding for pro-active initial clinical assessments. This recognised that those populations have a higher risk for serious health outcomes from a COVID-19 infection.
The model of care continues to reflect the move from a pandemic response to an equity-based approach targeting those at higher risk of poorer health outcomes from COVID-19 including priority and vulnerable populations. This model of care aligns with the current COVID-19 testing plan, public health measures and policy settings, and keeps within the budgeted forecast for COVID-19 funding until 30 September 2023.

Pharmacy guidance
All existing Care in the Community (CitC) pharmacy services relating to COVID-19 continue unchanged. The pricing schedule is contained in Appendix 1.

COVID-19 Antivirals Eligibility Review
This service recognises that some Service Users seeking Pharmacist-Only Supply of COVID-19 antivirals will be found to be ineligible.
If a provider consults with a Service User and discovers they do not meet the Pharmac eligibility criteria for funded COVID-19 antivirals, the provider can claim the COVID-19 Antivirals Eligibility Review fee.
If a provider consults with the Service User and discovers they meet the Pharmac eligibility criteria for funded COVID-19 antivirals, but these medicines are not appropriate for clinical reasons, the provider can claim the Medicines Management Consultation fee.
As per the current Service Specification, the reason the antivirals were not supplied must be documented in CCCM.
In exceptional circumstances, if a COVID-19 Antivirals Eligibility Review takes longer than 15 minutes providers may claim two service fees.

APPENDIX 1:
PRICING SCHEDULE FOR COVID-19 Care in the Community – PHARMACY SERVICES

Consult type - Virtual medicines management advice and support

                        In-home visit where clinically required for COVID-19 cases

  
Pricing Item Funding Rate (GST exclusive)
COVID-19 Antivirals Eligibility Review (if the service user doesn’t meet Pharmac eligibility criteria for COVID-19 antivirals), Per 15-Minutes $37.50
Medicines Management Consult, Per 30-minutes $75.00
After-hours weekday and weekend Medicines Management Consult, Per 30-minutes $112.50
Compliance Packaging (for COVID-19 specific medicines eg, Paxlovid renal dosing) $10.00
In-Home Visit (for 1 pharmacist), Per 60-minutes $150.00
In-Home Visit (for an additional support person), Per 60-minutes $50.00
In-Home Visit - Mileage rate, Per kilometre $0.83
Reimbursement of Prescription Co-Payment, Per eligible medicine $4.35
Reimbursement for Medicine Delivery, Per Delivery $7.00

 

Notes
• The pricing schedule only applies to confirmed or probable COVID-19 cases. There are now no exceptions for close contacts or household contacts as there is no requirement for these people to isolate.
• Ordinary business hours are 8:00 am to 6:00 pm on Monday to Friday (excluding public holidays in the providers geographic area) or as agreed between an individual provider and their district (as per the Integrated Community Pharmacy Services Agreement (ICPSA)
• Pharmacy home visits should be claimed on a per trip basis. That is, if the pharmacist visits three service users during a trip that takes one hour, they should charge one $150 fee not three $150 fees
• Conditions of claiming:
o No fees are to be charged to service users
o No simultaneous claiming against any other funding stream
• Where clinically indicated, in exceptional circumstances, providers may claim multiple service fees if an extended consultation is needed. For example, if a Medicines Management Consult for a complex case takes longer than 30 minutes providers may claim two service fees.