Covid 19 coronavirus: Earlier vaccination for border workers, Hipkins says

New Zealand’s 10,000 border workers with the highest risk of catching Covid could be vaccinated before the official start of the rollout in April, Covid-19 Response Minister Chris Hipkins says.

Two of the four vaccines on order – Pfizer and Janssen -have begun the process for approval with Medsafe, the Weekend Herald has learned.

Hipkins said the plan was for border workers to get vaccinated within a fortnight of the first Pfizer batch of 200,000 courses arriving, which is estimated to be at the start of March.

“At this point we don’t know exactly when it is going to be,” Hipkins told the Weekend Herald.

“It could be three weeks from now or it could be the last week of March, but it is more likely to be the beginning of March from what I understand.”

“Our goal is to have our border workers vaccinated within two weeks of them [the vaccines] arriving in the country and we are geared up and ready to do that.”

Those workers were being tested weekly or fortnightly already and the vaccination would be built into the testing cycle.

“I am absolutely confident that the day they land, we will roll out the border worker vaccinations.”

There was nothing slowing the country’s ability to vaccinate border workers.

“They are absolutely number one and it will happen immediately as soon as the vaccines arrive.”

Border workers are at the top of the NZ sequencing and rollout for a mass vaccination plan released in December โ€“ although the list is being refined, according to director general of health Dr Ashley Bloomfield.

But the more contagious strains of Covid spreading through Britain, Europe, the United States and South Africa have prompted calls by National and Act for greater urgency in bolstering the border. Another 18 cases were reported at the border yesterday over two days.

From today, all passengers from the US and Britain will require a pre-boarding Covid test and will be tested again as soon they arrive.

Australian Prime Minister Scott Morrison last week announced a faster rollout of its first vaccine – also Pfizer. Approval is likely this month from the Therapeutic Goods Administration (TGA) and the first vaccinations by the end of February.

Hipkins said that assumed Australia would actually be delivered the vaccine earlier and he said it was unfair to suggest Australia was moving quicker.

Asked if New Zealand would ask Pfizer for early delivery of a small number of courses for border workers from the first batch of 200,000 he said: “We are always talking to the pharmaceutical companies. Our people are always leaning on them to get delivery of any of the vaccines as quickly as we can.”

Bloomfield said Medsafe was working “in lock-step” with its Australian counterpart and contact had been made again this past week with the TGA and the group rolling out the vaccine.

“We are confident that we are still very much in step with them. They way I think about is ‘are we both on the same grid and in the same race’ and very much so,” he told the Weekend Herald.

The Pfizer application was most advanced but, for all four vaccines, there were dedicated teams assessing the information as it was made available.

Asked if the Pfizer approval could be sped up in line with Australia’s timeline, he said: “The timelines are pretty pacey as it isโ€ฆWe are confident we are still very much working to a similar timetable as Australia in terms of our process of approving the vaccine and getting it onshore.”

There was also a lot of effort keeping abreast of emerging information on the vaccines about safety and efficacy as they were being deployed elsewhere.

Bloomfield said as more information arrived, for example about the Pfizer rollout, Medsafe and TGA were sending a single set of questions through rather than different ones.

“Normally that response from the companies takes four months and with the last set of questions we’ve sent back, we have asked for a turnaround of a week.

“That is a tangible example of the pace and approach we are applying to every step in the process so we are in a position to have an approved vaccine, we are really confident around safety, we have the vaccine onshore and we are able to deliver it as soon as is the right time to do that.”

Nikki Turner, the director of Auckland University’s Immunisation Advisory Centre, said it would be appropriate to consider an early vaccine for border staff but the first problem would be availability when other countries had much bigger problems.

“They have healthcare providers dying, frontline staff dying, so that is where the priority lies, ethically, first.

“Ethically, other countries need it more than us at this point. If there was vaccine available, then yes, we could consider protecting those in New Zealand who are at highest risk.”

But as well as vaccine supply, approval would be needed for that small group.

“It is do-able and appropriate because they are at higher risk. I do not think it is do-able and appropriate for the rest of the country because at the moment New Zealand is managing to contain Covid.”

If the situation changed, New Zealand needed to be nimble enough to change its approach.

“But we shouldn’t panic because on the other side, you’ve a community saying ‘we want to know these vaccines are safe and effective’.”

VACCINES Q and A

Who will get the Covid-19 vaccines in New Zealand and when?
Starting in April, top of the queue will be about 10,000 people working at the border, in managed isolation and quarantine, plus health workers with the highest risk of exposure the household contacts of both groups.

Who decides?
The broad-brush sequencing of the rollout was approved and announced in December by Jacinda Ardern although some refinement is being considered, according to the Ministry of Health, such as giving higher priority to older people. The second group will be high-risk frontline health workforce and high-risk frontline public sector and emergency services. The rollout for the general public is due to start in the second half of this year.

Will those priorities remain if there is a new community outbreak of Covid?
Largely, but if there is a limited outbreak in an area, the vaccine would be available for the population affected by the outbreak โ€“ assuming the vaccines had arrived in the country before an outbreak.

When are they due to arrive?
The first lot are scheduled to arrive in March, made by Pfizer-BioNtech, which is already being rolled out in the United States and Britain. The nine freezers in which they are stored at -70C have arrived and logistical planning is in train.

What has New Zealand ordered?
โ€ข Pfizer โ€“ BioNtech: 750,000 courses (ie 750,000 people getting two jabs each), first batch of 200,000 starting to arrive in March.
โ€ข Janssen: 5 million. The first two million to begin arriving in the second quarter of 2021, option of three million more to arrive throughout 2022. The only vaccine requiring just one injection.
โ€ข Oxford University – AstraZeneca: 3.8 million courses to start arriving in the second quarter.
โ€ข Novavax: 5.36 million courses to start arriving in the second quarter of 2021.

Why do we need enough for 15 million people when we have only five million people?
It allows for failure or delay in some of the orders, and enough to give to Pacific countries as well.

Who approves the vaccines and how long will it take?
Medsafe is a unit within the Ministry of Health and is responsible for the approval of medicines and vaccines. It works closely with its Australian counterpart, the Therapeutic Goods Administration (TGA). Pfizer is likely to be first, as early as this month in Australia, and not long after by New Zealand.

Is New Zealand fast-tracking its approval process?
Yes, in as much as processes which normally take months or years have been compressed. Regulators and pharmaceutical companies are acting with speed. Vaccines in the US and UK have been given regulatory approval for emergency use. Trials have shown them to be effective, but the trials have not been completed and more information is being gleaned through the rollout. New Zealand and Australia will make decisions on more advanced, though not complete, information. Approvals by Medsafe are likely to provisional because of the limited data, according to the Ministry of Health.

Have any vaccines started or finished the approval process?
Pfizer and Janssen have started.

Will any have to be approved as genetically modified organisms?
Auckland University’s Immunisation Advisory Centre says the two viral vector vaccines, Janssen and AstraZenca, will require approval as GMO vaccines from the Environmental Protection Agency. But the EPA says it has received no application yet.

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